Real-world evidence (RWE) captures health data from outside controlled clinical trials, such as wearable devices, patient forums, electronic health records, and symptom tracking apps. It reflects the daily realities of individuals managing chronic conditions, navigating medications, and seeking answers when the system fails to provide clarity.

As Yael Elish, one of the founders of the mega crowdsourcing transportation platform WAZE and now CEO and Founder of the patient RWE platform StuffThatWorks, has said, “Patients will never have a seat at the table until their data is considered part of the navigational guide for new medicines, devices, and indications of use.”

She’s right, but perhaps we must push ourselves to a new level of acknowledging why we are pursuing new approaches to care. This is not just about offering patients a seat at the allegorical table. It’s about acknowledging that the table of discovery and development exists for their benefit. The science, systems, and research all exist to serve their needs. Their voices and their lived experiences must inform the path forward.

A Silent Majority Speaks: The Data We Ignore

A recent survey conducted by StuffThatWorks, which gathered insights from more than 15,000 patients across 145 medical conditions, revealed a staggering disconnect. 92% of patients expressed a willingness to participate in clinical trials. Yet, 84% said they had never been asked, never invited to the table of health innovation.

This isn’t a communications oversight—it’s a justice issue. The system is failing those it claims to serve. Patients are ready to contribute. Some are out of options and want concrete action steps. They are waiting to be seen, heard, and engaged. Their personal care and experiential data they offer doesn’t just enrich our understanding—it recalibrates it.

“The Pharma Industry’s efforts to include patient voices have been a step in the right direction; however, they remain on a very small scale today,” notes Caroline Redeker, chief strategy officer at Advanced Clinical, a leading clinical research organization. “Interacting with a minimal number of patients without scale does not accurately represent the full patient population with the condition.  Using available static data (claims, EMR) detached from the patient covers the ‘what’ of patients – how many, where, with claims or treatments of a condition, and mostly in the US.”  

Redeker adds: “The more important factors in trial design include the ‘why,’ including most bothersome symptoms, effectiveness of treatments, regional differences, comorbidity considerations, and other valuable information to accurately design the right trial.  The ‘why’ information can only come directly from the patients.  The future will bring patients and their organized data to the table and include patient insights from all over the globe.”

Real-World Realities: Lessons from Ehlers-Danlos Syndrome

Consider Ehlers-Danlos Syndrome (EDS), a connective tissue disorder with 13 recognized subtypes, ranging from the more common hypermobile form to the rare, life-threatening vascular subtype. Each type carries a distinct constellation of symptoms and risks. Some people face chronic dislocations and mobility challenges, while others live with the daily fear of spontaneous organ rupture.

A single disease name masks and encompasses a spectrum of experiences. Standard clinical trial models often can’t keep up with that complexity. But thousands of patients with EDS are documenting their treatment responses, flares, and management strategies across RWE platforms such as StuffThatWorks—building a picture of this disease that’s as varied, inclusive and individualized as the people living with it.

“The StuffThatWorks survey expands the usual definition of real-world data to include this novel direct patient-inputted database,” says George Sands, MD, FAAN, FAHA, FACC, a former senior director at Pfizer and noted advocate for collaborating with patient communities  “Patients and patient advocacy groups want to partner with sponsors, whether pharma or academia, and to be fully represented in research endeavors. This is very different from sponsors looking to recruit and retain research participants more fully. This is about collaborating.” 

Dr. Sands adds, “Additionally, it is important to have all different patient populations, including people of color, so their data is included in the trials and can be used for clinical care. Otherwise, clinicians have to extrapolate based on those included in the trials; it doesn’t always work exactly.” 

That kind of data, born of day-to-day life, isn’t just complementary to clinical trials. It completes a fuller picture essential for developing effective treatments. Without it, we risk designing therapies that help in theory but fail in practice.

From Inside-Out to Outside-In

Much of medicine’s traditional approach to research is inside-out, starting with what companies aim to prove and working outward through the trial process. That’s not inherently wrong—it is how rigorous science is structured—but that is not enough.

We must also embrace outside-in realities as part of the innovation journey, where patients’ lived experiences inform what we explore, how we measure success, and who we prioritize.

Craig Lipset, founder of Clinical Innovation Partners, and co-chair of the unifying NGO/research industry Decentralized Trials & Research Alliance, and former Head of Clinical Innovation at Pfizer, has long championed a rebalancing of power in clinical trials.

“To earn and maintain trust, research participation must become a symbiotic relationship powered by a bidirectional flow of data and learnings, says Lipset. As patients share insight into study design, bring real-world data into trials, and share experience that shapes new endpoints, sponsors must commit to ensuring that study data and results are flowing back.”

That vision is becoming increasingly possible. With technologies that enable decentralized trials, remote monitoring, and electronic patient-reported outcomes, we can now collect real-world data at scale. However, that only matters if we respect what the data tells us and are willing to let patient experiences guide the research agenda. We give lip service to the importance of patient voice in biopharma research and marketing, but do we see them as “customers” of innovation?

The Science of Listening

Real-world evidence is the patient’s language—a narrative built not in labs but in lived experience. It’s not peripheral to science—it is science when equity is the goal. When patients share their stories, whether on online platforms, through wearables, or in digital symptom trackers, they are offering far more than an anecdote. They are offering insight. They contribute to the science of what works, for whom, and under what conditions.

And when we listen, we don’t just become better researchers. We become better healers.

We stand at a pivotal moment. Innovation can either deepen the divide between patients and science or bridge it. Real-world evidence is the support structure for that bridge. It offers us the opportunity to democratize discovery and reimagine research collectively.

Reflects StuffThatWorks Elish, “The current methods of involving patients in the clinical and health spaces are doomed to failure.  Patients’ voice will be heard ONLY when turned into organized data, at scale.  Because no one can argue or ignore organized data at scale. Once that’s accomplished, the integration of patient voice will proliferate and become easily accessible to everyone in multiple forms, including a simple AI-based chat question.  We are doing that at StuffThatWorks; it’s core to our mission and vision.” 

Ultimately, the patient wants to be invited to the table—but not as a token guest. Without them, there is no table worth setting. The patient is not a peripheral player in this system—they are the system’s purpose. They are not guests in the system. They may not be the core customer of the health system, a universe that centers around its economic viability. Still, in the world of health system kinetics, where we examine the relationship and priority of the sector pieces, they are the reason we unite to invent solutions to confront disease, despair and death.  And the future of medicine depends on how well we recognize that truth.

The future of medicine hinges on one choice—do we continue treating patients as passive subjects, or as co-creators of the care that might save their lives? That’s not philosophy. That’s leadership.

Interested in this topic – here is more to explore:

Aman Gupta: Patient Inclusivity: The Missing Piece In Pharma’s Global Innovation Strategy

The Need for High Quality, Reliable Information that is Data-Driven – A Conversation with Yael Elish

Gil Bashe: Real-World Evidence Unlocks Consumer Voice to Improve Care

The post How Real-World Evidence Proves the Power of Patient Engagement appeared first on Medika Life.

