Yesterday (Monday) there was a great session about advertising in health care—but actually impossible to blog about as it was mostly funny videos! Great stuff from Hollywood writer Marty Montgomery who works with Vic Stretcher, HealthMedia Inc, & also from Michelle Sobel, Emmi. Go look at their sites, but briefly, people are prepared to learn about stuff that they are interested in and entertained by!

Ix this morning started with Earl Steinberg from Resolution Health and Jim Prochaska from Pro-Change Behavioral Systems. Lots of data but shorter version is, targeting and tailoring data to those targeted patients works pretty well.

Next, an award for Susan Edgman-Levitan pioneer in patient information and advocacy who actually founded Picker Institute—the originally patient survey organization. Apparently finding out what patients actually thought and wanted was a new idea before Susan showed up!

Then, David Sobel, famous Kaiser doc who figured out that group visits for patients improve outcomes.

He started the presentation by asking what would get him a 5 on the
evaluations. He got a bunch of responses about what people wanted to
know. He said that if he really had the courage he’d do a workshop,
because the model of dumping information via powerpoint and lecture on
people is the wrong model for Ix!

But he’s too scared to do that, so instead he compares Ix to a drug.
It works, it has few side effects that go away quickly, but his
colleagues are in denial about it and have found it a tough pill to
swallow! Even within Kaiser where allegedly there are aligned financial
incentives, and there are still a bunch of reasons why this is a huge
problem. (Organizational inertia of one kind or another).

His prescription? Figure out self care, as that’s the place to
improve productivity. As 80% of care is delivered by patients. If you
help them to manage and share that expertise it helps dramatically with
overall system productivity.

Patient groups—80% of what chronic patients need to know is common
and can be shared across diseases—and you need to get the professional
out of that room! Or you can let them be re-educated out of their
helping role….as the important thing is to let the patients self-lead
and use a script. (He’s working on this with Kate Lorig at Stanford). The most important finding? The process is more important than the content.

Then realize that 75% of disease symptoms are psycho-social. And we
provide “me, an expensive incapable resource” to deal with this. The
psycho-social stuff is most of medicine. Common among patients who don’t even qualify for diagnosis of depression.

Worse, health behavior change doesn’t predict better
outcomes—instead better outcomes based on attitudes, belief and
self-efficacy. Confidence counts. So they reshaped the program to
increase people’s sense of confidence and control. So they now teach
techniques to improve these….”we need to teach basic life skills”.
They’ve put several of these in a book called the Mind and Body Health Handbook.

And the last part is how to change the way people talk to (and therefore train) themselves while they’re being lectured! http://kphealtheducation.org
is the site for their new programs helping clinicians understand how
people interpret information as it’s being delivered…(well worth
looking at the site).

And yes David Sobel deserves a 5!