Eric, I am a nurse in California and completely agree with your 3-tiered system for personal health care. We have such wisdom and technology available to us today that we should be able to do a better job of reaching out to patients instead of forcing them to reach out to us. Thank you for sharing your experiences! BTW, lived and worked in OREGON for many years and love, love, love the Legacy system there : )
POV: You are watching this video because your connections academy Unit in Health Sciences is telling you to answer 5 questions based on what this Ted Talk. (No disrespect to this guy, of course, his story is important and he makes a lot of good issues with the health care system.)
There is already a branch of health care in the U.S. that puts the patient at the center of a team-based approach to medical care. It's called Osteopathic Medicine. An ostoepathic physician is a "D.O" instead of an "M.D." It's more holistic & hands on. The basic tenent is that a patient is not a "disease" but rather a person with a mind, body & spirit. There are 26 osteopathic medical schools operating across the U.S. today.
When the current system is utilized correctly, all of the goals Eric mentions are achieved. The patient does all they can at home. When they are in need of care, they visit their primary care physician. If the primary care physician feels that the patient needs to see a specialist, a specialist is seen. If multiple physicians are caring for the same patient, his or her records (allergies, medical history, medications, etc.) are communicated.
I agree with Dishman on the fact that health care is more beneficial when there is "care networking". When there is no communication between doctors, the patient may be paying more money to re-do tests and doctors may end up making mistakes. For example, if the patient goes to two different specialized doctors, and there is no communication, then neither doctor will have all of the information/records on the patient, which makes it easier for them to make mistakes that may be detrimental for the patient. One thing that can help in care networking is using Electronic Health Records (EHRs). In America, there is a push for EHRs but not all providers are on board. In order for EHRs to be useful, everyone needs to be on board. EHRs can help in sending over information/records for patients to different facilities/practices faster and more efficiently. It will cut costs for both the patients and providers, it will lower the rate of mistakes, and it will even be beneficial when doctors need to write out prescriptions. Overall, it will help to keep the patients healthy and it will help to reinvent health care in a positive way.
I definitely understand what you are saying. At the same time, I have to make the point that protests rarely accomplish things. Often they are composed of people who want to make noise, rather than people who want to change the course of history (to whatever degree). To accomplish things, an organization often works far better when it is a small group of people dedicated to creating a certain reality, rather than a group of people who are simply unhappy with the current state of affairs.
I agree with Eric. Health care is a system that should be more about the network. Mistakes are made frequently when there is no communication between the doctors and nurses, then the nurses and CNAs. If one goes to the hospital, then is sent to their own doctor for a follow up, if there is no communication between these two doctors, they could make mistakes and stop or start a new medication that could be potentially harmful to the patient. There needs to be a way where all doctors can communicate with each other and be able to keep the health care system running efficiently without making fatal mistakes, or mistakes at all.
I understand that your comment is relatively old but this is actually trying to be implemented through electronic health records(EHR). The forces at work are attempting to create a uniform system in which all health records can be accessed by any of the patient’s providers. This is great for three main different reasons. To begin with, it makes the patient’s chart more complete. It is harder for the provider to finish the patient’s encounter without filling in all of the information needed. Secondly, it makes reading the provider’s notes much easier. It creates a unified system that anyone should be able to readily read and comprehend. Lastly, it allows for better communication between providers. Through electronic health records, providers can send notes to each other with an attached patient. Basically everything becomes more organized. However, EHR also has a few problems. What happens if the internet goes out and doctors are not able to look up vital patient information? What if the EHR program fails and goes down(this happens often in our office and it is unbelievably annoying and inconvenient)? What happens if there is hack of the record database and the information gets into the wrong hands? What if insurance companies begin to use health records to grant or deny insurance? What happens if all the databases are hacked and all of the information is deleted? All of these are worries that will need to be addressed in the coming years. Another problem I have about Electronic Health Records is that not all doctors are using the same system. There are numerous programs for storing health records. There should be one integrated system to facilitate learning and patient transfer. Providers could learn one system and only have to adapt to system updates. Likewise, with a click of the button the provider could send the patient information to a doctor across the country. Likewise, the patient information could be tied to bracelet that the patient could wear.
As I see your point on frequent mistakes in the health field, I strongly disagree that the healthcare system should be based on networking and that it is a fix to the mistakes made by healthcare professionals. I believe that this will in turn cause more errors in diagnoses, tests, and the way people handle their health issues. In the first pillar mentioned by Eric Dishman, 'Care Anywhere', he states that hospitals are way outdated and it is time to come up with something new. Hospitals will never go out of style in my opinion, they are way too important in the world we live in to get rid of them as a whole. For a person to be able to give themselves proper care anywhere where a medical expert is not present, they will need to know the right medical terminology, be proficient with technology, be well enough to care for themselves, and have enough money to be able to afford whatever technology is needed for their illness. That is a lot to expect out of every person around us. Dishman really focused on how expensive hospitals are, yet he does not address how expensive the equipment the healthcare professionals use are. Yes, hospital bills are expensive, but the equipment used is way higher in price by far. Also, how reliable is technology? The costs of damages to the software or equipment, that can easily happen to any device, could cost an arm and a leg to a blue collar citizen. The poverty rate in our world is continuing to grow, and probably won't stop anytime soon, so adding extra dollars to people can deteriorate their life experience as a whole. Along with discussing this pillar, Dishman states, "you have to earn your way into a hospital or clinic by being sick enough for it." This statement is outrageous to think that a person would have to wait until their illness gets so bad that they are unable to treat it themselves with all the machines that doctors use to be able to check themselves into a medical facility. This I believe will be a major cause in increased fatality. Some people don't know how serious their illness is unless tested and told so by a doctor. Take cancer for example, there are many different symptoms of early signs of cancer. How is a patient to know if the fatigue they are experiencing is the start of Leukemia and not the common flu? If they