The LLM Cancer Mentor App is a revolutionary tool for cancer patients, caregivers, and physicians. It’s like having a WAZE for navigating the complex cancer diagnostic and care journey.  No longer do patients have to wait for their next appointment to get answers to their questions. They now have a high-level concierge coach available 24/7, ushering in what innovation theorist John Nosta calls ‘The Age of Cognition ‘.

“Perhaps one of the most complex things about oncology is complexity itself. From clinical knowledge and understanding to articulating difficult concepts with patients. Part of what large language models (LLMs) offer is the ability to provide a cognitive assistant that serves up information that is organized and important, and delivers it away that is more relevant and understandable,” said Nosta to Medika Life. “This is perhaps most important with patients who often find the complexity of oncology to be one of the worst toxicities of both therapy and disease,” he added.

ChatGPT Controversial Perhaps, But Patient Preferred

Last year, a controversial JAMA study suggested patients often preferred ChatGPT tools to physician conversation.  A chatbot generated quality and empathetic responses to patient questions online in this cross-sectional study.  While physicians doubted the study’s design, it was evident from data and public conversation that technology available in real-time answering patients’ pressing clinical and emotional needs was sought and welcomed. Even Eric Topol, MD, a long-time AI advocate reports that augmented information can potentially save lives.

Now, the large language model (LLM) called Dave AI was created by Belong.Life increases patient engagement and provides personalized support.  Medika Life spoke with one of the world’s foremost digital health leaders, who marshaled the potential of technology and tapped medical and drug development experts and patient feedback systems to develop AI, ChatGPT, and LLMs tools to support cancer patient advocacy and innovation.  Eliran Malki, the co-founder and CEO of Belong.Life, is a proven entrepreneur and business leader who has founded, financed, and led several successful companies, including More IT Resources Ltd., acquired by Dell-EMC, Veracity Ltd., acquired by EMET, and others.  Together with Co-Founder Irad Deutsch, they launched Belong.Life almost a decade ago. Today, the company serves patients around the globe.

Malki’s blueprint for success isn’t a closely guarded secret – he consistently creates tech platforms that provide easily accessible, practical, and consistent value to users.  Belong.Life is a multilingual HIPAA, GDPR, and ISO-compliant community combining science, service, and solutions to unite patients, payors, product innovators, policymakers, and provers. It demonstrates that the LLMs can provide patients with the support essential to their cancer care journey – augmented information on-demand.

[The  Dave Cancer Mentor app can be downloaded here.]

Dave AI Created to Improve the Patient Journey

Eliran Malki, Co-Founder and CEO, Belong.Life: Dave AI was among the reasons we launched Belong Life – to improve people’s care journey and, ultimately, possibilities for outcome success. We trained this unique LLM (large language model) on an extensive knowledge base of 80 million discussions between patients and physicians. Over eight years, it’s accumulated knowledge of numerous physicians with 100,000 patients discussing the Belong Life app. The training process involved anonymizing and aggregating data to ensure patient privacy and security.

Gil Bashe, Editor-in-Chief, Medika Life: Incredible, eight years and 80 million discussions. How did you distill millions of exchanges and infuse them into Dave AI’s mind? Could you explain the process?

How Does the Dave AI LLM Work?

Malki: We started about six to seven years ago. There are a lot of questions that sometimes people lack the confidence to ask their physicians. People too often have only 10 or a maximum of 20 minutes with their provider. Patients want to ask the top two to three pressing questions, but you don’t do that if you are shy or intimidated to raise a topic.  At the same time, physicians want nothing more than help. Dave AI is a bridge between patients and their physicians – it helps prepare and strengthen the person-to-person relationship.

Here is a video summary of how Dave AI works:

With Dave AI, you can ask about treatment options, potential therapy side effects, clinical trials, or even managing your symptoms – pain, sexual function, or personal care. You’ll receive a supportive, comprehensive answer that covers all aspects of your query. We want to give the best services to patients at all hours, day and night, to educate and empower. Dave AI enables us to support millions of patients and prepare them to use their time with physicians productively. Everyone can get maximum support immediately. It’s suitable for payors, good for providers, and, most importantly, for patients.  It’s a model that combines the best of medicine, patient-physician relationships, and technology.

Dave AI Access for Everyone was Important to Belong.Life

Bashe: I have a question about cost. I understand there’s a free app download on any platform at no cost to the patient.

Malki: Yes, free of charge. We created three service levels to ensure this LLM technology is accessible to all.  The new Dave AI Mentor app is a free zone with premium services. The Dave AI Mentor answers questions and works with patients as a navigator along their cancer journey. It will ask about your upcoming tests; it will help people keep a diet and exercise regimen on track. Depending on your journey, it will be a health case manager and a constant ally. Dave AI will call you and answer questions that you ask, and it will also ask you questions to help model engagement. It’s similar to a coach,

We’re doing many things with hospitals, physicians and insurers that now cost $14.99 monthly. If you are an insurer, you can offer a patient, Dave AI, as a mentor or a case manager who’s available 24/7 and provides support with education and information for $150 per year. It’s the same for hospitals.

Bashe: So, are there different levels of Dave AI services to provide for people with varied economic and information needs?

Malki: Correct. There is a free version, a Pro version, and a Power Plus version. Everyone gets a seven-day trial to use everything. Most users renew. We start billing in January. If people don’t want to pay for an entire year midpoint in the cycle, they can use the free version first.  Many patients prefer the yearly subscription at $120 to $179, which offers unlimited access and added services.

Bashe: I’m curious – do you white-label Dave AI for hospital systems? For example, would it be possible for centers of excellence such as Memorial Sloan Kettering or Hackensack Meridian to secure a branded version of Dave AI catering to their patient needs?

Malki: Yes.  This is central to our service and patient care efforts. We are a technology company.  But we are, first and foremost, a patient-care service platform.  We want people to use and access the best of technology to improve their health.

Bashe: I wanted some background about basic free Dave AI. Now, some people are economically hard-pressed at the same time. Though $149 per year is not a lot when your life may be on the line, you have ensured that there is access to all, regardless of economics. How do Dave AI, Dave AI Pro, and Dave AI Pro Plus differ?

Imagine an Interactive Cancer Expert Available 24/7

Belong.Life’s new oncology AI mentor, Dave, provides accurate, personalized and accessible information instantaneously for people navigating the cancer journey. Dave is available on Belong’s Beating Cancer Together app.

Malki: Some people post 2,000 questions – some read  more than 5,000 posts.  Access to Dave AI for all is essential.  At the same time, someone speaking with an expert resource for 2,000 posts and chats should become a subscriber to the service because it is an incredible investment for us to create, operate, and continuously perfect the system.

Bashe: How many questions can you ask from the free Dave AI before going from Dave AI Pro to Dave AI Plus?

Malki: The free version is limited to 10 questions; the user must wait a week afterward—10 for the first week and then five per week. Many patients value the service, realize its immediate benefits, and are willing to pay. Taking a photo of a clinical document – uploading diagnostic test results – and understanding the document while you are still in the MRI waiting room is an incredible benefit, rather than waiting before you see the physician to discuss the written report. It is of considerable value that Dave AI can read, analyze, and provide feedback almost immediately.   

