Newsweek Profiles June 2012 Man of the Month, Matthew Zachary


Shout out to our very own June 2012 Man of the Month, Matthew Zachary, who e graces the cover of Newsweek.

See his story and catch up on the wonderful work he is providing:

Patients and “Their” Medical Records: Crossing the Chasm

Jane Sarasohn-Kahn

This blog was originally published by Health Populi on July 17.

Most physician practices and hospitals in the U.S. have installed electronic health records (EHRs). But in a classic Field of Dreams scenario, we have made patients’ medical records digital, but people aren’t asking for them or accessing them en masse. “How do we make it easier for patients to request and manage their own data?” asks a report from the Office of the National Coordinator of Health IT (ONC), Improving the Health Records Request Process for Patients – Highlights from User Experience Research.

The ONC has been responsible for implementing the HITECH Act’s provisions, ensuring that health care providers have met Meaningful Use criteria for implementing EHRs, and then receiving the financial incentives embedded in the Act for meeting those provisions.

Now that the majority of health care providers in the U.S. have indeed purchased and implemented EHRs, it remains for patients, health consumers, and caregivers to take advantage of them. In my post on the EHR Field of Dreams effect, I highlighted research from the U.S. General Accountability Office that explored the question of how the Department of Health and Human Services should assess the effectiveness of efforts to enhance patient access to EHRs.

The ONC team conducted in-depth interviews with 17 patients to understand their health IT personae and personal workflows for accessing their personal medical records. The research also considered medical record release forms and information for 50 large U.S. health systems and hospitals, and interviewed “insiders” –health care stakeholders inside and outside of ONC — to assess how patients request access to medical records data and look for solutions to improve that process.

Why is it so important for people to access their medical records? By doing so, patients and caregivers can better manage and control their health and well-being, ONC notes, by preventing repeat tests, managing clinical numbers (like blood pressure for heart or glucose for diabetes), and sharing decision making with doctors and other clinicians — together, the process of patient and health engagement which boosts health outcomes for individuals and populations.

The general process of a patient requesting their health data works like this, illustrated by the patient journey of Melissa and Ava Crawford, a mother and toddler daughter portrayed in the ONC report:

  • A patient/consumer makes an initial inquiry
  • The consumer requests the records, which can be done via a paper authorization form (that is then completed and either mailed or faxed to a provider) or online via portal. Sometimes a consumer must write a letter request to the provider and mail or fax that paper ask.
  • The consumer waits for a response, which ONC calls “a bit of a black hole for consumers.” This can be as long as 30 days under the HIPAA law.
  • The health system receives and verifies the request, then verifies the patient’s identify and address.
  • Health systems then fulfill the records request, often a printed copy of the medical record that can be faxed or mailed, PDF files, or a computer disk (CD).

ONC conducted research into the consumer journey along this process to identify opportunities to improve the patient experience of requesting and receiving personal health information.

Most Americans see their doctors entering medical information electronically, and most people say accessing all kinds of medical information is important, the Kaiser Family Foundation learned in a health tracking poll conducted in August 2016. However, there are big gaps in the information available to U.S. patients online, such as prescription drug histories and lab results: two very popularly demanded information categories. And through the consumer-patient demand lens, 1 in 2 U.S. adults said they had no need to access their health information online, as the chart from the KFF poll attests.

How to bridge the chasm between self-health IT, providers and patients? The most effective patient engagement technologies are biometric measurement devices like WiFi scales and glucometers, apps, texting and wearables — with portals ranking last — according to physicians and clinical leaders polled in a New England Journal of Medicine (NEJM) survey published earlier this month.

The top benefit of engaging patients with these technologies is to support people in their efforts to be healthy, and to provide input to providers on how patients are doing when not in the clinic, this research found.

My friend and collaborator Michael Millenson wrote in the BMJ this month about patient-centered care no longer being “enough.” In this era of technology-enabled healthcare, and rising consumerism among patients, three core principles must underpin the relationship between patient and provider:

  • Shared information
  • Shared engagement
  • Shared accountability.

Michael quotes Jay Katz from his book, The Silent World of Doctor and Patient, who talked 35 years ago about the concept of “caring custody.” Jay explained this as, “the idea of physicians’ Aesculapian authority over patients’” being replaced with “mutual trust.”

It is not enough to build and offer a technology “meant” for patients and people to use for their health and healthcare. Trust underpins all health engagement, and must be designed and “baked” into the offering. Today, that trust is built as much on consumer retail experience (the last-best experience someone has had in their daily life, exemplified at this moment by Amazon) as in a new social health contract between providers and patients.

Tech Tonics Podcast: Margaret Laws – Where Non-Profit & For-Profit Healthcare Innovation Collide

This post was originally published by Venture Valkyrie on July 10. 

Margaret Laws has been working at the intersection of the for-profit and not-for-profit healthcare world for many years. This world has had an explosion of activity to find solutions to major public health and personal health challenges; according to Margaret, these worlds are beginning to blur and the newest foundations and non-profits are actively trying to bring the resources and discipline of private business sector to the big problems we are facing in the social sector. Her life’s work has been to straddle both of these worlds and try to bring them together.Margaret Laws

Today Margaret is CEO of HopeLab, an Omidyar Group entity, focused on improving the health and well-being of kids by creating engaging technologies backed by rigorous research. They rely on a combination of rigorous science, user-centered design and strategic partnerships to drive broad impact. The organization works on a wide variety of themes that benefit from the intersection of technology and health, from early childhood health to the mental health of teens.