receive the right medical attention and are ran through the correct tests by a healthcare professional, their chances of finding those results sooner are much higher than trying to figure it out on their own. In the discussion about the second pillar, 'Care Networking', DIshman talks about how we need to get rid of 'isolated specialists' and start working with 'multidisciplinary teams'. If we get rid of our healthcare professionals that specialize in a specific area, we lose a great amount of knowledge in those fields of work. For example, the difference in children and adults. If we get rid of pediatricians, how are we going to be certain any doctor can perform all the specific, necessary tests on children? When Dishman states in the video, "80% of medical error is caused by communication problems within a medical team", he definitely contradicts himself because the rate of software crashing or equipment breaking is at the same if not higher percentage. Therefore, it makes his argument on that invalid. Lastly, Eric Dishman says "a relationship with a doctor is a relic of the past". This comment I strongly disagree with because relationships with your doctor is one of the most important parts in your medical experience. In a doctor, you look for someone you can trust. Someone you can trust with yourself, your children, your parents, and any one of your friends or family. Having who knows you, medically, inside and out is a major advantage in the healthcare world. Lastly, the third pillar, 'Care Customization', Dishman discusses how there is too much 'guess work' in the medical field. He believes that humans being cared for are treated as averages not individuals in healthcare. "We should experiment on an avatar on software, not on a body in suffering,' Eric Dishman states. I strongly disagree with this comment because every person is different. Every human body requires different needs medically, therefore we should not build a software to analyze us when our doctor has been analyzing patients with different illnesses for much longer. Experience trumps innovation. A computer system may seem like it knows everything, but every software has it's flaws, and I don't think we are in the right time to be so dependent on technology for our health. The points Eric Dishman brings to the table are well thought out, creative, and innovative ideas, but I disagree with being so dependent on technology to take full care of our health. I also disagree with letting someone all of the complicated technology and machines that healthcare professionals use in hospitals on their own. It is not efficient costly as well as adapting to many different levels of intelligence.
During this TED talk, the patient explained the challenges he faced after being diagnosed with cancerous cells on his kidney, being unable to receive a kidney transplant, and only having 2-3 years to live. He felt not only extreme sadness but was also fearful. There was a lack of connection and trust between the patient and his physicians treating him. The physicians did not display a sense of empathy, nor did they communicate appropriately to the patient or between themselves. The patient felt isolated and alone. Not only that, the patient lived longer than the predicted 2-3 years and also received a kidney transplant later in life. The patient was asked about his condition multiple times and felt as though he was not heard or being listened to. The physicians were not conveying their knowledge in a way that was understandable to the patient and they also communicated false information. I feel that communicating misinformation goes against the ethical principle of beneficence. Additionally, the physicians were not being honest or truthful. Beneficence is the act of doing and promoting good among physicians. Beneficence is an important concept that highlights individual uniqueness. What might be an appropriate diagnostic or treatment plan for one patient might not be for another patient with a similar condition. Patients should not be lumped into categories, but rather treated individually. Care should be centered around the patient. The patient emphasized that what he wanted was a sense of connectedness to his team of healthcare professionals. What is important is to treat patients as unique individuals, listen, and communicate effectively. There needs to be a coordinated team of healthcare providers who work as a team to properly provide patient care. In class we learned about many different professional attributes which I feel apply to this specific scenario. These attributes of professionalism are: altruism and service, accountability, respect, integrity, honesty, compassion, excellence, self-regulation, and lifelong learning. One quote from lecture that was adapted from NBOME that I feel resonates with this patient-physician encounter is, “physicians must consistently demonstrate high moral and ethical standards in the conduct of medical education, training, research and practice. This includes properly establishing, maintaining, and concluding the physician-patient relationship in a manner that is altruistic, compassionate, conscientious, respectful and culturally sensitive.” All in all, it is crucial to practice these professional attributes to allow for proper patient care as well as avoid giving the patient misinformation which is largely unethical, and work as a coordinated team among interprofessional disciplines to ensure positive patient outcomes.
Eric made some great points about how our current health system is flawed. There needs to changes made to benefit health of all. But we have people out there that do not even have access to affordable health care that even allows them to go see a doctor. Since we do not have that how can we expect that patient should have this technology to permit "care anywhere" to be successful? Another issues I have with Eric's approach is that he said that the one-on-one between the patient and the doctor would be not more. But if you want the to happen how can you also want "care customization?" Because with "care customization" doctors and medical teams need to learn the goals and what is important to the patient. But if they don't have the interaction and relationship with the patient how will that happen? It can't. Also, for so many years its been, if you get sick, you go to the doctor and they help. Now people are being asked to do low level care on themselves? How can we ask of that when there are people in this nation that do not take pride or put time into their health? I think Eric's issues stem with the doctors on his original medical team. I would help that a lot of medical teams out there do work together for the good of the patient. Let's try to better the bonds and relationships between doctors and specialist before completely changing the current system. To throw away such a complex system seems like a mess. Let's modify it and use some of these ideas to help promote health for everyone. In addition, as an Occupational Therapy major, a lot of the things Eric lists are already roles of an OT. Like learning self, care and medication management.
Although this seems like the best case scenario for healthcare as a whole, “care anywhere”, “care networking”, and “care customization” will only work if people are willing to initiate it themselves and, sadly, most aren’t. Being involved with in home health care myself, I know people are stubborn in their ways and if the whose system were to change (even if for the better of all) there would be unwillingness to participate from a large audience. Yes, health is a main priority for most people, but from what I see, most people only look out for their well being and rely on a specialist or primary care physician to do the work for them; however, this is how the healthcare system is set up! To change that, along with everyone’s idea of healthcare, would be a monstrous task.
With the corona virus outbreak healthcare is being forced to move towards “telehealth”. Maybe this will be the turning point we needed to push medical care forward.