Scheduling a meeting with a physician is time-consuming and emotionally consuming. You call to wait days or weeks – a day feels like a lifetime.  Sometimes, you need questions answered immediately, seek elaboration, and say, “Please explain again; I didn’t understand that.” So, Dave AI is crucial for patients’ care and mental well-being.

Bashe: With Dave AI Pro Plus, people can ask as many questions as possible?

Malki: Yes.  As many as you want, all the time, 24/7.

How Does Smart Tech Get Smarter?

Bashe: I wanted to get a sense of the evolution of Dave AI. So, I understand that Dave AI is very smart today. How does Dave AI maintain that high level of intelligence week after week?

Malki:  Great question. This is a unique and critical accuracy feature that we patented.  It’s known as the Arch Methodology. The Arch stands for Accuracy, Responsibility, Compliance, and Hallucination-free. AI must always answer accurately; if Dave AI doesn’t know the answer, he can’t invent it. He will say, “I cannot answer.” Telling the AI what not to answer is as important as telling them what and how to respond.

We have several LLM multiplexers. [AS1] This is also one of our patents. All information goes through feedback classification, sentiment analysis, an RLHF Engine (Reinforcement Learning from Human Feedback), and a machine learning approach combining human guidance to train the AI tool..

Every change also goes through several tests and the automated ARCH-validated protocols.

Speed Accelerated for Clinical Trial Inclusion

We have been offering a clinical trial recruitment service for patients for the past six years. The average time for matching a patient to a clinical trial before  September 2023 was 5.4 days from when the patient started speaking to us.. Once we launched and added another LLM called Tara to our clinical trials matching program, the median connect time was 9 minutes, and the average was 2 ½ hours. The patient also can upload their documents, and the system will do all the work.

Eliminating the Tension of Waiting for Answers

The BelongAI Dave – Cancer Mentor app provides 24/7 accurate, personalized, and proactive support and information for people navigating the cancer journey.

Bashe: If you have 15,000 patients, those are 15,000 people who don’t have to wait 5.4 days.  There is also the issue of reducing anxiety levels for someone who has just been diagnosed with cancer. How do they take control of a situation when their life is out of control? They collect information and act on it. If they’re lingering in the trial search environment for five days or three days, that increases their anxiety levels. If they search for only three hours, that reduces their anxiety level.

It’s a little bit like having an interview for a job, and you’re waiting 5-6 days to find out if you got the job, or if they call you back in 3 hours and you got the job, what’s your anxiety level while waiting to hear about the job? It’s off the charts. By day 5 ½, you’re wondering why you didn’t get it.

Unintended cruelty is baked into the clinical trial enrollment and care system, which keeps people hanging. Dave AI and Tara AI eliminate that factor.

Malki: It gives them hope. The patient asked for and got information relevant to the clinical trial, whereas people generally wait till a physician tells them.

Bashe: The reality is that Dave AI hones the process. The patient isn’t necessarily going to run off and enlist in a trial; they’ll say to their doctor, “Look, I’ve gotten three possible trials from this database that fit my profile; what do you think?” It’s not an exclusion of the doctor; it’s accelerating the doctor’s ability to look over information and reply. Technology is not a replacement for a doctor; you understand that democratizing decision-making accelerates your enterprise’s decision-making pace. Same with the doctor.

The doctor, who’s cognitively sharp and psychologically sturdy, now has a patient who is much more engaged with the system. It’s not that Dave AI is the only trusted source; it’s that Dave AI is accelerating the patient’s ability to engage their doctor. The doctor can speak to the patient for five minutes and say, “I looked over your stuff; I think these are three good choices; I would go with this one as the priority, and tell me when you’ve enrolled.” The doctor never loses control over the patient. Oncologists want patients who remain alive.

I have a key question I will make sure to grab: How does Dave AI today get smarter tomorrow? What’s the rate of ability to make Dave smarter?

Malki: There are several factors involved in being smart in AI.. If you want chats, you will need Open AI, Gemini , or something like that, as you see in a mixed style, or Falcon, which is among the best. There are top five in the world as generative AI, and we’re just using three of them, running them on our classifications and our data – there’s no one in the market with our data. No one has the same physician-patient discussion database.

What makes us much better is that we added data from Dave AI’s patient exchanges. We deploy these patient discussions, remarks, and feedback. Dave AI is continuously improving.

Layers and Levels to Ensure Accuracy

Malki: 

We took the platform of AIand built three levels of what we call autonomous AI. Level 1 is controlled;. This is the easiest step forward for pharma, the FDA, and regulations. Gen 2 – this information is 100% accurate because the first one is pre-defined and pre-scripted; I have the approved answers, and the physician sends the second one.

Level 2 is a generative AI agent for specific documents, only . That’s amazing for hospitals, especially for logistical or administrative questions. Information that can lower stress and free the professional team.

Level 3 is a fully automated conversation with AI.  This is a Highly scaleable and valuable solutions

Bashe:  We’ve entered the cognitive age. With large language models, you’re in conversation. It understands that there’s a conversational tone to every exchange. You can use the LLM for half an hour or 40 minutes until you feel you’ve exhausted your train of thought.

Malki: Every payor, every provider, and every patient needs access to these platforms  as triage services to lower stress – the burnout level for professionals and increase the value to patients.  To review for Medika readers, here are the three Dave AI service options:

Dave Pro:

• Proactive check-ins with users about previously discussed concerns, scheduled treatments, and more.
• Precise, comprehensive, and empathetic answers to cancer-related questions and challenges.
• Document analysis and explanations of clinical terminology in easy-to-understand language.
• Access a personalized, continuously updated library of information on treatment options, side effects, and emotional well-being.
• Medication management, appointment notifications, and reminders.

Dave Pro Plus offers Dave Pro features through Tara, Belong.Life AI-powered assistant that matches patients to clinical trials based on their unique medical situations and locations. Through ongoing searches, Tara identifies new treatments and clinical trials and shares easy-to-read monthly summaries to update patients on treatment possibilities.

Dave Community allows patients to interact with Dave in a public forum, enabling users to understand other patients’ challenges and interactions with Dave.  

So, what do doctors think about Dave AI?  

We spoke with Ilya Iofin, MD, the Chief of Orthopaedic Oncology Service at Mount Sinai Hospital.

“Thank you, Gil. I first started working with Belong in 2017 or 2018.  Dave AI gives accessibility because you have this additional resource where anyone can understand the answer. AI is trained and based on what physicians say. You can use medical lingo and confuse everybody or try to explain it in terms that a reasonably intelligent person can understand. I think AI will do the same thing if AI learns from physicians who can get their thoughts and information across in reasonable human speech.

“Specialized medicine, especially oncology, differs from any other field. I’m a physician. If I talk to a car mechanic, he needs to explain, in terms I understand, how a car and engine work. Or I’ll just be as confused as the guy who knows nothing about cars. That’s the benefit of this LLM for people confronting cancer.”

