About Me
I took a wrong turn on Fruit Street (in front of the Massachusetts General Hospital) 15 years ago and wound up an accidental tourist in the land of connected health (then called telemedicine). Since then I’ve had enormous fun and fulfillment working with a talented group of individuals whose mission is to bring care to the patient, where the patient is, when the patient needs it and to offer the patient tools to enable her to be her own provider whenever possible. The term “connected health” reflects the range of opportunities for technology-enabled care programs and the potential for new strategies in healthcare delivery.
A division of Partners HealthCare, the Center for Connected Health works with Harvard Medical School-affiliated teaching hospitals, including Massachusetts General and Brigham and Women’s Hospitals. I am also active in my specialty of Dermatology both as a clinician and educator.
I enjoy questioning assumptions about healthcare delivery, particularly those that involve the assumed need for a patient and provider to meet face to face for healthcare to happen. We are on the verge of a profound change in healthcare delivery driven by the synergy between three trends: personalized medicine, connected health and payment reform.
- Joseph Kvedar, MD
Director, Center for Connected Health, Partners HealthCare
I feel like a kindred spirit, at least in terms of learning how to use these new social media tools to evangelize new options in healthcare. At first it appears we are talking to ourselves. The experts assure us, – if you build it, they will come.
We will see. As someone who designed an EMR for the paperless physician office 15 years ago, I am persuaded that sometimes you wait years to see the fruits of our labors. Hope you’ll check out our latest “fruit” – an innovative method of assessing muscle effort to help prevent injury and rehabilitate more effectively through the conversion of muscle vibration to force.
Dr Kvedar – what if we redefined the word ”patient’ to mean people who have limited or no autonomy in a process due to incapacity? I would suggest substituting it in most cases with consumer, customer or client. If we imagined a spectrum between autonomy and dependence, with patient firmly at the dependence end of the spectrum, do you think we could help solve the positioning of the healthcare debate? Investment vs cost, education (teaching) vs passive acceptance (& misunderstanding & non-compliance). The list is endless. If consume healthcare, we are also investors. We buy a service (knowledge, time, experience, etc) which has a market price.
wow. I would be hesitant to label all patients as dependent or incapacitated. I’ve had a number of needs of the healthcare system in the last few years that labeled me as a patient, but I in no way feel dependent or incapacitated. maybe I missed the point.
I would agree with Dr. Kvedar’s hesitancy to use that definition for patient. I miss the point of why we would do this.
Along with the new label would come the stigma that comes with the newly-defined “dependency” the word would evoke. The sociological implications, I believe, would do more harm than good.
For example, I am a “disabled” vet. The immediate image that, unfortunately, comes to mind for most people is of a wheelchair-bound, jobless, person who is totally dependent upon others for his care.
In reality, I am a published researcher with credentials and a full life who hasn’t been in a wheelchair nor dependent on someone for continual care. My disability is a spinal injury but it does not require any more than careful living on my part rather than special equipment that restricts me. There are many more like me (with even greater disabilities) who you would walk by on the street and never know were “Disabled” Veterans.
In short, in less than a century we have come a long way from envisioning only death when people are admitted into hospitals or have treatments performed for whatever reason. TO change the definition to mean dependent or incapacitated would have serious sociological ramifications.
A patient in today’s context means “a consumer of health-care” to alter that would be a step backward.
Have I missed the point of re-labeling? If so, please illuminate me further. I always appreciate learning more………..
My point is that language is really important. I am not sure that I agree that patient means “a consumer of healthcare”. If this were true, I would not try to change this. I just don’t believe that it is so and can be fairly certain that it is not so here in Ireland nor in the other countries in which my company invests – the UK, France, Austria, the US, etc. The word patient means a lot of things to different people and it can be a loaded term. I am merely suggesting a much narrower definition. If we were primarily healthcare consumers, we would be having very different discussions about cost versus value or investment, entitlements versus responsibility, etc. As I say, I think the issue is one of definition and that we use the word patient to mean too many things.
Sorry to leave an unrelated comment, but I couldn’t find any contact info for you. I’m wondering if you’d be interested in having a guest post on your site. Please drop me an e-mail at elizabethomalley39@gmail.com. Thanks!
Dr. Kvedar,
I really appreciate all of your thoughts on self-quantification. As a PhD nursing student whose focus is on driving behavior change interventions, your insights are most helpful. Would you be interested in speaking about this via phone sometime?
Ashley Reynolds, MSN, RN, ACSM-HFS
http://www.linkedin.com/profile/view?id=37996730&trk=tab_pro
you can feel free to email me. jkvedar@partners.org
we’ll try to set up a time to talk if you like
Dr. Kvedar,
Our many problems with healthcare, it appears, stem from the “industry” having gone ahead of ourselves. Three sets of contradictions manifest themselves, particularly in the US, but also increasingly elsewhere in the world:
1. Innovation and technology versus the compulsive “need” to use them in a service setting, raising costs all around;
2. Specialization versus general practice or family medicine, that have manifested themselves in glorifying the former and altering incentives at the supply level; and
3. Indirect payment mechanisms (employer insurance) versus purchase as consumers, resulting in inability of consumers of healthcare to appreciate expense and according importance to consumption patterns and how behaviors could alter them.
New and evolving technology could help, but only if underlying structures are disrupted and incentives created to recast these contradictions. What can be done? For one, it might help if direct out-of-pocket expense is encouraged with appropriate tax incentives for both consumers and providers of preventive or primary care. This would also require means to foster competition in the retail marketplace for such out-of-pocket services. For another, de-incentivize consumption of high expense care that is not life threatening. This could include dis-incentives to practitioners and providers that direct patients to such forms of care (including endless tests). Some of these are already being done, but these are piecemeal without an all-encompassing strategic perspective. Somehow, we need to get back to basics – that of prevention being better than cure.
nice thoughts and well articulated.
Hi Dr Kvedar,
My name is Liz and I am the community manager of I Had Cancer (ihadcancer.com) – an international social support network for everyone who has/had cancer or is supporting someone through the disease. Our community is well over 5000 members strong from 65+ different countries; we launched 5 months ago. I wanted inquire whether you would be willing to feature us, based on the subjects you cover, I thought it would be a good fit.
Our service focuses on creating real, organic connections between people in similar situations. Our community search filters are intuitive and very easy to use. You can search for others by type of cancer, type of user (supporter, survivor and fighter), age, year of diagnosis, gender and location and a number of other interesting features that help facilitate communication between users (check out Dear Cancer – a soap box for cancer).
We hope that by allowing members to easily connect, share experiences and information, the acquired knowledge will turn them into medical self-advocates. Our founder, Mailet Lopez (33 years old at the time) survived breast cancer due to a chance encounter with a stranger – I would love to put you in contact with her. I encourage you to check out the site for yourself to really understand what our site does and how it works.
We have gotten some wonderful press recently abroad and aim to generate it across the US. http://www.thesun.co.uk/sol/homepage/woman/health/health/3868932/Social-network-for-cancer-survivors.html.
Looking forward to hearing from you. If you choose not to feature us, please forward this email to someone who might be interested or please provide me with their contact information. Thanks.
Best of health and wealth to you,
-Liz@ihadcancer.com