+Bubbles 007 Our society is advancing with new software and technology but we still hold onto certain aspects in our healthcare system that are simply outdated. Like Eric mentioned, we need to establish care anywhere and not just in one specific location, like a hospital. We essentially need to create access to medical care through new technology and programs so patients are able to receive the proper care. Eric points out the importance of “care networking.” Many doctors and specialists are too consumed in their own work to collaborate with other medical team members to help with the patient’s best interest. Instead of specializing in one area, Eric suggests that medical professionals should team up and create a unit that will communicate more efficiently and successfully for the patient’s needs. I find it scary when doctors and medical staff are not all on the same page. Through the miscommunication, mistakes (sometimes fatal) are made, especially when dealing with prescription medications. Communication is a must when it comes down to establishing an efficient medical team for patients. Again, I believe Eric is spot on with these ideas. Sometimes the best interest of the patient gets lost in all of the medical “scurry” that occurs within the healthcare system. Eric advocates for change in the healthcare system through the perspective of a patient who has encountered medical errors and discrepancies. It’s about time we break the mold on our current healthcare system and implement Eric’s ideas of change and improvement.
I think Healthcare should be a collaboration of not only Primary care Physicians with other physicians but with providers from all different fields. If a patient comes into the emergency room with a possible conjunctivitis, the provider should be able to contact an optometrist who will help him make a more accurate diagnosis. Likewise, an optometrist who sees a diabetic patient should be able to contact a physician to discuss the patient’s health and attempt to correct it. Medicine is so intertwined that it is impossible to separate it into individual branches. An interesting idea to promote this connectivity between the different professions is to create a class that takes students from each respective profession and allows them to connect. This would not only benefit them knowledge wise but financially as well. If the providers know other providers in the area, they are able to make referrals. I also agree with the idea of better communication of health care professionals in regards to medicine. My grandmother is constantly in and out of the hospital and they are always giving her different drugs and stopping her from taking other ones. The cardiologist will come in and give her one drug while the next day the lung doctor will come in and take her off the drug because it can cause harm to her already poor lungs. I work at a doctor’s office and I understand why it is so complicated to keep track of each person’s medications. You have to see so many patients each day in order to stay open and even more to make enough money to survive. It is a constant battle between seeing more patients and spending more time with the patients. Our office focuses on patient care(obviously) but this isn’t what all offices focus on. Some offices focus purely on numbers; the more patients they see the more money they make. However, what most people don’t understand is that this is not only immoral but also not always true. There is a niche of patients that understand what quality healthcare is and will pay for it. Thus both principles will make approximately the same amount of money. In general, most providers would rather see 4 patients and make 25$ each compared to 10 patients and make 10$ each. Patients come from all over the country to see us when they could go anywhere for their healthcare. We make a personal connection with the patients and greet them by name when they enter the office.
Not to pick on you in particular but that is exactly the problem. "Someone should do something." If change is ever going to happen it is going to be in large part by expressed public demand.
There are many points that Eric pointed out throughout his talk that had me thinking. Right from the beginning of his talk, Eric mentioned how he was being seen by six different physicians between two hospitals, yet not one could exactly pin-point the type of condition that he had. All that was mentioned was that he had a kidney problem, yet couldn't have a kidney transplant. What? When I first heard him say that, I immediately questioned it. Kidney problem, yet no transplant? Doesn't make any sense. Then he went on to say how he only has 2-3 more years to live. If I were in his shoes, I would have automatically shut down. When you hear a medical physician say that, you expect them to be 100% confident in what they are saying, if it comes to being life-ending. Obviously Eric lives a lot longer than the predicted 2-3 years, which is great, yet frustrating. If he were to of never ran into that woman in the lobby, or looked up the condition that affects the geriatric population, then he could have been in a "slump" or chose to not live his life out. It's frustrating because when other people, unlike Eric, are told that sometimes they have less than that to live. However, physicians need to make sure they are diagnosing patients with the correct conditions. Later on in this talk there was a statement about how sometimes sending patients to the hospitals, may not always be the best move. In addition to that, sending some of the sickest patients to the hospitals may even worsen their condition. People don't normally think of this but hospitals can be the most "sterile" yet most contaminating places at the same time. Think about it. Where do the most sick people go to seek treatment? Hospital. If someone is on the verge of death, most likely where are they? Hospital. A huge virus is going around and causing everyone to become very ill, where are they? Hospital. Hospitals are very beneficial to society, yet a silent killer. Sick people can become more sick, quicker just by going to the hospital. Going to a hospital or clinic can also break someone's wallet as well. No matter how long one is in there, they can be a financial burden to one's family. Sad, yet true. Eric made another point, he stated, "Eighty percent of medical errors are actually caused by communication and coordination problems amongst medical team members". WHAT! HOW?! Communication is key, especially when it comes to the health care field, and trying to diagnose a patient. He then went on to discuss how THREE different physicians prescribed him the same medicine in three different versions. He was suffering an over-dose problem. I do not understand how nobody noticed that before hand. There needs to be more and better communication between these health professionals, and egos to not get in the way anymore. Better teamwork skills, leads to better outcomes for the patients at the end of the day.
I think we should be more careful with Sean. Unlike you, he seems to internalise criticism. It has an effect on him. Lets be more sensitive in our dealings with him.
I see where the mistakes were made here. Obviously the doctors were not talking within each other. A personal health system could be good. It is amazing how Dishman can just show us an image of his kidney and see how it is doing. Technology is an amazing thing and is great that he can just hurry and see if anything looks wrong on his kidney. This reminds me of another video i have seen. People want more personal care with their doctors and quicker ways to see their doctor. It is true when Dishman says many people can't afford the expensive costs of using the machines doctors have. I'm surprised when he says " eighty percent of medical errors are actually caused by communication and coordination problems amongst medical team members." I have heard this in another video as well. Its horrible that they thought he had a heart problem when he was actually overdosing because they gave him so much medication. There needs to be more team work within health care. If everyone communicates better and more openly, there won't be so many flaws. I think no matter what we do our health care system will be flawed in some way.
the part when he talks about care coordination problem around the 9:00 minute mark can easily be solved with better integration of pharmacists in the health care team. pharmacists take 4 years of graduate school education solely dedicated to drugs but are still considered as "pill counting" useless members of the health care team. physicians need to get off their high horse and realize hindering integration of pharmacists in primary care is only causing more pain and suffering.