Welcome to the Age of Cognition

Dave AI and LLM enable patients to navigate the complexity of medical care – from diagnosis to treatment to being in dialogue with their care team – which are critical to outcomes.  Malki and his team of engineers, physicians, medical professionals, and patient allies are showing us that LLM is not space-age technology.  LLM enables people diagnosed with cancer to overcome one of the disease’s biggest challenges: learning a language they never thought or wanted to understand.

Patient Advisory

Medika Life has provided this material for your information. We note that this platform and information provided are not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage readers to discuss any clinical decisions on treatment or care with a health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life.

The post LLM Cancer Mentor “Dave AI” Offers WAZE-like 24/7 Personalized Support, Making it a Game-Changer in Patient Care appeared first on Medika Life.

Not to take anything away from the Senator’s apparent concern for his constituents’ real, valid frustration with the health system, but is his villain the right one? Is it a fundamental misreading of the facts of the US health ecosystem to believe that there is any one villain in the system at all? The real, underlying reason that the US health system is so fragmented is that the system itself is the problem. And, as it must be, the system will be the source of any viable solution that makes navigating less challenging and more holistically unified.

Stop Blaming Individual Sectors — Look at the Aggregate

High drug prices are just one symptom of a health ecosystem already becoming increasingly fragmented several decades ago. The problem was well-established and recognized when economist Dr. Alain C. Enthoven wrote about it in the American Journal of Managed Care more than a decade ago, positing that inefficient allocation of resources negatively impacted quality, cost of care and medicines, and patient outcomes.

Since then, little has changed. In 2016, FINN Partners released a survey showing that the fragmented health ecosystem was placing an ever-greater burden on patients, the people the system is supposed to protect and serve — and was increasingly failing. Eight years later, the results of this survey will not have changed significantly.

For decades, payers, patients, policymakers, product innovators, and providers turned a blind eye to fragmentation. And while policymakers prefer to spotlight a popular villain — drug cost — the relentless search for villains won’t fix fragmentation. If we attack one piece of the ecosystem rather than look at the problem, we will fail to make meaningful change. While putting pharmaceutical company CEOs under the glare of the Senate HELP spotlight may provide a tremendous election-year photo-op, bipartisan grandstanding is antithetical to addressing the health system’s continued splintering.

If the System Were a Patient with Multi-System Failure, Would We Treat Only One Organ?

We now know beyond a doubt that the health system is fragmented and has a cost impact. It is time to move from this era of fragmentation into the “post-fragmentation” period. Rather than finger-pointing and finding scapegoats, what’s needed is a fuller understanding of how the system works — and fails to work — for the patient. This requires looking at the full picture objectively, without accusation, to understand better how the different players in the system can work together to support the same goal: a health system in which the patient, not the system itself, is the health system’s true beneficiary.

It’s a fact: prescription drug prices in the United States are higher than in other nations, averaging 2.78 times those seen in 33 different countries, according to the February 2024 RAND report. But are pharma companies the sole cause of this patient burden and health-system chaos? Absolutely not: drug costs comprise about 11 percent of the total $4 trillion in US health expenditures. In reality, provider and hospital services total almost half of US health spend (31.4 percent and 20.3 percent respectively).

Fragmentation Adds to Patient Care Burdens and Costs

Fragmentation leads to out-of-control spending across the system. According to a 2018 Commonwealth Fund study, Medicare recipients “with three to four chronic conditions and highly fragmented care are 14 percent more likely to visit the emergency department, and six percent more likely to have a hospital admission.”

If the US health system were a publicly traded corporation, this hemorrhaging of cash would have been decisively stopped years ago. Taken together, the $4 trillion in annual US healthcare costs can be laid on the doorstep of nearly every player in the ecosystem, from insurance companies to PBMs, pharmacies, pharmaceutical companies, government, hospitals, and venture capital, to name a few — even endless consumer demand and neglected preventive care.

Operating with a business-as-usual approach will carry steep costs in money and lives. When the system fails to engage people proactively with heightened risk for heart disease, cancer, diabetes, and other non-communicable illnesses, when it denies patients diagnostic procedures ordered by their physicians, when it shifts patients from working medications to substitute therapies due to a non-medical switch decision, curiously, some parts of the system benefit to the detriment of patients.

These situations shouldn’t be, as the consequences of the current line and the decisions they reward can be dire, leading to rising costs, diminished patient care, and even death. Ultimately, the chaos around care delivery comes from considering patients a necessary fly in the system’s ointment. The patient is not the health system customer. The system is a customer unto itself.

Can We All Focus On Why the System Exists — To Heal Patients?

We recognize the health system’s failings but must also identify its strengths and potential for improvement. This will allow us to reorient our thinking and ask, “Now, what do we do to put the patient back into focus as the ultimate customer and the preferred beneficiary of the system?”

Stanford Physician Ilana Yurkiewicz, an internist, hematologist, and oncologist, in her book Fragmented: A Doctor’s Quest to Piece Together American Health Care, published by W. W. Norton, argues that it’s actually fragmentation that’s the central failure of health care today, resulting in a system that uses more than twice the economic resources other developed nations dedicate toward health and which results in poorer life expectancy outcomes:

“There’s an unspoken assumption when we go to see a doctor: the doctor knows our medical story and is making decisions based on that story. But reality frequently falls short. Medical records vanish when we switch doctors. Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims.”

No longer are we debating whether the system is fragmented or not. We must shift our mindsets and drop the mistaken belief that identifying bad players in the ecosystem will fix the problem. With ecosystem fragmentation as the diagnosis, what is the treatment path to better management? This is where “Health System Kinetics” (HSK) enters. HSK fosters collaboration and leverages health information technologies — AI, ChatGPT, GenAI, and LLMs — to create an eco-dynamic that prioritizes people’s well-being and works toward longer, healthier lives.

The Health System is Greater Than Its Sector Parts — Study its Kinetics

Health System Kinetics objectively studies factors and sector-to-sector relationships influencing individual and collective health outcomes. It includes biological, environmental, social, and economic determinants of health. Understanding health system kinetics will allow the health system to evolve for the better, benefiting its stakeholders and addressing gaps and inefficiencies in people’s care by fostering a proactive, positive approach.

Understanding why fragmented care is a system-wide illness is a starting point we passed long ago. Looking at the health ecosystem as an ever-changing aggregate — kinetics — rather than separate sectors at fault is the opportunity to move beyond the present chaos.

Fragmentation goes beyond the left hand, not knowing what the right is doing. Too often, it means that the left hand won’t acknowledge the right hand’s very existence. While rising costs concern everyone, it’s essential to keep our eye on the goal of keeping people healthier at home, out of the hospital, and, if possible, far away from illnesses. To do that, we must address the misalignment of incentives and lack of coordination in the health ecosystem.

Applying Health System Kinetics will allow us to understand better how we can do this to provide better patient care, reduce health professional burnout, and give patients with chronic conditions greater attention. The objective study of the interconnectedness of the parts of the healthc system will promote a better understanding of how these components work together now — and how they can be changed to work better together in the future. Failing to take this approach means we won’t see meaningful change, and that’s not an option.

