Jen’s Posterous

The way electronic medical records are used now has not yet had a real impact on the quality or cost of health care,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health, who led the research project.

From: "Little Benefit Seen, So Far, in Electronic Patient Records - NYTimes.com."

Between CEOs earning exorbitant salaries and news of frequent patient policy cancellations, the public, and many within the healthcare industry itself, are expressing outrage over the huge profits that health insurance companies continue to enjoy, and are increasingly casting the insurance industry as the villians in the health reform debate. 

But just how well are these companies really doing?

From: "Q3: Top Health Insurance Company Earnings Reports - FierceHealthFinance - Health Finance, Healthcare Finance."

Whoops - forgot to add health insurance to the startup budget....;)

80 percent of engagement around a post happens on day one, and that 60 percent of that happens within the first hour. What was surprising, however, is that this is actually a decrease from the numbers Grigorik has for 2007. According to his data from two years ago, 95 percent of engagement happened on the first day, and 90 percent of that was within the first hour.

From: "Technology Review: Blogs: TR Editors' blog: The Speed of Online Conversation."

This article is a must read - Grigorik believes online conversations' D-day replication is slowing down a bit as our distributed networks increase in size via weak ties, which have slightly slower bonding/sending capabilities.

Social networks are getting more complex via nodal interactions, so our filtering of value slows down about 15%. It'll be interesting to see what happens in another year of social networking distribution.

Will our weak tie/"friend of a friend" human filters cause engagement to drop another 15% or so?

Previous studies have shown that the oxytocin hormone has a positive effect on positive feelings. The hormone is released in the body naturally during childbirth and when engaging in sexual relations. Participants in an experiment who inhaled the synthetic form of the hormone displayed higher levels of altruistic feelings, and it is supposed that the hormone plays an important role in the formation of relationships between people.

However, in earlier studies carried out by other investigators with rodents, it was found that the hormone is also related to higher levels of aggression. Therefore, it was decided to examine whether the hormone also affects negative social sentiments. The present study, which was published in the journal Biological Psychiatry, included 56 participants.

From: "The narrow line between love and jealousy."

 Sharing detailed personal health information in a public forum isn’t smart.  Sure the tongue-in-cheek comment about your ingrown toenail isn’t likely to create problems.  Discussions about anything more serious isn’t for others to hear.  Keep in mind that everyone from employers to insurance companies are tuning in to what you have to say.

Hmmm.

Having problems getting past that first sentence and the general fear factor approach.

"Hope is an important part of happiness. But there's a dark side to hope," a co-author of the study, Dr. Peter A. Ubel, said in a news release. "We think [the permanent colostomy patients] were happier because they got on with their lives. They realized the cards they were dealt, and recognized that they had no choice but to play with those cards. The other group was waiting for their colostomy to be reversed. They contrasted their current life with the life they hoped to lead, and didn't make the best of their current situation."

There's a lesson here for healthcare professionals, too, the authors wrote. Healthcare professionals want to give their patients hope and may be reluctant to correct false hopes. But patients may be better off facing the truth.

"While hopeful news may be easiest to deliver, it may not at all be in the interests of the recipients because it may interfere with emotional adaptation," the authors wrote.

From: "Sometimes patients shouldn't hold on to hope | Booster Shots | Los Angeles Times."

Whose job is it to 'correct' false hopes?

If someone had 'corrected' my unrealistic (clinically speaking) hope that I'd keep my right leg, if someone had 'corrected' my unrealistic (clinically speaking) hope that someday I'd run again (multiple 5ks and a Sprint Tri later), if someone had 'corrected' my unrealistic (clinically speaking) hope that I'd be able to wear a 1.75 inch heeled shoe, would that mean they were just helping me "play the cards" I'd been dealt?

Whose job is it to 'correct' my emotional adaptations to 'reality?'

If anyone succeeded in doing that, I wouldn't be here, in Silicon Valley, starting a health tech company, with no previous tech experience.

Facing my medical truths was about *not* abandoning hope. In fact, it was facing my medical truths that led me to move to San Francisco and begin to build things that help other people who are patients NOT abandon hope.

People want to know what to do, yes. People want to know what to worry about, yes. People want to know what to expect (good/bad), yes.

But sometimes holding on to hope is the only thing that keeps us holding *on* to our lives, much less "getting on" with them.

The day our healthcare system advocates killing hope is the day we have truly buried a system that operates "in the interests of the recipients."

You know what I hope? I hope I don't live to see that day realized.

In some very energetic people's lives you see something like wing flutter, where they alternate between doing great work and doing absolutely nothing. Externally this would look a lot like bipolar disorder.

Paul Graham may be a genius. Lisa Haneberg is the first person who told me to 'flap my wings' at a SIPA meeting, my first time visiting Silicon Valley, in 2006.

How right she was about being aflutter...

Related to the difficulties of delivering on time and on budget are other promises that should never be taken at face value:

"We want you to be a change agent and shake things up."

Bosses and boards often espouse change as a desirable goal but less often embrace its implications — e.g., firing old hands, closing or selling historically-core assets, or challenging organizational assumptions. Officials generally like things stirred but not shaken (unlike James Bond's martini). So if you are told that you've been hired or assigned to shake things up in the interests of change, don't believe it — even if it's clear that a turnaround is necessary.

This promise tastes dust the minute controversy surfaces. Controversy is embarrassing, time-consuming, and takes eyes off the situation needing change and onto the personality of the change agent.

From: "Promises You Should Never Believe (or Make) - Rosabeth Moss Kanter - HarvardBusiness.org."

Before you try to 'shake things up,' always consider, deeply, realistically, your motivations for doing so.

Maybe the only change agents who actually change things leave organizations where they've found 'stirring' ineffective and start their own gig?

Open to commentology...

If you still think YouTube is just for those durned kids, you're really missing out. We at FierceHealthcare have decided to present seven of our favorite healthcare videos, with topics ranging from the serious (a critique of U.S. public health efforts in controlling H1N1) to the purely silly (an anesthesiologist singing about his duty to "sit and listen to the beep.") 

For their creativity, educational value and pure passion, we hereby deem these videos Fierce! Have fun checking them out; we certainly did.

 
 Diagnosis Wenckebach

 

 
 Bringin' Safety Back

 

 
 UAB Emergency Department Rap

 

 
 Breathe

 

 
 The Anesthetist's Hymn

 

 
 H1N1 Rap

 

 
 H1N1 Influenza Update Briefing

Next: Diagnosis Wenckebach

From: "7 YouTube Healthcare Videos Worth Watching - FierceHealthcare."

PS - Chad Hurley, sorry again for not recognizing you right off at TEDMED. All the jumping around must have jostled my brain pan...