These new tools should be in the hands of doctors, not random individuals. That way, if something isn't right, the doctor will be able to say, "Hey wait a minute this doesn't seem right".
If the current systems are used correctly, the goals Eric mentioned would happen. It takes team work as he says but then you get into the problem of specialist and doctors are too busy to collaborate with each other. I feel we need better medical teams and set up a more personal level instead of just being a part of the "system". Let me know what you think I am a college student trying to learn more about healthcare and what comes along with it.
I agree that we need to first try and find a solution to the problem before jumping to a whole new system all together. If we got medical professionals the understand the importance of communicating with one another now, then a lot of the problems mentioned in this speech would be avoided. Some of the ideas mentioned makes a lot of sense to me. We shouldn't admit patients that are not sick enough to be in the hospital for fear of other complications, and we should make care of the patient centered around their goals. What is important to the patient should also be important to the health care professional. Some of his ideas however, I do not see to be very efficient. I think it would do more harm than good for healthcare and for our economy to make it an options to patients to be able to perform their own diagnostic tests. Not only would it push out the need for other healthcare professions, but it could also put the patient at risk and make their path to treatment even longer. The patient is not trained or have the credentials to be able to perform a test on themselves, but it also could be done wrong, which complicates the whole process if diagnosing. Also, if the image taken from this test shows an emergency or a critical condition, there is no health professional on hand to inform the patient and take action appropriately. Another fault in the speech is the idea of complete genomes. Not only would this be a very extensive process, but it would also take an incredible amount of money to complete. The idea sound good, however, it would tale a lot of time and resources to be able to avoid trial and error in patient treatment. Another issue with genomes is how can we trust that there is only the one purpose for them? There is no way of saying whether or not there could be other purposes to this information and if individuals would feel comfortable having complete genomes on file. It could be similarly related to the ethical debate of Neonatal Biobank and the presumed consent of including blood spots in their files. Although he has good ideas that could make a crucial difference in healthcare, it is important first to try and make the system that already exists more precise before implementing a whole new idea of healthcare that could come along with a whole new set of problems.
I believe the plan about people taking their health in their own hands. Take your medical records. Sign up to your insurance website and see your labs, bring notepad write questions take notes, etc. Yes, there are home devices that every person should have to check glucose levels, blood pressure, pH, etc. I could be wrong
I dont believe that supplying every patient with a personal ultrasound device is cheaper than having people come to one building and sharing the same, more powerful, accurate device. These devices are cool, but you arnt really working out what the real problem is. Just chucking existing tech in the rough direction.
"putting the patient at the center of a treatment team" yes it should be this way, but it is not. Also politicians should put the people at the center of their decisions, but that will not happen either.
As much as I encourage sharing information to benefit others, once those who back companies, or in some way hold stock within medical corporations, see an increasing decline of revenue: I think deals will be made and lives may even be threatened in a political fashion to ensure the status quo. Medical practitioners/investors are paid if you're sick, not healthy, in most cases. The system defeats itself since many work for these facilities. Basically, it will be brutal before it can get better.
It seems like, partially, it's suggested we re-initiate bartering and cut jobs from facilities. If the population reciprocates and takes measures to ensure a smooth transition, and regardless thereof, it seems entirely practical and preventative. The problem lies in the previous sentence; lessening income, even if for humanity on the whole, will not likely be taken with any manner of legitimate consideration within the upper echelon of financial supremacy (within the medical field, that is).
it won't happen because people give up and think that's the way the world is running. Unless you fight for the right thing for yourself, no one will fight it for you. Politicians and doctors fight well so far.
This would help to unclog hospitals, though experts will always be necessary. I don't care if you can tell exactly when you'll develop cancer and how to stop it from growing, technology will always have glitches and we'll always need help to properly set a broken bone or dislocated joint. Uness you'd rather we all become Bender.
As a 4th year year medical student who is to graduate in 1 month, I find this guy really disoriented. He does not realize that people with rare and complicated diseases like his need extensive testing. Also he thinks that he can incorporate medical technology into everyday life (never gonna happen because you need doctors to interpret all the data generated). He's right about personalized medicine because the aim is to treat the patient and not the population and this is the future of medicine.
@Abedalhamid44 haha you don't need doctors to interpret data you need engineers who know how to think. I went to medical school after getting my professional degree as software computer science n w/o UpToDate or DynaMed docs esp med students r walking shells of there former selves numb to fact of how many medical mistakes kill people. I graduated and said no thank you and have my conscious back. Med School edu esp rotations is stuck in the dark ages.. I develop apps n make millions now go figure
Eric, I am a nurse in California and completely agree with your 3-tiered system for personal health care. We have such wisdom and technology available to us today that we should be able to do a better job of reaching out to patients instead of forcing them to reach out to us. Thank you for sharing your experiences!
BTW, lived and worked in OREGON for many years and love, love, love the Legacy system there : )
POV: You are watching this video because your connections academy Unit in Health Sciences is telling you to answer 5 questions based on what this Ted Talk.
(No disrespect to this guy, of course, his story is important and he makes a lot of good issues with the health care system.)
😂
There is already a branch of health care in the U.S. that puts the patient at the center of a team-based approach to medical care. It's called Osteopathic Medicine.
An ostoepathic physician is a "D.O" instead of an "M.D." It's more holistic & hands on. The basic tenent is that a patient is not a "disease" but rather a person with a mind, body & spirit.
There are 26 osteopathic medical schools operating across the U.S. today.
this was quite an emotional talk, it is good to see people who are emotionally attached to something try to make a difference
When the current system is utilized correctly, all of the goals Eric mentions are achieved. The patient does all they can at home. When they are in need of care, they visit their primary care physician. If the primary care physician feels that the patient needs to see a specialist, a specialist is seen. If multiple physicians are caring for the same patient, his or her records (allergies, medical history, medications, etc.) are communicated.