Do Not Let the Virus Kill its Host — the Health System

We have diagnosed the illness that plagues our health system; it’s a virus called fragmentation. It’s time to examine our biases, behaviors, and business goals. The primary mission is to recognize that we are people — sometimes patients — all seeking to enjoy a healthier life. Suppose fragmentation is the wall that separates us from better access to care. In that case, health professionals in every ecosystem sector can be empowered to pursue their calling with passion and tear down that wall.

Looking for a villain in the health ecosystem, something lawmakers have been doing for the last several election cycles, may be suitable for campaigning but not for progress — not for continued innovation and patient care. Progress can only be achieved when we get past the mindset of the period in which we have been — the period of acknowledging the system is fragmented — and move into the post-fragmentation era, in which we view the system through the lens of health kinetics and eco-dynamics.

When we look at and understand how all parts of the system work together — or fail to –we enter an era in which we no longer debate who’s to blame. Proper understanding will allow us to compromise, adjust our aims, improve our practices, and finally, make changes that remove the health system as its own beneficiary, replacing it with the patient as the system’s customer.

[Special thanks to John Bianchi for his review of this health policy economics article that shifts the conversation from sector-to-sector blame to a forward-looking perspective; to industry friend and mentor John Nosta for encouraging me to put these thoughts into publication and to Dr. Dean and Anne Ornish, pioneers in preventive and consumer empowered health and co-founders of Ornish Lifestyle Medicine.]

The post We Know the Health Ecosystem is Fragmented, Resulting in Rising Costs and Poorer Patient Outcomes, But What Are We Doing About It? appeared first on Medika Life.

The sessions (and meals) – positioned around the exhibit floor were meaty – and welcomely unscripted, offering plenty of time for real-world reflections on the state of health delivery.  Afterward, speakers would mingle on the exhibit floor to answer questions and continue the conversation.  Whether an intended benefit for attendees or not, the meeting structure was a great hit and strengthened ViVE as a go-to community where people can interact and discuss challenges and possibilities. 

The number of attendees was right-sized, where meeting and exchanging thoughts is a priority and at a time when the economy and health system are under a magnifying glass.  The system is broken. That’s a collective given. However, where we go next remains a mystery.

Some 6,000 people were in Nashville for this four-day CHIME intensive, and the schedule of events – official and unofficial – offered plenty of opportunity – need – to catch up.  There were specialty Start-Up, Interop Now, and Cybersecurity Pavilions for the ever-curious and Speed-Connection Forum for deal makers and plenty of action on the exhibit floor.

Some of the add-on gatherings included: the Start-Up Health Transformers Session, UC Davis and FINN Partners Summit on Innovation and the timed release of the Galen Growth Digital Health Report on US Health Provider Systems, the Nashville Entrepreneur Center Evening Meet-Up, and the always fun and welcome Pinksocks Get-Together at the famed Springwater.

MAGIC AROUND THE EXHIBIT HALL

The everyday magic centered around the exhibit hall – home to the mainstage presentations, provided meals, pop-up post-5 PM receptions, and varied entrepreneurial hubs.  That offered plenty of opportunities to connect with innovators who reserved exhibitor space. 

The themed location of exhibits also supported a deep dive for conversation with people looking to improve the flow of information within health systems, better utilize information for preventive care or harness the power of smart tech and wearables.  Most importantly, there was a general acknowledgment from the speakers and vibe that our health system doesn’t lack innovation – it is sorely in need of structural healing. 

ADDRESSING HEALTH ECOSYSTEM PAIN POINTS

In this way, the range of companies appearing on and wandering the exhibit floor made the meeting well worth the time investment.  Many of the companies present at ViVE are worth following (those here are in alphabetical order).  These are among the enterprises that are addressing pain points of the health ecosystem and rallying to pressing patient needs:

• AssureCare, a population-health company connecting payers, providers, pharmacies, and government-sponsored healthcare programs across the US, is taking the long-awaited patient-centric approach using technology to generate better insight through health information. This company is working to converge pharmacists’ and pharmacy data into a bigger population health picture. AssureCare hopes to break down silos in healthcare data sharing from specialty pharmacies to national chains.

• Babson Diagnostics is doing what over-promoted Theranos failed to deliver. Babson is reimagining the diagnostic blood testing experience making routine blood testing less invasive, more convenient, affordable, and empowering people to take charge of their health. The holy grail of patient testing has been to bring it into the retail pharmacy setting using technologies that require one-tenth the sample blood volume of traditional venipuncture methods without sacrificing quality, accuracy, or menu breadth and pushing these diagnostic tests into a well-known setting where convenience corresponds to patients’ upcoming physician visit is in itself a big step in the right direction.

• CereCore® is elevating hospital operational effectiveness.  Its systems are already based in top-performing US hospitals, enabling this health IT enterprise to improve processes, data security and clinical applications. Hospitals remain the most expensive points of care within the US health ecosystem.  Generating insights and learning to mine and apply data earlier in the patient engagement process is key to improving care and reducing costs.  Hospitals cannot go it alone; tapping into a well-proven system is a smart starting point.

• CPSI has combined several companies under its corporate umbrella focusing on health solutions and services for community hospitals, clinics, and post-acute care facilities. These are the health systems that are known to struggle as more and more systems look to align with other, larger entities. The path to system-wide health has been to ensure a better patient care experience, improve financial operations and offer community hospitals and affiliated clinics EHR solutions that can accurately code assignments for reimbursement. While many companies in the field are looking to “innovate,” sometimes the greatest care advances are in strengthening the care system’s capacity to be economically viable.

• eVideon uses smart-room technology to streamline clinical workflow and transform the patient room into an immersive environment. This company enables hospitals and long-term care clinics to integrate EMR and other installed technologies to display real-time information through the in-room Smart TV, digital whiteboard, digital door sign and bedside tablet. The platform is streamlining clinical workflow and reducing the technology burden on clinicians. This system even features in-room surveys and video chat so the patient has a greater real-time voice.

• Harmony Healthcare IT is the data management firm that moves and stores health organizations’ patient, employee and business records. Among the category of veteran players, it continues to pioneer health IT tech in many ways.  Founded in 2006, this company works with more than 550 clinical, financial, and administrative software in the US and Canada.

• HCTec provides services to more than 1,500 academic medical centers, health systems, community hospitals, critical access hospitals, and healthcare provider organizations. While patients are supposedly the health system’s priority, it’s vital to remember that if the care locations are poorly staffed and lack infrastructure, their mission will be severely hampered.  At a time when hospital systems are integrating, getting their staff and EMR systems connected is a mega – even life-saving priority. 

• Interwell Health is a kidney-care management platform in a field that has become one of the most pressing health sector needs.  The Centers for Disease Control and Prevention (CDC) estimates that 37 million Americans are affected by kidney disease, and most are unaware of their progressive condition.  With kidney disease reaching near-epidemic levels, how physicians care for patients and help them navigate a fragmented reimbursement environment is a monumental task. The cascade of care – from diagnosis to dialysis – requires access to practice knowledge and reimbursement.  Learning about an illness is the start of a process and getting the care essential to keeping people on track to prevent additional medical risks is where medical outcomes are judged.

