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“Deep Support” in Patient Care
Reengineering Healthcare to Support Patient-Centered
Communication and Continuity of Care
Bradford W. Hesse, PhD
Chief, Health Communication
& Informatics Research
Thursday, May 1, 14
Thursday, May 1, 14
“Greatest innovators (e.g., Henry
Ford) ... discovered the possibility
of a new kind of convergence
between consumers’ desires,
technological capabilities, and
organizational innovations.”
The Support Economy
SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The
support economy : why corporations are failing individuals and
the next episode of capitalism. New York: Viking.
Thursday, May 1, 14
“Greatest innovators (e.g., Henry
Ford) ... discovered the possibility
of a new kind of convergence
between consumers’ desires,
technological capabilities, and
organizational innovations.”
The Support Economy
SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The
support economy : why corporations are failing individuals and
the next episode of capitalism. New York: Viking.
Thursday, May 1, 14
“Deep support provides ongoing
relationship based on advocacy,
mutual respect, trust, and the acute
alignment of interests.”
The Support Economy
SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The
support economy : why corporations are failing individuals and
the next episode of capitalism. New York: Viking.
Thursday, May 1, 14
“Deep support provides ongoing
relationship based on advocacy,
mutual respect, trust, and the acute
alignment of interests.”
The Support Economy
SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The
support economy : why corporations are failing individuals and
the next episode of capitalism. New York: Viking.
“The new digital technologies are
essential to the successful
consolidation of this new ... logic.”
Example
Thursday, May 1, 14
Source: Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K,Yood JG, Taplin SH (2005). Cervical cancer in women with
comprehensive health care access: Attributable factors in the screening process. JNCI, 97(9), 675-683.
The Support Economy
Thursday, May 1, 14
Source: Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K,Yood JG, Taplin SH (2005). Cervical cancer in women with
comprehensive health care access: Attributable factors in the screening process. JNCI, 97(9), 675-683.
The Support Economy
WHY IMPORTANT?
Thursday, May 1, 14
Communica)on	
  Errors	
  at	
  Root
Source: Mazor KM, Roblin DW, Greene SM, et al. Toward patient-centered cancer care: patient perceptions of
problematic events, impact, and response. J Clin Oncol. May 20 2012;30(15):1784-1790.
• Interviews with 416
cancer patients across 3
clinical sites (Mazor, et al,
2012)
• Asked about events
where something “went
wrong,” the event could
have been prevented, and
the event could have
caused significant harm.
Results*
• 28% described problem with
medical care
• 47% described a
communication problem
• 24% described problem with
both communication and
medical care
* Of those reporting error
Thursday, May 1, 14
Accoun)ng	
  for	
  Two	
  Types	
  of	
  Error
Errors of Commission:
Doing something wrong
(root cause of detectable
errors)
Errors of Omission:
Failing to do something
right (e.g., Pap failure - leads
to more insidious
consequences)
Thursday, May 1, 14
Thursday, May 1, 14
Just a 1% reduction would save $400 billion
Thursday, May 1, 14
Eliminating Errors
SOURCE: Hesse, B. W., & Shneiderman, B. (2007). eHealth research from the user's perspective. Am J Prev
Med, 32(5 Suppl), S97-103.
Thursday, May 1, 14
Source: Hesse BW. Public Health Informatics. In: Gibbons MC, editor. eHealth Solutions for Healthcare Disparities. New
York, NY: Springer; 2007. p. 109-129.
Engaging Patients, Managing Populations
Thursday, May 1, 14
HITECH Act
Thursday, May 1, 14
Meaningful Use as Building Blocks
Thursday, May 1, 14
Thursday, May 1, 14
Consumers: HP 2020 Goals
http://www.healthypeople.gov/2020
Thursday, May 1, 14
Consumers: Surveillance, Internet
Source: Hesse, B.W., Gaysinsky, A., Vieux, S., Ottenbacher, A., Moser, R.P., Blake, K.D, Chou, W.S., Beckjord, E. (in
press). Meeting the Healthy People 2020 Goals: Using the Health Information National Trends Survey to Monitor Progress
on Health Communication Objectives, Journal of Health Communication.
Thursday, May 1, 14
Consumers: Surveillance, Med Use
Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.
Thursday, May 1, 14
Consumers: Surveillance, Med Use
Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.
Thursday, May 1, 14
Consumers: Surveillance, Med Use
Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.
Thursday, May 1, 14
Consumers: Surveillance, Med Use
Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.
Thursday, May 1, 14
Technology:Adoption
Thursday, May 1, 14
Technology:Adoption
Thursday, May 1, 14
Technology: Development
Wendy Nilsen
Thursday, May 1, 14
Organizations: Biggest Gap
Computational Technology for
Effective Health Care advocates re-
balancing the portfolio of investments
in health care IT to place a greater
emphasis on providing cognitive
support for health care providers,
patients, and family caregivers ...