MANY people want to start it, but we need a push! I hope to be part of the push : D
I agree with Dishman on the fact that health care is more beneficial when there is "care networking". When there is no communication between doctors, the patient may be paying more money to re-do tests and doctors may end up making mistakes. For example, if the patient goes to two different specialized doctors, and there is no communication, then neither doctor will have all of the information/records on the patient, which makes it easier for them to make mistakes that may be detrimental for the patient.
One thing that can help in care networking is using Electronic Health Records (EHRs). In America, there is a push for EHRs but not all providers are on board. In order for EHRs to be useful, everyone needs to be on board. EHRs can help in sending over information/records for patients to different facilities/practices faster and more efficiently. It will cut costs for both the patients and providers, it will lower the rate of mistakes, and it will even be beneficial when doctors need to write out prescriptions. Overall, it will help to keep the patients healthy and it will help to reinvent health care in a positive way.
No relation... but Mr. Dishman truly does get it. As a nurse, I hope to be a part of this movement. To treat our patients holistically. Great video.
I definitely understand what you are saying. At the same time, I have to make the point that protests rarely accomplish things. Often they are composed of people who want to make noise, rather than people who want to change the course of history (to whatever degree). To accomplish things, an organization often works far better when it is a small group of people dedicated to creating a certain reality, rather than a group of people who are simply unhappy with the current state of affairs.
I agree with Eric. Health care is a system that should be more about the network. Mistakes are made frequently when there is no communication between the doctors and nurses, then the nurses and CNAs. If one goes to the hospital, then is sent to their own doctor for a follow up, if there is no communication between these two doctors, they could make mistakes and stop or start a new medication that could be potentially harmful to the patient. There needs to be a way where all doctors can communicate with each other and be able to keep the health care system running efficiently without making fatal mistakes, or mistakes at all.
I understand that your comment is relatively old but this is actually trying to be implemented through electronic health records(EHR). The forces at work are attempting to create a uniform system in which all health records can be accessed by any of the patient’s providers. This is great for three main different reasons. To begin with, it makes the patient’s chart more complete. It is harder for the provider to finish the patient’s encounter without filling in all of the information needed. Secondly, it makes reading the provider’s notes much easier. It creates a unified system that anyone should be able to readily read and comprehend. Lastly, it allows for better communication between providers. Through electronic health records, providers can send notes to each other with an attached patient. Basically everything becomes more organized. However, EHR also has a few problems. What happens if the internet goes out and doctors are not able to look up vital patient information? What if the EHR program fails and goes down(this happens often in our office and it is unbelievably annoying and inconvenient)? What happens if there is hack of the record database and the information gets into the wrong hands? What if insurance companies begin to use health records to grant or deny insurance? What happens if all the databases are hacked and all of the information is deleted? All of these are worries that will need to be addressed in the coming years.
Another problem I have about Electronic Health Records is that not all doctors are using the same system. There are numerous programs for storing health records. There should be one integrated system to facilitate learning and patient transfer. Providers could learn one system and only have to adapt to system updates. Likewise, with a click of the button the provider could send the patient information to a doctor across the country. Likewise, the patient information could be tied to bracelet that the patient could wear.
As I see your point on frequent mistakes in the health field, I strongly disagree that the healthcare system should be based on networking and that it is a fix to the mistakes made by healthcare professionals. I believe that this will in turn cause more errors in diagnoses, tests, and the way people handle their health issues.
In the first pillar mentioned by Eric Dishman, 'Care Anywhere', he states that hospitals are way outdated and it is time to come up with something new. Hospitals will never go out of style in my opinion, they are way too important in the world we live in to get rid of them as a whole. For a person to be able to give themselves proper care anywhere where a medical expert is not present, they will need to know the right medical terminology, be proficient with technology, be well enough to care for themselves, and have enough money to be able to afford whatever technology is needed for their illness. That is a lot to expect out of every person around us. Dishman really focused on how expensive hospitals are, yet he does not address how expensive the equipment the healthcare professionals use are. Yes, hospital bills are expensive, but the equipment used is way higher in price by far. Also, how reliable is technology? The costs of damages to the software or equipment, that can easily happen to any device, could cost an arm and a leg to a blue collar citizen. The poverty rate in our world is continuing to grow, and probably won't stop anytime soon, so adding extra dollars to people can deteriorate their life experience as a whole. Along with discussing this pillar, Dishman states, "you have to earn your way into a hospital or clinic by being sick enough for it." This statement is outrageous to think that a person would have to wait until their illness gets so bad that they are unable to treat it themselves with all the machines that doctors use to be able to check themselves into a medical facility. This I believe will be a major cause in increased fatality. Some people don't know how serious their illness is unless tested and told so by a doctor. Take cancer for example, there are many different symptoms of early signs of cancer. How is a patient to know if the fatigue they are experiencing is the start of Leukemia and not the common flu? If they receive the right medical attention and are ran through the correct tests by a healthcare professional, their chances of finding those results sooner are much higher than trying to figure it out on their own.
In the discussion about the second pillar, 'Care Networking', DIshman talks about how we need to get rid of 'isolated specialists' and start working with 'multidisciplinary teams'. If we get rid of our healthcare professionals that specialize in a specific area, we lose a great amount of knowledge in those fields of work. For example, the difference in children and adults. If we get rid of pediatricians, how are we going to be certain any doctor can perform all the specific, necessary tests on children? When Dishman states in the video, "80% of medical error is caused by communication problems within a medical team", he definitely contradicts himself because the rate of software crashing or equipment breaking is at the same if not higher percentage. Therefore, it makes his argument on that invalid. Lastly, Eric Dishman says "a relationship with a doctor is a relic of the past". This comment I strongly disagree with because relationships with your doctor is one of the most important parts in your medical experience. In a doctor, you look for someone you can trust. Someone you can trust with yourself, your children, your parents, and any one of your friends or family. Having who knows you, medically, inside and out is a major advantage in the healthcare world.