Margaret is well known in the venture capital world as well, having led the California Health Care Foundation’s innovation investment fund for many years. She is driven by a curiosity to keep learning and a passion for improving how people live and thrive.

We are delighted to host Margaret on Tech Tonics today.

You can listen to her interview now.

Or by going to iTunes by clicking HERE or on the Connected Social Media website HERE.

We are grateful to our sponsor, AARP Market Innovation. for supporting this episode of Tech Tonics. AARP Market Innovation, which works to spark innovation in the market that will benefit the quality of life for people over 50.


Disruptive Women Celebrates Independence Day

Robin Strongin

As we get ready to celebrate July 4th I wanted to share some thoughtful words, difficult questions, and wonder how it is that in 2017, there are many in the US who do not know what it means to be free, to be independent.

We have made such encouraging progress but before too many hotdogs and apple pie are consumed, join me in watching this video.

You might want to go easy on the fireworks, until we can answer Frederick Douglass’ question: “What to the American slave, is your Fourth of July?” Douglass “The Meaning of July 4th for the Negro”

It Takes a Village, and a Tribe: Women Help Women Locally, Globally

The idea that “it takes a village” to raise children and maintain a healthy community has resonated for women all over the world ever since the 1975-85 UN Decade for Women brought women together from every corner of the world. “Women hold up half the sky,” became another mantra heard often at the 1995 review of the Decade known as the Fourth World Conference on Women.

I thought about both expressions, reminders of women’s solidarity, strength, survival skills and commitment to social change and human rights, when I worked with pregnant refugee women in Greece recently.

The experience grew out of my communication with a woman in Montreal who runs a small program that supports pregnant and postpartum women in the city of Thessaloniki and at a refugee camp an hour north of there. Our conversation soon grew into an international dialogue in which a network of women who shared the goal of helping refugees in Greece spoke to each other.  Soon What’s App text messages and emails were flying fast and furious between Canada, Greece, France, the UK and the US. It was women’s networking at its best and it resulted in my being able, along with a friend from France, to offer personal and practical support to women from Syria and various African countries whose stories of seeking refuge would break your heart.

Part of what made this experience interesting and illuminating is that outside of my French physician friend who joined me in Greece, I didn’t know any of these women, although I met one of them in Thessaloniki briefly at the airport.  But all of us were connected to refugee women for the same reason: We shared the goal – and the drive – to help women whose lives were deeply challenging. And so we became a self-identified “village” connected by our cell phones and our commitment to help.

But we were more than a village. We were also a tribe, a group of like-minded people, women in this case, with a common goal and interest. And we were all feminists, who like other social activists, often feel the need to fill an identified vacuum.  We didn’t wait for permission to act or stand by until we were chosen for the task. We just saw a need and were determined to be useful.

I understood this concept of tribal identity and action more clearly when, soon after my return from Greece, I heard Seth Godin, an author and entrepreneur, talk about the importance of “tribes” on NPR’s Ted Radio Hour. He illuminated what he called “disruptive leadership,” which he said begins with a deep understanding of a situation that may not resonate for others. It’s a situation that calls for action and “positive disruption.”

The situation for women refugees in Greece, particularly if they are actively childbearing while living in a refugee camp or isolated apartment, certainly called us to action. These are women exhausted by their long, strenuous and often dangerous journeys. The have been forced to abandon their countries, their extended families, their homes. They often live in subhuman conditions for months, even years. (Many have endured living in tents surrounded by stagnant water through cold winters.) They have no money except for small monthly allowances provided by a United Nations agency that does nothing to address their isolation, boredom and despair. Sometimes their husbands or partners are abusive or absent. It is a huge challenge to survive and to keep their children safe in a place where they have no friends and don’t speak the language. In other words, they live in a huge vacuum. And that is why my tribe goes to Greece.

We have these attributes, identified by Seth Godin in disruptive leaders, in common: We challenge the status quo. We connect people. We commit to our common cause, and our tribe. We share a generous curiosity about others. And together we build a culture where we are safe and understood so that we can do the work of filling the vacuum.

Godin’s thinking gave me a framework – an AHA Moment – in which to contemplate the work I and other women were doing in Greece. The women I met doing the work reminded me of the tribal nature of such connection, which I have personally experienced whether I am with other feminists, other social activists, or other Jewish people.  We “get” each other. We have common histories and experiences that don’t need to be explained. We are safe together and we find joy in what binds us.

The women refugees in Greece reminded me how blessed I am to have various tribes. This particular tribe enabled me to enter a painful vacuum, to fill it to some degree with much needed practical help, emotional support, and in many cases, deep affection.

I wouldn’t have missed being positively disruptive for anything in the world.

Elayne Clift, a doula, has worked internationally in maternal and child health. She writes from Saxtons River, Vt. Her latest book, an anthology, is TAKE CARE: Tales, Tips and Love from Women Caregivers (David Braugher Books, 2017)



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