• ixlayer is partnering with payors, retail pharmacies, direct-to-consumer brands, biopharma, health systems, and telehealth providers to create quick and easy diagnostics for common conditions where reducing cost is possible – before an illness is much more severe. This platform “white labels” its tests for major customers with direct patient access and enables numerous testing options and seamless integration with its customers and lab partners. Like many innovation leaders, its goal is to shift engagement to earlier stages when a disease presents and its management has far more cost-effective treatment options.

• Juli was front-and-center at the American Telemedicine Association meeting in San Antonio earlier this year. The consumer-direct platform – available through a convenient app – supports people with chronic health conditions such as asthma, migraine, depression, bipolar disorder, hypertension or chronic pain through several evidence-based approaches. This consumer health empowerment tool integrates information that impacts health and awareness by tracking health responses to environmental data (e.g., weather, air pollution, pollen) through smartphones or popular wearables and aligning health.  The information can help shift the sick-care reactive system to a self-care preventive care approach.

• Lifepoint Health, the Nashville-headquartered provider, has, since its founding, become a national health system serving patients, clinicians, communities and partner organizations across the healthcare continuum.  A spin-out of the pioneering HCA, this system now includes more than 50,000 employees, 62 community hospital campuses, 50 rehabilitation and behavioral health hospitals – plus 200 additional care sites, including managed acute rehabilitation units, outpatient centers, and post-acute care facilities.  It was no surprise that Lifepoint Health was present at ViVE.

• Loyal is among the first companies to offer end-to-end digital and AI-powered solutions tracking the patient journey; its software solutions for improved care utilization can be found within the nation’s top health systems and hospitals. From selecting a provider best suited for treating a specific condition to closing a feedback loop on patient experience, they have demonstrated that feedback is desired and that people who engage their health networks tend to show greater loyalty.

• Sheba Medical Center was part of the expert conversation at ViVE – a surprise for some as Newsweek World’s Best Hospitals five years straight – this medical system sent representatives from more than 6,000 miles away to share insights on how it maximizes technology across its care systems.  Its acute-care hospital, rehabilitation center, research and training programs, medical simulation center, center for disaster response, and the ARC Innovation Center for redesigning global healthcare all tap into the full range of digital and health technologies. At ViVE, its head of innovation spoke about the importance of looking for innovation from within its walls and the benefits of sharing best practices around the globe.  

• Teladoc Health appears to be about accessing care from many locations, but the pandemic demonstrated that the platform could provide much more to improve people’s well-being.  Now, telemedicine has become a given and has shown its value in patient adherence, management of chronic conditions such as diabetes, checking in with people enrolled in clinical trials and dealing with senior care needs.  In post-acute hospital care, telemedicine can support the outpatient process and keep people healing at home.  This global leader in delivering whole-person virtual care – including primary care, mental health, chronic condition management, and more – is the category must-watch innovator.

WHAT’S UP NEXT FOR HEALTH INNOVATORS?

The success of ViVE had many looking forward to April and HIMSS in Chicago, and CNS Summit in Boston this November.  For health innovators planning for 2024, mark your calendars for ViVE February 25 – 28, 2024, in Los Angeles.  If you have already marked your calendar for those dates, it’s a sure sign that #ViVE2023 was a hit!

The post ViVE Was an Out-of-the-Box Hit Among the Digital Health and Health Innovation Tribe appeared first on Medika Life.

To suggest patients can influence the machine that drives modern healthcare is naïve and indicative of a flawed understanding of the realities of the industry. It is nothing more than pandering to the cash cows of the industry – you and I.

It is not merely the patients who are powerless cogs in the machinations of healthcare. Their care providers suffer a similar fate. Caregivers are not responsible for the systematic erosion of patient centered medicine, they too are victims. Focusing on relationships between provider and patient is therefore a wholly fruitless endeavor.

Systemic remedies are required

As an analogy, consider if you will, the provider and the patient as cellmates in a high security prison constructed and manned by pharma, insurers and their intermediaries. No amount of debate and planning between the two cellmates is going to result in their release or an improvement in their living conditions. Their only hope lies in reprieve and relying on the humanity of their jailers. If it is lacking, the pair are doomed.

Call me cynical (guilty as charged) but I cannot envision a world in which healthcare companies suddenly decide to eschew profitability for the benefit of their customers. If anything, with every passing decade, rampant capitalistic profiteering will likely worsen the lot of patients and providers, as more intermediaries emerge in the ever growing chain of healthcare and market share declines with negative population growth.

In short, our current health system globally, warped over decades from a humanity based, service industry into the profit based system of exploitation we now deal with, is as good as it gets for you and I. It cannot and will not change.

Appeasing the masses

No one likes to feel they are trapped in a system over which they have little or no control. As the healthcare system evolves and refines itself, incremental changes will center care on establishing dependency (treatment, not cure) and further isolating the farmers (providers) and their flocks (you and I) into managed farming units focused on maximizing revenues.

If you’ve seen intensive chicken farming, you get the idea.

All the signs are there and have been for the last two decades, but like all unpleasant realities, we simply turn a blind eye, as we understand on an instinctive level that we are powerless to affect change. And yet, we continue to posture, we continue to whistle into the wind. All to no effect.

While it is true that patient advocacy groups do occasionally secure small victories, these victories inevitably come at a price, usually exacted on services or pricing in a fashion so subtle that the further erosion of control goes unnoticed.

Patient activism is even encouraged by the industry to pacify the masses. The industry will go as far as sponsoring and participating in many of the patient advocacy groups that proliferate the healthcare market. Appearances matter, results however, cost extra and never at the expense of the bottom line or without a quid pro quo.

Escaping Alcatraz

So what choice then, for patient and provider, caught up in the gears of a machine intent on using them for the pursuit of profits? It is too late to walk any of this back and it cannot be undone. We lack the social backbone to address it and those who can address it lack any form of incentive that supersedes profit.

How do we return healthcare to its former heady days of doctors serving their patients, of ethical medicine, of deep bonds of trust and respect between both patient and provider. How do we ensure that future generations can benefit from technology and medical advances to improve their health, rather than being cycled into a chain of dependency, for those fortunate enough to afford anything approximating to care.

If we cannot change the existing system, the unpleasant alternative is to part ways with it. To strike out into the medical wilderness, forgoing healthcare insurers, pharma and the wretched leeches that inhabit the spaces between. To separate, permanently, the ties that bind both patient and provider to flawed systems that perpetuate abhorent levels of care.

I firmly believe this to be our only option if we are to ensure fair and free access to healing for future generations.

How this future would look and what it would encompass for doctors and patients remains to be seen, but the break needs to be made, before the gates shut for good on the flock.

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Social Security adjudicators working on applications for benefits have licensed professionals to evaluate the case and rate them regarding the person’s ability to perform any work. Physicians and licensed psychologists never see the applicants, only the information in the file.