Lastly, the third pillar, 'Care Customization', Dishman discusses how there is too much 'guess work' in the medical field. He believes that humans being cared for are treated as averages not individuals in healthcare. "We should experiment on an avatar on software, not on a body in suffering,' Eric Dishman states. I strongly disagree with this comment because every person is different. Every human body requires different needs medically, therefore we should not build a software to analyze us when our doctor has been analyzing patients with different illnesses for much longer. Experience trumps innovation. A computer system may seem like it knows everything, but every software has it's flaws, and I don't think we are in the right time to be so dependent on technology for our health.
The points Eric Dishman brings to the table are well thought out, creative, and innovative ideas, but I disagree with being so dependent on technology to take full care of our health. I also disagree with letting someone all of the complicated technology and machines that healthcare professionals use in hospitals on their own. It is not efficient costly as well as adapting to many different levels of intelligence.
SOunds like a sadly typical journey through health. So pleased he was able to navigate this and design treatment that allowed him to live.
During this TED talk, the patient explained the challenges he faced after being diagnosed with cancerous cells on his kidney, being unable to receive a kidney transplant, and only having 2-3 years to live. He felt not only extreme sadness but was also fearful. There was a lack of connection and trust between the patient and his physicians treating him. The physicians did not display a sense of empathy, nor did they communicate appropriately to the patient or between themselves. The patient felt isolated and alone. Not only that, the patient lived longer than the predicted 2-3 years and also received a kidney transplant later in life. The patient was asked about his condition multiple times and felt as though he was not heard or being listened to. The physicians were not conveying their knowledge in a way that was understandable to the patient and they also communicated false information. I feel that communicating misinformation goes against the ethical principle of beneficence. Additionally, the physicians were not being honest or truthful. Beneficence is the act of doing and promoting good among physicians. Beneficence is an important concept that highlights individual uniqueness. What might be an appropriate diagnostic or treatment plan for one patient might not be for another patient with a similar condition. Patients should not be lumped into categories, but rather treated individually. Care should be centered around the patient. The patient emphasized that what he wanted was a sense of connectedness to his team of healthcare professionals. What is important is to treat patients as unique individuals, listen, and communicate effectively. There needs to be a coordinated team of healthcare providers who work as a team to properly provide patient care. In class we learned about many different professional attributes which I feel apply to this specific scenario. These attributes of professionalism are: altruism and service, accountability, respect, integrity, honesty, compassion, excellence, self-regulation, and lifelong learning. One quote from lecture that was adapted from NBOME that I feel resonates with this patient-physician encounter is, “physicians must consistently demonstrate high moral and ethical standards in the conduct of medical education, training, research and practice. This includes properly establishing, maintaining, and concluding the physician-patient relationship in a manner that is altruistic, compassionate, conscientious, respectful and culturally sensitive.” All in all, it is crucial to practice these professional attributes to allow for proper patient care as well as avoid giving the patient misinformation which is largely unethical, and work as a coordinated team among interprofessional disciplines to ensure positive patient outcomes.
Eric made some great points about how our current health system is flawed. There needs to changes made to benefit health of all. But we have people out there that do not even have access to affordable health care that even allows them to go see a doctor. Since we do not have that how can we expect that patient should have this technology to permit "care anywhere" to be successful? Another issues I have with Eric's approach is that he said that the one-on-one between the patient and the doctor would be not more. But if you want the to happen how can you also want "care customization?" Because with "care customization" doctors and medical teams need to learn the goals and what is important to the patient. But if they don't have the interaction and relationship with the patient how will that happen? It can't. Also, for so many years its been, if you get sick, you go to the doctor and they help. Now people are being asked to do low level care on themselves? How can we ask of that when there are people in this nation that do not take pride or put time into their health? I think Eric's issues stem with the doctors on his original medical team. I would help that a lot of medical teams out there do work together for the good of the patient. Let's try to better the bonds and relationships between doctors and specialist before completely changing the current system. To throw away such a complex system seems like a mess. Let's modify it and use some of these ideas to help promote health for everyone. In addition, as an Occupational Therapy major, a lot of the things Eric lists are already roles of an OT. Like learning self, care and medication management.
Although this seems like the best case scenario for healthcare as a whole, “care anywhere”, “care networking”, and “care customization” will only work if people are willing to initiate it themselves and, sadly, most aren’t. Being involved with in home health care myself, I know people are stubborn in their ways and if the whose system were to change (even if for the better of all) there would be unwillingness to participate from a large audience. Yes, health is a main priority for most people, but from what I see, most people only look out for their well being and rely on a specialist or primary care physician to do the work for them; however, this is how the healthcare system is set up! To change that, along with everyone’s idea of healthcare, would be a monstrous task.
Full Circle America is doing this NOW. Our program is a person-centered, medical home program that builds a network of support around the individual.
That" guy. talking true bottom of he"s heart an what a lovely woman to give that kindney to Him!
This dude is great. He's totally got it.
With the corona virus outbreak healthcare is being forced to move towards “telehealth”. Maybe this will be the turning point we needed to push medical care forward.
Eric's perspective on the improvement for our healthcare system is spot on. I could not agree more.
+Bubbles 007
Our society is advancing with new
software and technology but we still hold onto certain aspects in our
healthcare system that are simply outdated. Like Eric mentioned, we need to establish care anywhere and not just in one specific location, like a hospital. We essentially need to create access to medical care through new technology and programs so patients are able to receive the proper care. Eric points out the importance of “care networking.” Many doctors and specialists are too consumed in their own work to collaborate with other medical team members to help with
the patient’s best interest. Instead of specializing in one area, Eric suggests that medical professionals should team up and create a unit that will communicate more efficiently and successfully for the patient’s needs. I find it scary when doctors and medical staff
are not all on the same page. Through the miscommunication, mistakes (sometimes fatal) are made, especially when dealing with prescription medications. Communication is a must when it comes down to establishing an efficient medical team for patients. Again, I believe Eric is spot on with these ideas. Sometimes the best interest of the patient gets lost in all of the medical “scurry” that occurs within the healthcare system. Eric advocates for change in the healthcare system through the perspective of a patient who has encountered medical errors and discrepancies. It’s about time we break the mold on our current healthcare system and implement Eric’s ideas of change and improvement.
