When I started this blog, many years ago, it was intended to serve as a place where I could gather my writing from other places. Over the years, I've found more of my writing specifically for the blog. When I started at the Community Health Center, I didn't have as much time and energy for personal writing and so the tenor of the blog changed. Likewise, as the audience changes, so does my writing.
I have not been cross-posting blog posts I write for the Community Health Center here, for a large variety of reasons. However, I there have been some blog posts there that I've felt were particularly important. Today, I posted one of them. Psychiatric Telemedicine for Uninsured Patients without Stable Housing. It has a wonky title, but I hope you will stop by and read it. As an aside, SB 13, AN ACT CONCERNING A STUDY OF TELEMEDICINE SERVICES passed the Insurance committee with all 18 members at the committee meeting voting in favor of it. Unfortunately, it was tabled for the calendar.
Another topic I've been following is a very lively discussion on SpinSucks, PR Crisis for Skittles In Wake of Controversial Teen Shooting. How should Wrigley's respond to the increase in sales and people suggesting Wrigley's should donate the money "to the family or causes that would help with racial reconciliation or underprivileged communities".
With around 150 comments there, mine might get lost, so I figured I'd share them here:
John F. Kennedy once said, "When written in Chinese the word crisis is composed of two characters.One represents danger, and the other represents opportunity". It seems as if there is too little focus on the danger, and not enough on the opportunity.
Like many corporations, Wrigley's has a commitment to social responsibility.http://www.wrigley.com/global/principles-in-action/people.aspx
"We aim to make a difference by respecting diversity and encouraging inclusion, consistently improving our health and safety practices, providing volunteer opportunities for our associates and through philanthropy with real impact."Wrigley should focus on this and highlight efforts to help make communities safer. "Any kid should be able to walk safely to a neighborhood store."
Use the opportunity to build the brand's Social Responsibility cred.
In a follow up I was asked how I would advise them to do it while staying out of the politics. I responded:
I believe that focusing on neighborhood safety can be presented as a neutral issue. Everyone wants safer neighborhoods, whether they be members of Neighborhood Watch, or parents of black youth. It is a common ground, and by focusing on the common ground, they aren't giving into the activists, they are staying neutral to the politics, and are probably least likely to end up in legal problems.If I were there, I would probably look at putting money into grants to neighborhood organizations that are working towards this. I'd probably try to do a little branding with this, something like the "Safer Rainbow Initiative".
I'd probably do it as part of the Wrigley Company Foundation as part of their "sustainable local initiatives... to improve communities around the world"
Last month, I wrote a blog post about personal Genomics. It is a topic I've been getting more and more interested in. The other day, a friend tweeted about a discussion on LinkedIn, Would you have your genome sequenced?.
84% of the respondents said they would. The subsequent discussion hit a lot of issues, including how testing relates to various U.S. Federal acts like the Health Insurance Portability and Accountability Act (HIPAA), the Americans with Disabilities Act (ADA), and the Genetic Information Nondiscrimination Act (GINA).
One person posted a link to a blog post, Whole Genome Sequencing and Calculating Risk Tolerance. The blog post pointed to an article, Harvard Mapping My DNA Turns Scary as Threatening Gene Emerges. It was an article I concurrently found links to from a different discussion.
The author, through genetic testing, discovered he had a variant called JAK2, associated with rare, cancer-like, blood diseases. It is a great article and well worth the read. As the author explored the ramifications of finding out about genetic propensities to rare diseases, he noted
a 1999 study in the American Journal of Human Genetics found that about 1 percent of 4,527 people who were told they had the gene that causes Huntington’s disease, a progressive nervous system disorder, attempted or committed suicide, or were hospitalized for psychiatric reasons
Does knowing about certain risks, link that of Huntington's disease increase other risks, like that of attempting suicide? How should we, and particularly, how should genetic counsellors, deal with these shifting risks? Should genetic counsellors get get some training in psychology, or work with psychologists?
I'm not sure, but even after reading all of this, if there was affordable direct to consumer Whole Genome Sequencing available, I'd still go for it. But then again, I like to explore new technologies and innovations, partly in hope that my explorations might help others.
Thursday I headed into New York for part of Social Media Week. The first speaker was Jay Walker, @TedMedJay. He spoke about how we are living in a world of evolving systems that engineering thinking just doesn't work for dealing with such systems. Instead, he spoke about how we need to think about mental models. He started off by looking at a simple, powerful, and frequently used mental model, "What Would Jesus Do". He then moved on to talk about mental models in health care; invincible teenage boys, the born lucky model, where people think that health outcomes won't affect them, because they're lucky, and the car mechanic model where folks go to the doctor simply to get fixed up. He then went on to talk about models like the 'specialist' model, which is getting more and more challenged by more and more specialization and the Star Trek model where nanobots will fix everything. There is also a 'rational actor model' whereby patients are believed to make better health decisions if they are simply presented with better information.
Yet, technology, Jay went on to say, doesn't solve problems, it creates tools that can be used to help people solve problems based on their mental models. For example, technology, in and of itself, cannot end racism. And as to the rational actor model, it fails to explain why so many people, even though they know smoking is bad for them, still smoke.
All of this was well and good, but the thing that would have been more interesting would have been a discussion about how we help establish new mental models. Jay did talk talk about 'personal informed model', based on being open minded and continuously learning. It sounds like a good idea, but as Jay noted, too many people decide they are done learning when they leave school.
Looking at bigger systems, the pharmaceutical, insurance, medical complex is not set up to encourage doctors and patients to pursue more cost effective health outcomes. So, the bigger question becomes, how do we challenge and change the pharmaceutical, insurance, medical complex?
Perhaps some of the discussions that took place during the rest of the day provides clues, but that will have to wait for another blog post.
One of the metrics I often use, when thinking about conferences I attend, is how many interesting new people I interact with. The Health Hub at Social Media Week in New York, #smwhealth resulted in a smaller number of new people I interacted with, but a much higher quality of interactions.
Starting off the list is Alex Fair, @faircaremd. "Chief Instigator at FairCareMD, The 1st Open Healthcare Marketplace where Patients and Doctors can meet and agree on fees that are fair to both." He's fairly serious about tweeting from conferences and during the second half, we sat next to each other, shared a power outlet and various comments about the conference.
Next is Paulo Machado, @pjmachado. "Husband-Father-Friend-Passionate about driving the adoption of innovation that improves the healthcare delivery model." He was wearing a @reginaholliday jacket and did a lot of good tweeting as well.
Mike Painter, @paintmd "Senior Program Officer at RWJF" He did some good tweeting while @TedMedJay was on the stage. I only got a chance to meet him briefly in passing.
Then, there was Jerry Weinstein, @tummler10. "Cynical Idealist. Competitive Zen. AKA: Writer. Editor. Strategist. Producer. Certified Mediator." We did not get a chance to meet face to face, at least as far as I know. However, we did have some fairly interesting interactions on Twitter that I hope to follow up on.
A couple other people that I interacted briefly with, included @careplanners @elleehenry. I'm probably missing quite a few others, but these are the people that I remember particularly jumping out at me. Thanks for a great #smwhealth. Happy #ff everyone.