Thursday, May 1, 14
Digital Future
“Computing forTeams”
Organizations: Human System Integration
Thursday, May 1, 14
Digital Future
“Computing forTeams”
Organizations: Human System Integration
Thursday, May 1, 14
Organizations: Improving Process
StephenTaplin Neeraj Arora
Thursday, May 1, 14
Organizations: Process Support
Thursday, May 1, 14
Target: Empowered Partners
Thursday, May 1, 14
Thursday, May 1, 14
Deep
Support
Thursday, May 1, 14
Thank you!
Slideshare.nethttp://www.slideshare.net/BradfordHesse
Thursday, May 1, 14

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Patient-Centered Communication and Continuity of Care

  • 1. “Deep Support” in Patient Care Reengineering Healthcare to Support Patient-Centered Communication and Continuity of Care Bradford W. Hesse, PhD Chief, Health Communication & Informatics Research Thursday, May 1, 14
  • 3. “Greatest innovators (e.g., Henry Ford) ... discovered the possibility of a new kind of convergence between consumers’ desires, technological capabilities, and organizational innovations.” The Support Economy SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking. Thursday, May 1, 14
  • 4. “Greatest innovators (e.g., Henry Ford) ... discovered the possibility of a new kind of convergence between consumers’ desires, technological capabilities, and organizational innovations.” The Support Economy SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking. Thursday, May 1, 14
  • 5. “Deep support provides ongoing relationship based on advocacy, mutual respect, trust, and the acute alignment of interests.” The Support Economy SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking. Thursday, May 1, 14
  • 6. “Deep support provides ongoing relationship based on advocacy, mutual respect, trust, and the acute alignment of interests.” The Support Economy SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking. “The new digital technologies are essential to the successful consolidation of this new ... logic.” Example Thursday, May 1, 14
  • 7. Source: Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K,Yood JG, Taplin SH (2005). Cervical cancer in women with comprehensive health care access: Attributable factors in the screening process. JNCI, 97(9), 675-683. The Support Economy Thursday, May 1, 14
  • 8. Source: Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K,Yood JG, Taplin SH (2005). Cervical cancer in women with comprehensive health care access: Attributable factors in the screening process. JNCI, 97(9), 675-683. The Support Economy WHY IMPORTANT? Thursday, May 1, 14
  • 9. Communica)on  Errors  at  Root Source: Mazor KM, Roblin DW, Greene SM, et al. Toward patient-centered cancer care: patient perceptions of problematic events, impact, and response. J Clin Oncol. May 20 2012;30(15):1784-1790. • Interviews with 416 cancer patients across 3 clinical sites (Mazor, et al, 2012) • Asked about events where something “went wrong,” the event could have been prevented, and the event could have caused significant harm. Results* • 28% described problem with medical care • 47% described a communication problem • 24% described problem with both communication and medical care * Of those reporting error Thursday, May 1, 14
  • 10. Accoun)ng  for  Two  Types  of  Error Errors of Commission: Doing something wrong (root cause of detectable errors) Errors of Omission: Failing to do something right (e.g., Pap failure - leads to more insidious consequences) Thursday, May 1, 14
  • 12. Just a 1% reduction would save $400 billion Thursday, May 1, 14
  • 13. Eliminating Errors SOURCE: Hesse, B. W., & Shneiderman, B. (2007). eHealth research from the user's perspective. Am J Prev Med, 32(5 Suppl), S97-103. Thursday, May 1, 14
  • 14. Source: Hesse BW. Public Health Informatics. In: Gibbons MC, editor. eHealth Solutions for Healthcare Disparities. New York, NY: Springer; 2007. p. 109-129. Engaging Patients, Managing Populations Thursday, May 1, 14
  • 16. Meaningful Use as Building Blocks Thursday, May 1, 14
  • 18. Consumers: HP 2020 Goals http://www.healthypeople.gov/2020 Thursday, May 1, 14
  • 19. Consumers: Surveillance, Internet Source: Hesse, B.W., Gaysinsky, A., Vieux, S., Ottenbacher, A., Moser, R.P., Blake, K.D, Chou, W.S., Beckjord, E. (in press). Meeting the Healthy People 2020 Goals: Using the Health Information National Trends Survey to Monitor Progress on Health Communication Objectives, Journal of Health Communication. Thursday, May 1, 14
  • 20. Consumers: Surveillance, Med Use Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. Thursday, May 1, 14
  • 21. Consumers: Surveillance, Med Use Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. Thursday, May 1, 14
  • 22. Consumers: Surveillance, Med Use Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. Thursday, May 1, 14
  • 23. Consumers: Surveillance, Med Use Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. Thursday, May 1, 14
  • 27. Organizations: Biggest Gap Computational Technology for Effective Health Care advocates re- balancing the portfolio of investments in health care IT to place a greater emphasis on providing cognitive support for health care providers, patients, and family caregivers ... Thursday, May 1, 14
  • 28. Digital Future “Computing forTeams” Organizations: Human System Integration Thursday, May 1, 14
  • 29. Digital Future “Computing forTeams” Organizations: Human System Integration Thursday, May 1, 14
  • 30. Organizations: Improving Process StephenTaplin Neeraj Arora Thursday, May 1, 14