I think Healthcare should be a collaboration of not only Primary care Physicians with other physicians but with providers from all different fields. If a patient comes into the emergency room with a possible conjunctivitis, the provider should be able to contact an optometrist who will help him make a more accurate diagnosis. Likewise, an optometrist who sees a diabetic patient should be able to contact a physician to discuss the patient’s health and attempt to correct it. Medicine is so intertwined that it is impossible to separate it into individual branches. An interesting idea to promote this connectivity between the different professions is to create a class that takes students from each respective profession and allows them to connect. This would not only benefit them knowledge wise but financially as well. If the providers know other providers in the area, they are able to make referrals.
I also agree with the idea of better communication of health care professionals in regards to medicine. My grandmother is constantly in and out of the hospital and they are always giving her different drugs and stopping her from taking other ones. The cardiologist will come in and give her one drug while the next day the lung doctor will come in and take her off the drug because it can cause harm to her already poor lungs. I work at a doctor’s office and I understand why it is so complicated to keep track of each person’s medications. You have to see so many patients each day in order to stay open and even more to make enough money to survive. It is a constant battle between seeing more patients and spending more time with the patients. Our office focuses on patient care(obviously) but this isn’t what all offices focus on. Some offices focus purely on numbers; the more patients they see the more money they make. However, what most people don’t understand is that this is not only immoral but also not always true. There is a niche of patients that understand what quality healthcare is and will pay for it. Thus both principles will make approximately the same amount of money. In general, most providers would rather see 4 patients and make 25$ each compared to 10 patients and make 10$ each. Patients come from all over the country to see us when they could go anywhere for their healthcare. We make a personal connection with the patients and greet them by name when they enter the office.
youre totally right!
yes ,there is always a solution of the problem inside the problem,thanks for nice analysis ..
Not to pick on you in particular but that is exactly the problem. "Someone should do something." If change is ever going to happen it is going to be in large part by expressed public demand.
So, who gets sued if somebody end up dead or misdiagnosed?
need to make laws on amount of children before we start playing as a team
There are many points that Eric pointed out throughout his talk that had me thinking. Right from the beginning of his talk, Eric mentioned how he was being seen by six different physicians between two hospitals, yet not one could exactly pin-point the type of condition that he had. All that was mentioned was that he had a kidney problem, yet couldn't have a kidney transplant. What? When I first heard him say that, I immediately questioned it. Kidney problem, yet no transplant? Doesn't make any sense. Then he went on to say how he only has 2-3 more years to live. If I were in his shoes, I would have automatically shut down. When you hear a medical physician say that, you expect them to be 100% confident in what they are saying, if it comes to being life-ending. Obviously Eric lives a lot longer than the predicted 2-3 years, which is great, yet frustrating. If he were to of never ran into that woman in the lobby, or looked up the condition that affects the geriatric population, then he could have been in a "slump" or chose to not live his life out. It's frustrating because when other people, unlike Eric, are told that sometimes they have less than that to live. However, physicians need to make sure they are diagnosing patients with the correct conditions.
Later on in this talk there was a statement about how sometimes sending patients to the hospitals, may not always be the best move. In addition to that, sending some of the sickest patients to the hospitals may even worsen their condition. People don't normally think of this but hospitals can be the most "sterile" yet most contaminating places at the same time. Think about it. Where do the most sick people go to seek treatment? Hospital. If someone is on the verge of death, most likely where are they? Hospital. A huge virus is going around and causing everyone to become very ill, where are they? Hospital. Hospitals are very beneficial to society, yet a silent killer. Sick people can become more sick, quicker just by going to the hospital. Going to a hospital or clinic can also break someone's wallet as well. No matter how long one is in there, they can be a financial burden to one's family. Sad, yet true.
Eric made another point, he stated, "Eighty percent of medical errors are actually caused by communication and coordination problems amongst medical team members". WHAT! HOW?! Communication is key, especially when it comes to the health care field, and trying to diagnose a patient. He then went on to discuss how THREE different physicians prescribed him the same medicine in three different versions. He was suffering an over-dose problem. I do not understand how nobody noticed that before hand. There needs to be more and better communication between these health professionals, and egos to not get in the way anymore. Better teamwork skills, leads to better outcomes for the patients at the end of the day.
So he's talking about holistic medicine rather than scientific medicine. This isn't revolutionary, it's been around for years.
I think we should be more careful with Sean. Unlike you, he seems to internalise criticism. It has an effect on him. Lets be more sensitive in our dealings with him.
I see where the mistakes were made here. Obviously the doctors were not talking within each other. A personal health system could be good. It is amazing how Dishman can just show us an image of his kidney and see how it is doing. Technology is an amazing thing and is great that he can just hurry and see if anything looks wrong on his kidney. This reminds me of another video i have seen. People want more personal care with their doctors and quicker ways to see their doctor. It is true when Dishman says many people can't afford the expensive costs of using the machines doctors have. I'm surprised when he says " eighty percent of medical errors are actually caused by communication and coordination problems amongst medical team members." I have heard this in another video as well. Its horrible that they thought he had a heart problem when he was actually overdosing because they gave him so much medication. There needs to be more team work within health care. If everyone communicates better and more openly, there won't be so many flaws. I think no matter what we do our health care system will be flawed in some way.
This is a bit too sappy for my taste. I like TED talks with hard facts, not soft emotions.
This might work only if the tutorials are reviewed an approved by a large number of individual specialist.
I agree with him, the purpose of this idea is very good but need the government incentive to beggin.
the part when he talks about care coordination problem around the 9:00 minute mark can easily be solved with better integration of pharmacists in the health care team. pharmacists take 4 years of graduate school education solely dedicated to drugs but are still considered as "pill counting" useless members of the health care team. physicians need to get off their high horse and realize hindering integration of pharmacists in primary care is only causing more pain and suffering.
