Health 2.0 Moving Forward, Going ROPE, Doing Good: Ted Eytan, Matthew Holt , Organized Wisdom Push the Envelope

The combined talent, willpower, business acumen, and capital in the room at Health 2.0 will be a force with which to be reckoned...and getting ready for the event usually kickstarts some interesting discussions as everyone prepares to bring the A-game.

Two of my favorite bloggers this morning offer up innovative views on work environments and 'do good, be well' initiatives.

Here are the goods and why they're relevant to Health 2.0 and consumer-centric care:


1. Ted Eytan details a new "Results Only Patient Experience" (ROPE), built on the platform of Best Buy's Results Only Work Experience (ROWE).

Why Does it Matter?

• It's already happening in the Health 2.0 sphere - Organized Wisdom is the first Health 2.0 company to go completely ROWE. Better yet, OW takes a collaborative approach, sharing their "Getting Results Toolkit" - read all about it here.

• I've been a ROWE worker 2x, first as an analyst and business development director, now as an all around healthcare ranger, blogger, and social startup junkie. It's not all peaches and cream and working in your pajamas (although yes, I have worked in PJs). The typical day Ted posts comes perilously close to describing some of my weekdays, especially when I lived in downtown Baltimore or when I'm at home in Rotterdam. Self-management is a must. And yeah. It can be a hell of a lot of fun. I don't think anyone who knows me would call me a slacker (at least I hope not...).
  

• ROWE works 'best' for certain types of organizations and personalities, but certainly does privilege the knowledge-worker class who can afford to do work from anywhere (literally - I'm typing this blog entry sitting in a tent at Chincoteague Island, Va). LOTS more healthcare organizations could go ROWE, or, more appropriately, could "ROPE & ROWE" (nice nautical imagery there Ted).
  

• The bottom line about why I love being a ROWE (and shortly, advocating for a ROPE environment using the Nexthealth app) worker: it's all about results. What I get done. Not when I get it done, or even necessarily how long it takes me. And the real beauty is that I get a hell of a lot more done working from anywhere I'm comfortable than when I'm stuck in a cubicle drinking lame coffee or listening to my coworkers rave about the Sex and the City movie.
  

• Also, consider this: in a daily 'normal' work or classroom environment, the time you spend with rear parts in the seat is the most important thing - it's more about attendance than it is about output. In class, I'd finish work early and whip out a book. In a 'traditional' 9-5 I'd finish work early and be bugging supervisors for something else to do, a new project, etc. I was a pest. A productive pest, but a pest nonetheless. Now, if I finish something early, it's on to the next thing.
  

• MARKET RESEARCH: If you want to get a better look about what kinds of organizations in your area are offering ROWE environments, just go to your local Craigslist jobs page. Click the "telecommute" button, et. voila. Search results tailored to ROWE workers or organizations exploring the concept. Note there probably aren't many healthcare orgs in the list of results. Here's an example of results from my home-away-from-home, Washington DC, this morning at 9:07 am.
  

2. Over at The Health Care Blog, Matthew Holt and his wife Amanda share their own 'do good' goals. Matthew's asking companies who want to mine his brilliance to help buy a kid a bike. Amanda, who just had some pretty serious back surgery, will also sport supporting companies' colors on during her upcoming training rides (and yep, we'll probably see some photos on THCB).

Why Does it Matter?

• Social entrepreneurship is arriving early to the Health 2.0 stage, considering the conferences themselves have been around for just under 2 years. Matthew and Amanda are doing something really neat here, and bravo to both of them for helping spread the wealth to benefit Saigon Childrens' Charity. To my knowledge, it's the first time they've 'asked' us, the readership, to help out a crusade. This is an awesome step and the first time I've seen something like this done outside of Doc Rob's sending Zippy all over the world and outfitting us all in Zippy wear to help fight kids' brain cancer.
  

• A fascinating conversation from #gnomedex on Twitter.com last week began when Beth Kanter (@kanter) raised almost 4k in under an hour SIMPLY by having those in attendance begin to tweet about the event. Her social philanthropy demonstrated a few things brilliantly: peer pressure in giving works (for good or ill), almost anyone will give $10, and you have to coordinate a few things brilliantly to cut through the noise with an 'ask' - right time, right place, right people spreading your message, and right amount.
  

• Doing good is contagious. Doing good is viral. But we don't always (or even usually) give because we're saints.
  

• If your competitors start do-good initiatives, and you don't, you'll look like a boob. Is this the 'right' reason to give? Probably not. Nor is the fact that giving in this case will get you a photo and nice writeup on The Health Care Blog.
  