Applicants that can’t lift at least 5 lbs. for a specific length of time may still be seen as able to do sedentary work, and here’s where the cards are stacked against them.

The Dictionary of Occupational titles, last updated in 1977, lists over 12,700 jobs many available for unskilled, sedentary workers at that time. Among the jobs are shoe sole gluer, fish scaler, nut sorter, dowel inspector, and egg processor. Where in the US do we have people gluing soles on shoes or sorting nuts?

A pinball machine repairer is still available, but how would a person with sedentary issues be able to do that? The jobs are still listed as existing here, and adjudicators see that as a valid reason to deny benefits to a disabled person. Shouldn’t the listings be updated? Who’s responsible for that?

Some people receive benefits who can do other than sedentary work and be employed in a variety of jobs. I recall a man that field workers found lying under his truck doing repairs on it. Another man was engaged in a home repair business, a third was pulling a boat trailer, and the list continues.

How do I know about this? I worked as a medical consultant for Disability for over a decade, and I attended meetings where they pointed out recent fraud. Adjudicators told me about the old job listings they were using to deny benefits, and as long as they were in that book, they were used.

Those who knew they didn’t deserve benefits know one thing that protects their fraudulent claims; many states may have only two field inspectors to check up on questionable claims.

How does Disability know about these claimants? It’s simple; someone reported them to Social Security. As far as I know (from my years working there), there are no regular visits to check up on those receiving benefits. A paper trail tracks some on a one, three, or never basis according to their assigned disability rating. The last are those seen as rated with no medical improvement expected, such as terminal cancer or, perhaps, another terminal illness that will result in death within one year.

Reports may prompt the inspectors to make a trip out into the field. Nosey or unhappy neighbors and vigilant citizens keen to report fraud are the banes of those who are inappropriately collecting benefits. No reports might mean a cursory trip occasionally to check up on someone. Otherwise, various forensic methods will be used to catch the fraudsters.

Think how many people have been denied because they couldn’t find a fish scaling job. Also, think about the stress, the endless hours of trying to contact someone to help, or the process of giving up in depression. Isn’t it enough that they want to work and can’t? How demeaning is that?

Don’t we determine our self-worth by how we contribute to society or our families? Being pushed aside like this is saying the disabled are worthless, and that’s not as bad as it gets. Some may commit suicide. I don’t have data on that, but it’s not a bad guess on my part.

If you or someone you know has been denied Social Security Disability benefits, you have a right to ask for a reconsideration and a review after that by a judge. Should you not be satisfied with the outcome, contact the local office of your state’s Federal Senator and ask for a “sensitive inquiry” on their part.

You can also contact an attorney who specializes in these cases. Their fee is set by law and determined by how much money (often back benefits) is realized.

The post Ruling Against the Disabled and Denying Social Security Benefits to Them appeared first on Medika Life.

MCLEAN, Va., & BEDFORD, Mass.–(BUSINESS WIRE)–A new MITRE-Harris Poll Survey on Patient Experience finds 52 percent of individuals in the United States feel their symptoms are “ignored, dismissed, or not believed” when seeking medical treatment. That number rises to 6-in-10 within the Hispanic community.

“And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

The polling also revealed that more than half of Blacks and Hispanics feel the “healthcare provider is biased against me based on their attitude, words, or actions,” contributing to a 4-in-10 average across all demographics. Fifty percent (50%) of respondents also reported “a healthcare provider assuming something about me without asking me.”

Additionally, the results indicate that several groups are all much more likely to experience bias, doubt, or language barriers when seeking treatment. These include individuals identifying as a person with a disability or having a chronic health condition, those responsible for managing access to healthcare for a family member or friend, and members of the LGBTQ+ community.

“These findings confirm unacceptable disparities in patient experience along racial and ethnic lines, for the LGBTQ+ community, and for those who are managing chronic health conditions or navigating the world with disabilities,” said Juliette Forstenzer Espinosa, senior Medicare, Medicaid, and Affordable Care Act Marketplace strategist, MITRE. “And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

Rob Jekielek, managing director, The Harris Poll, said, “With the evolution of online patient portals and digital support tools, we have seen stronger usage among those who need to navigate the system the most—individuals with a chronic illness or disability and those who manage the healthcare needs of others. However, this has not translated to substantially lower frustration with the healthcare system, including understanding of coverage and claims. Confusion and uncertainty are even higher among the majority of Americans who use the system sporadically, or only when specific needs arise.”

Additional key findings from the MITRE-Harris Poll Survey include:

• When consumers have a concern or question about a bill, they struggle with whom to call.
  Fifty-four percent (54%) of insured individuals in the United States say they don’t know whom to contact if they have an issue with a bill or claim. Individuals self-identifying as disabled or dealing with chronic illness, caregivers, Hispanics, and younger generations are more likely to say they do know whom to contact if they have issues.
• Prevalence of unexpected medical bills decreases slightly.
  Forty-three percent (43%) of insured Americans report receiving an unexpected bill because their insurance did not cover as much as expected – a decrease from a 2021 MITRE-Harris Poll Survey when 47 percent reported a billing surprise.
• Patients are overwhelmingly using portals.
  Nearly 9-in-10 insured individuals use online patient portals more often for test results (70%), appointments (64%), and medical records (63%) than for other applications, such as finding a healthcare provider (58%), reviewing insurance benefits (54%), managing prescriptions (54%), or filing a health insurance claim (37%). Insured Black, Indigenous, and people of color (BIPOC) groups are more likely than white individuals to use patient portals to find a healthcare provider or file a claim.
• Patients seeking some specialists may wait two months or more for a visit.
  While most Americans can schedule an imaging appointment or a visit with their primary care provider or general practitioner in less than two weeks, 1-in-5 say it can take two months or more to meet with specialized professionals such as mental health providers, specialty physicians, dentists, or optometrists.

Methodology

This survey was conducted online within the United States, September 27-29, 2022, among 2,047 adults (ages 18 and over) by The Harris Poll on behalf of MITRE via the Harris On Demand omnibus product.

Editor’s Notes:

• Survey findings and commentary slide presentation is available by request to media@mitre.org.
• Health Insurance Marketplace open enrollment runs from November 1, 2022 to January 15, 2023.

About The Harris Poll

The Harris Poll is one of the longest-running surveys in the U.S. tracking public opinion, motivations, and social sentiment since 1963, and is now part of Harris Insights & Analytics, a global consulting and market research firm that delivers social intelligence for transformational times. We work with clients in three primary areas: building twenty-first-century corporate reputation, crafting brand strategy and performance tracking, and earning organic media through public relations research. Our mission is to provide insights and guidance to help leaders make the best decisions possible. To learn more, please visit www.theharrispoll.com.

About MITRE

MITRE’s mission-driven teams are dedicated to solving problems for a safer world. Through our public-private partnerships and federally funded R&D centers, we work across government and in partnership with industry to tackle challenges to the safety, stability, and well-being of our nation. Learn more at mitre.org.

©2022 MITRE #22-4132 12-15-2022

Contacts

Media
Mike Murphy, external communications principal, MITRE media@mitre.org.