These new tools should be in the hands of doctors, not random individuals. That way, if something isn't right, the doctor will be able to say, "Hey wait a minute this doesn't seem right".
If the current systems are used correctly, the goals Eric mentioned would happen. It takes team work as he says but then you get into the problem of specialist and doctors are too busy to collaborate with each other. I feel we need better medical teams and set up a more personal level instead of just being a part of the "system".
Let me know what you think I am a college student trying to learn more about healthcare and what comes along with it.
I agree that we need to first try and find a solution to the problem before jumping to a whole new system all together. If we got medical professionals the understand the importance of communicating with one another now, then a lot of the problems mentioned in this speech would be avoided. Some of the ideas mentioned makes a lot of sense to me. We shouldn't admit patients that are not sick enough to be in the hospital for fear of other complications, and we should make care of the patient centered around their goals. What is important to the patient should also be important to the health care professional. Some of his ideas however, I do not see to be very efficient. I think it would do more harm than good for healthcare and for our economy to make it an options to patients to be able to perform their own diagnostic tests. Not only would it push out the need for other healthcare professions, but it could also put the patient at risk and make their path to treatment even longer. The patient is not trained or have the credentials to be able to perform a test on themselves, but it also could be done wrong, which complicates the whole process if diagnosing. Also, if the image taken from this test shows an emergency or a critical condition, there is no health professional on hand to inform the patient and take action appropriately. Another fault in the speech is the idea of complete genomes. Not only would this be a very extensive process, but it would also take an incredible amount of money to complete. The idea sound good, however, it would tale a lot of time and resources to be able to avoid trial and error in patient treatment. Another issue with genomes is how can we trust that there is only the one purpose for them? There is no way of saying whether or not there could be other purposes to this information and if individuals would feel comfortable having complete genomes on file. It could be similarly related to the ethical debate of Neonatal Biobank and the presumed consent of including blood spots in their files. Although he has good ideas that could make a crucial difference in healthcare, it is important first to try and make the system that already exists more precise before implementing a whole new idea of healthcare that could come along with a whole new set of problems.
Them feels!
but doing something for some group, means NOT doing something for another( familiar, political, or emotional-philosophic) i agree with you, though.
I don't trust anyone who says " ex specially "
wait, the correct diagnosis came through genome sequencing? how will something like that ever be cheaper than traditional medicine?
Is the new model telemedicine what he is referring about?
I believe the plan about people taking their health in their own hands. Take your medical records. Sign up to your insurance website and see your labs, bring notepad write questions take notes, etc. Yes, there are home devices that every person should have to check glucose levels, blood pressure, pH, etc. I could be wrong
I dont believe that supplying every patient with a personal ultrasound device is cheaper than having people come to one building and sharing the same, more powerful, accurate device. These devices are cool, but you arnt really working out what the real problem is. Just chucking existing tech in the rough direction.
"putting the patient at the center of a treatment team"
yes it should be this way, but it is not.
Also politicians should put the people at the center of their decisions, but that will not happen either.
totally
Someone should do something to get rid of those people.
As much as I encourage sharing information to benefit others, once those who back companies, or in some way hold stock within medical corporations, see an increasing decline of revenue: I think deals will be made and lives may even be threatened in a political fashion to ensure the status quo. Medical practitioners/investors are paid if you're sick, not healthy, in most cases.
The system defeats itself since many work for these facilities.
Basically, it will be brutal before it can get better.
So, basically, you want an online personal physician. Yeah, I think that's affordable.
It seems like, partially, it's suggested we re-initiate bartering and cut jobs from facilities. If the population reciprocates and takes measures to ensure a smooth transition, and regardless thereof, it seems entirely practical and preventative. The problem lies in the previous sentence; lessening income, even if for humanity on the whole, will not likely be taken with any manner of legitimate consideration within the upper echelon of financial supremacy (within the medical field, that is).
Not so sure about this
it won't happen because people give up and think that's the way the world is running. Unless you fight for the right thing for yourself, no one will fight it for you. Politicians and doctors fight well so far.
You mean emotion?
My thought exactly. That's when he lost me.
just need medical tricorder and a heal ray lol
I think the hard fact of this story is his(her) kidney and he being alive.
May name is dishma
That wouldn't happen in a perfect world.
placebo your way to health
This would help to unclog hospitals, though experts will always be necessary.
I don't care if you can tell exactly when you'll develop cancer and how to stop it from growing, technology will always have glitches and we'll always need help to properly set a broken bone or dislocated joint. Uness you'd rather we all become Bender.
so the kids go off to war, and the elderly are kept alive by 20-30 year olds?
your view allows for no greatness, i agree that in our current world, that isn't happening, but we can work toward it happening
Implant? No thanks!
As a 4th year year medical student who is to graduate in 1 month, I find this guy really disoriented. He does not realize that people with rare and complicated diseases like his need extensive testing. Also he thinks that he can incorporate medical technology into everyday life (never gonna happen because you need doctors to interpret all the data generated). He's right about personalized medicine because the aim is to treat the patient and not the population and this is the future of medicine.
I really love the idea behind this but I dont like how much he has a ranting voice or inflection in his voice.
07:48 ... hehe...
we already had that, it called follow the doctor instruction. dietitian and nurse shut up hahhaa
What and should astronomers put stars in the middle of our solar system?
You sir are ridiculous! :P
just Waooo
@Abedalhamid44 haha you don't need doctors to interpret data you need engineers who know how to think. I went to medical school after getting my professional degree as software computer science n w/o UpToDate or DynaMed docs esp med students r walking shells of there former selves numb to fact of how many medical mistakes kill people. I graduated and said no thank you and have my conscious back. Med School edu esp rotations is stuck in the dark ages.. I develop apps n make millions now go figure
bill gates is watching you!! haha +1
gamification
weee