• I had a great Twitter discussion with @michah, who was at #gnomedex (type this into the search field at www.summize.com for all the #gnomedex Twitter feeds) about whether or not people were giving to Beth's initiative because of competitive pressures or a desire to 'help.' To a certain extent, the values conversation in giving is often overly simplified, and this type of value judgment is only relevant if we're speaking from the pulpit, or Valhalla, which none of us are.
  

• BOTTOM LINE: Give for whatever reason you give. The important thing is that you give. Try not to judge others for what they get in return. This is the hybrid model of social philanthropy at work - do some good, get something good in return. Call it the bartering of philanthropy if you will, but it's how this system has always worked (sponsorships for events, launches, etc). Even those little balloons you buy in the checkout line at the grovery store are the barter system of philanthropy at work: You get to write your name and paste it on the window proving what a generous person you are. Final bottom line: Try not to fool yourself about reasons and motivations for giving. Be clear about what you want people to give, and what they'll get in return, just as Matthew's done at THCB. And if you don't want anyone to know what a good person you are, give and keep quiet about it.
  

And for goodness' sake people - buying a bike for a kid in Saigon is only 25 pounds....

Hospitals WANT Guitar Hero Healthcare

"Hospitals want involved patients" - from the Chicago Tribune.

Good piece, but a bit outdated.

The Joint Commission's Speak Up! Program has been around for a few years (at least since I used it as a Patient Advocate 'rounding' in 2003-2004), but you rarely see a specific staff person within the acute care setting responsible for implementing the program.

Our hospital, however, had a team of 5 Patient Advocates rounding on inpatient floors discussing the Speak Up! Program with patients and families.

What, we found, however, upon administering the program is indicative of the healthcare system's larger 'chronic' issues....

The process looked a bit like this:

1. PA enters the room, cheerily confirms identity with double checks (name, armband) - after asking if we can chat about the program and if the patient would like privacy while we do so.

2. Hands patient or family member/friend/caregiver/partner Speak Up! brochure while we give the pitch, usually multitasking and wiping staff board, refilling water pitcher at bedside, etc. Some people don't want the paper or the pitch, so PA asks if any other questions or any assistance we can provide.

3. Asks if patient has any questions or if we can be of assistance. 9 times out of 10 answer is resounding "yes" and issue is NOT related to Speak Up! program but medical care continuity (ie are my labs in yet? When will I be discharged? Who is my new nurse? What's for lunch?)

4. Chase down medical staff (nurse, tech, or in VERY rare cases doc) if it's a medical issue. Otherwise repeat we are 'only' PAs and not qualified to give medical information, but we have feet, and lungs, and can thus chase down and corner medical staff who can give correct info. (This would be why I wore sneakers, Nike Prestos, to work).

5. Bug caregiving staff incessantly if big issue, deliver message and confirm 'report' handoff verbally (and usually in my notebook with time and staff name cited in case I later had to do a variance).

6. Return to patient room and report progress on issue/contact resolution. Deliver sunshine and a smile (or 50).

Final findings from a year spent as a Patient Advocate:

1. Patients want to be involved. (10-80-10 rule: 10 percent unwilling/inable to self-advocate and be participatory, 10 percent hyperengaged, Guitar hero healthcare types, and middle 80 percent may be involved at varying levels).

2. Family members want to be involved.

3. Many doctors don't know how to treat patients who are verbally self-advocating...but if someone whips out a notebook and starts taking notes during the conversation they're on best behavior.

4. Communication between docs and nurses is often FUBAR. The blame baton is passed back and forth like care delivery communication is a contact sport. The rest of us, including patients, are relegated to acting as befuddled spectators.

5. Top issues of concern to patients are related to the 3 Cs: cure, care, communication.

Every initiative that purports to encourage increasing 'guitar hero healthcare' or 'patient involvement' must take systemic deficiencies in addressing the 3Cs into account. To ignore any of them is to court systemic failure.

Right now Ted Eytan is continuing to push on the most complete, viable definition of Health 2.0 for consumer-centric, patient-directed care advocates. Take a look. It's important work.

Until we can define 'involved' patients at a basic level, hospitals will have a hard time connecting idealistic goals to real strategic planning.

Patient involvement, CONSUMER involvement, is a vital component to figuring out 'what's next' for Health 2.0, and beyond.

Yesterday I sat in a nearly empty room at HIMSS DC Summit 2008 watching Jay Parkinson present the first truly consumer-centric GP practice model (here's some WSJ coverage).

Jay's new practice, Hello Health, is opening it's first storefront July 1st in NYC. Pay attention policymakers, hospital execs - the future of healthcare is closer than you think.