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But times change, which means what was usual previously may need to be updated to meet the spirit and needs of the times and, incidentally, not to swear by Roman or Greek gods/goddesses. The burning question facing medical education today is how best to revise the oath that some find anathema. If medicine is anything, it is based on philosophy and science when it comes to making potentially life-changing decisions for patients.

How does the oath meet the needs of women’s healthcare when a life is in danger if a therapeutic abortion is not performed? The whole concept of “harm” comes into direct conflict with the oath. Where is the harm and which is the greater harm?

Does the oath, as it stands, still have relevance in a world decidedly different from the one in which it was written, or are we still being held to standards set at that time?

The question is roiling medical school administrators and students alike who must take the oath. And this is not an insignificant instance of a simple ceremonial change; it involves careers and issues of life and death. It should be noted that neither the American Medical Association nor the American Association of Medical Colleges requires an oath.

In 2015, a survey of 111 medical schools in the United States and Canada took part in a survey of commencements and the oaths that were taken then and at white coat ceremonies. The results show that more than half of these ceremonies did not use the original Hippocratic text but some variant of it, which was unique to the school and to those students. Three elements were found to be present in all the oaths: respecting confidentialities, avoiding harm, and upholding the profession’s integrity.

In 1964 Dr. Louis Lasagna prepared “A Modern Oath” which addressed many of the same issues found in the Declaration of Geneva first published in 1948 and then revised in 2017.

Some schools have used the updated version of The Declaration of Geneva that addresses a number of key ethical parameters relating to the patient-physician relationship, medical confidentiality, respect for teachers and colleagues, and other issues.

The revised declaration of Geneva carries pledges to:

1) consecrate their life to the service of humanity,

2) respect for teachers and showing gratitude,

3) practicing medicine with conscience and dignity,

4) the health of the patient is to be their first consideration,

5) secrets confided to them are respected even after a patient’s death,

6) maintaining the honor and noble traditions of medicine,

7) not permitting considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or other factors to intervene in the provision of medical services,

8) respect for human life

9) not using their medical knowledge in violation of human rights or civil liberties

Social norms and concerns are now a part of these oaths and cover serious issues facing anyone in medicine today. The past is revered, but the present and future are also given their due in oaths being written by students today. There is no longer the mention of religious obedience in the oath and bias and discrimination have been addressed as well.

Ethical issues remain the province of the medical practitioner and are in flux with changes that will be encountered. Dramatic advances in technology will bring new, unexpected demands of physicians and other in healthcare. Flexibility of the oath would appear to be its abiding factor with regard to this future shift.

The post Old Medical Oath Needs Refresh From the Original Hippocratic Version appeared first on Medika Life.

But what if an error is made and propagated to the records in other facilities and keeps propagating again and again and again? The error becomes harder to untangle from the original database and all the others that quickly incorporated it in the interests of medical care.

Consider how one drop-down menu mistake for a patient’s medication might introduce bias in treatment into the record. But who would know it was a mistake if the patient never saw their record and felt there was no reason to ask for a copy?

The law is on the patient’s side, but facilities may not always be so willing to release the records. There is an exception where the facility could argue that the information would somehow harm the patient. Harmful to know what’s in your record? Are we children? How and when can a patient be refused access?

With limited exceptions, the HIPAA Privacy Rule (the Privacy Rule) provides individuals with a legal, enforceable right to see and receive copies upon request of the information in their medical and other health records maintained by their health care providers and health plans.

If you want more information on HIPAA regulations and your rights, there is material, and you can also file a complaint online.

How might inaccurate information be placed in your EHR? Many medications have similar names, and there may be two names for the same drug (brand name and generic). If personnel are unfamiliar with all the names and select the wrong one from the computer drop-down menu, your record has that error in it. But would that be a significant problem for you? I think it might.

Medications for psychiatric disorders, if entered into your record as a prior medication or one to which you had an AE (adverse event/allergy), staff reviewing your record will see it. Healthcare personnel is as fallible and biased as anyone else, and they may make certain assumptions about your mental state.

Any other medications that may have been entered incorrectly could also affect the treatments or drugs used in someone’s care. In any case, errors must be corrected, and the facilities that house them in their databases are required to make the adjustments.

Should everyone request a complete copy of their medical records? It’s a personal choice, but keeping your records ensures that you know what is in them, and you can have peace of mind knowing there are no untoward errors about which you were unaware.

Previously, requesting these records meant paying at least $1/page in some states, but today the entire thing can be burned onto a CD/DVD or put on a thumb drive. It’s not cumbersome and can easily be scanned for material information you want to select within the file. Remember that “pdf” documents have that “find” feature.

Obtaining medical records for yourself, a child, or a family member requires that you know the procedures. Here is a website that provides much of this information.

Have you looked at your medical records lately?

The post Unearth Your Medical Records And Be Prepared For Surprises appeared first on Medika Life.

Every step of the patient journey can have a profound impact on the way in which your patients experience their time in your care, from their check-in to the day of their discharge.

A 2016 report found that hospitals that provide a superior patient experience generate a 50% higher financial performance than average providers[1].

We see every day that higher patient experience ratings are consistently linked to higher hospital profitability. What’s more, your customers are more loyal and your hospital reputation is enhanced, with an increase in referrals.

The patient experience is often overlooked in healthcare.

We developed four holistic assessments which evaluate what is actually happening in your hospital in the following key areas. When looking at your hospital’s patient experience, you could conduct something very similar.

People: Beginning at 4 am until the end of the day, carry out a deep-dive assessment of your patients’ experiences and staff procedures.

Technology: Take a comprehensive review of the current state of technology at your hospital is undertaken. This includes telehealth and telemedicine which are becoming increasingly vital for patients in rural areas to enable them to access care.

Processes: Map out how you will evaluate individual staff roles, treatment procedures, and department practices

Data: Conduct an analysis of disparate, complex data that is carried out to identify the gaps in critical data collection and opportunities for improvement.

These assessments cover the OR, the ER, surgical services, supply chain management, and patient flow, involving your staff and patients at every stage to gain invaluable insight into your patients’ perspectives.

But the patient experience doesn’t end when they leave your hospital.

Continuum of Care Strategies for Hospital Operational Performance

With changes to regulations and reimbursement plans, quality patient care requires strong collaboration across all care settings. A key element of achieving a superior patient experience and improved profitability is an integrated continuum of care strategy.

HIMSS defines Continuum of Care as:
‘A concept involving a system that guides and tracks patients over time through a comprehensive array of health services spanning all levels and intensity of care.’

That can extend from birth to the end of life. HIMSS breaks the care continuum down into seven categories, including wellness, acute hospital care and ambulatory care. As the US population ages, continuum of care will become more critical to ensure no patients are overlooked.

This new reality is a challenge for healthcare organizations as what begins in your hospital no longer ends there. In many cases, pre-hospital care such as blood pressure management is also a critical part of the continuum.

As hospital margins are squeezed, the patient experience and continuum care will become critical strategies to improve your profitability.

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