NPR and Planet Money: Who Gets a Liver Transplant

NPRs Planet Money has a podcast this week titled ‘How Do You Decide Who Gets Lungs?’ It was an excellent examination of the current system for organ donation and recent changes to that system. An interesting point was made. Pre 2002 liver transplant lists were set by patients in ICU and time in ICU. Those in ICU were at the top and the longer you were in the higher your position on the list. Post 2002 it was changed to a more objective criteria including bilirubin, creatine levels among other clinical data. During the discussion physicians said that once the system changed the number of patients in ICU needing a liver transplant dropped significantly. They admitted that that may indicate gaming of the system. doh? In the new system it is harder to game it since the criteria is clinical and objective. 

Overall this was an excellent podcast on a very critical topic in healthcare. But I feel they missed a point. Transplantation is a huge business for both the institution and the HCP. There is an economic incentive to get the organ in order to do a transplant. I am in no way saying institutions or HCP position economics over patient care. What I am saying is that Planet Money may have missed another point to examine, what are the economics of transplants? But that is not as dramatic as life and death. 

The Office Visit: A Learning Experience?

Digital Tonto’s fourth paradigm shift is ‘From Transactions to Experiences’. This captures the essences of the three previous shifts and I believe has the greatest application in healthcare.

Greg states, previously the brand and the consumer had a one-time value exchange based on feature benefit attributes. Consumers expected x and received x. This mimics the brand (physician) and consumer (patient) historically and in many instances today. The physician offers a value: care and management of your health on an as needed basis. The features are apparent, knowledge, expertise, experience, prescription, etc. The benefits are equally apparent, wellness. It was a simple value exchange. I need a checkup, I saw my HCP, I had a cold, I saw my HCP, I have a chronic illness, I see my HCP. In between these moments of interaction with my HCP there is healthcare inactivity unless there is chronic or terminal illness. Or I am one of the growing numbers of patients who are going online or engaging in social media to improve my healthcare knowledge. Largely this occurs outside the office visit.  

The simple value exchange is morphing before our eyes. Brands are partnering with consumers in order to achieve ‘maximum utility and enjoyment from their purchase’. Brands want to create experiences for consumers. Remember, adult learners and all adults learn from experiences and upon reflection adults will integrate experiences into their lives.

As I’ve stated previously the office visit is not a drive by. It can be the place to begin life long learning. Physicians must engage in life long learning. It seems simple to have patients do the same? There are a huge number of patients engaging in learning about their own a loved ones healthcare. It is where, with little work, a HCP and patient can maximize the effect of simple check-up to the management of chronic illness. The smallest functional environment of learning in healthcare is the patient physician office visit. It does not have to end there. Both physician and patient can change that transaction to an experience and create a learning narrative. Make it a learning experience for both parties.

I will present ways to begin this healthcare learning experience in future posts.

Fighting the Drug War is Killing the Terminally Ill

Is this the lasting impression America has on pain management: it’s a criminal conspiracy?

Here

And those who should know how to treat pain don’t do it very well.

Here

How much of the former is driving the later because it gets the headlines, coverage, and sells? America hates junkies.

I would say we are trying to look taller fighting pain medication drug abuse by standing on the terminally ill. Somehow we need to find a way to do both AND not do one at the expense of the other.

It Just Seems So Obvious

“If the United States and its partners bought all of Afghanistan’s opium, a major source of corruption in Afghanistan would disappear, violence in Taliban-affected areas would fall, world supplies of heroin would crash, and a global shortage of morphine — a source of much hidden suffering — could be alleviated.”

Over 5 billion people worldwide have ‘low to nonexistent access’ to opioid painkillers. As of April 17, 2012 over 1,800 members of the US military have died in Afghanistan. 

Both these statistics are unacceptable. I do not know what it is like to loose a loved one to war. I do know first hand what it is like to it to watch a loved one suffer a death from cancer. If it was not for the brilliant and dedicated professionals at the hospice and their ability and expertise to administer morphine I cannot imagine witnessing her death. 

And that is the problem, those who have the power to make a difference to so many do not know first hand what those who’ve lost a love one to war or to terminal illness and death. Let alone those who are dying. Otherwise these statistics would be fixed.

http://tiny.cc/mzs2cw

Adults, learning, and online: They are connected.

Old news that deserves to be revisited: Pew Research Center ‘The Social Life of Health Information, 2011’ I would venture not much has changed in a year. This is just a sample of the data rich survey and report. 

Of the 74% of adults who use the internet:

  • 80% have looked online
  • 34% have read someone else’s commentary 
  • 25% of internet users, or 19% of adults, have watched an online video about health or medical issues
  • 23% of social network site users, or 11% of adults, have followed their friends’ personal health experiences or updates on the site.

 Adults using online resources are seeking a solution to a problem. Do you know the problem they want to solve as it relates to your brand or service? Do you understand where they are in there learning? What are you doing to ensure your brand or service is presenting a problem-centric message to those seeking solutions? Brand-centric messages do not connect with the deep needs of a someone seeking to learn. It does not connect an adult to you and your brand. And least we not forget social media is not an add on after thought if you are going to include it make sure it is tied to and part of your strategy. 

http://pewinternet.org/Reports/2011/Social-Life-of-Health-Info.aspx

Have you thanked a typeface today?

There is something reassuring about type. It has a feel, a personality. Type whispers right into the ear of the reader the soft context of the words. This love is a result of being married to a graphic designer for 30 years and gifting her early on with antique type books. Did you know:

The most common ligature is the “&” (ampersand). This was originally a combination of the letters “e” and “t”, et, the Latin for “and”. However, the ampersand is generally no longer considered to be a ligature — but that’s how it started out.”  http://ilovetypography.com/

Just imagine sitting down and designing a font. I can’t.