Category Archives: #consumerism

The Patient Waiting Room Rethought

Photo curtesy of Joseph Babaian (@JoeBabaian)

Yesterday Joe sent this tweet asking the #HCLDR family their opinions on the opportunities for improving the design within the above spaces.

My initial gut reaction, as many other people, was in pointing out the obvious. Things such as the TV, the picture on the wall, the chairs, the framed signed on the table, a lamp that is off, etc.

I even questioned the need for a waiting room? In theory, no patient should have to wait, and therefore, the waiting room could be eliminated.

As I began to ponder the question during my 2 hour drive today, I began to reframe the question in my mind.

Instead of asking what is wrong with the space or how to improve the design or the need for a waiting room, I started to think about challenges patients highlight.

Topics that we discuss during the weekly chats of #HCLDR.

What if we reframe and ask ourselves the following:

How can we help patients connect with one another?

In thinking about the space above (left picture specifically), I would rearrange the furniture to be in small circles or groups versus in a line.

Perhaps instead of the local news or Ellen on the TV I would show video’s from YouTube about nutrition, or the clinicians, or an important topic that is relevant to the community of patients congregating.

Maybe I would have a social worker in the space to help facilitate sharing, asking questions, and prepping/introducing those new patients with those that are coming back for a follow up.

Maybe the space should be more about sharing our stories, our common experiences, our fears, our questions with one another and use it as a learning opportunity? Maybe this is the space where we impact health literacy. Or address access to improved nutrition. Or share resources within the community.

Perhaps the space has nothing to do with waiting, but everything with building a tribe of patients that share a common thread and can learn from one each other’s experience.

Perhaps knowing a patient like me, the one sitting next to me, helps me realize that we do things like this.

We connect. We share. We learn. We grow.

Perhaps care at the N of 1 begins by connecting patients in the waiting room?

Let’s rename it the sharing room.

As always you can feel free to email me at cancergeek@gmail.com or follow me on Twitter @cancergeek

~Cancergeek

Patients Created Crowdsourcing

crowd

Crowdsourcing is a phenomena that was coined in 2005 by Jeff Howe and Mark Robinson, editors at Wired magazine. Their initial definition was specific to how businesses at that time were were leveraging the internet to outsource work to individuals.

3 years later, Daren C. Brabham was the first person to use the term in a scholarly article. He also wrote a book by the same name, Crowdsourcing, in 2013. (Jeff Howe wrote a book by the same title earlier in 2009: find it here)

Daren’s definition in his paper was the following:

Crowdsourcing is a type of participative online activity in which an individual, an institution, a non-profit organization, or company proposes to a group of individuals of varying knowledge, heterogeneity, and number, via a flexible open call, the voluntary undertaking of a task. The undertaking of the task, of variable complexity and modularity, and in which the crowd should participate bringing their work, money, knowledge and/or experience, always entails mutual benefit. The user will receive the satisfaction of a given type of need, be it economic, social recognition, self-esteem, or the development of individual skills, while the crowdsourcer will obtain and utilize to their advantage that which the user has brought to the venture, whose form will depend on the type of activity undertaken.

I believe that healthcare was the original pioneers in “crowdsourcing.”

I can remember being a small boy, and my aunts, uncles, and grandparents always calling my mother, a nurse, and asking her about their symptoms. They would discuss their aches, pains, coughs, phlegm, and number of days with my mother.

After seeing their physician, they again would call my mother and ask her about what the doctor told them. They would ask her questions about the diagnosis, the medications, the doctors recommendations.

As I moved into my own clinical expertise in oncology, I have had several family members, friends, and professional colleagues call and ask me the same types of questions.

I started to think, patients have always done crowdsourcing for their diagnosis. Healthcare just never had a formal name for it. (full disclosure, I give the “hat tip” to Dr. Krishnaraj for planting the thought for this post in my mind)

Screen Shot 2015-01-27 at 10.04.22 AM

In the days before the internet, it took place via a phone call. We would wake up, not feel well, pick up the phone, call our trusted friend, talk about how we are feeling, and they would weigh in with their opinion on your diagnosis.

We would go to the store, buy some medicine, and see what happens. Maybe after a few days we finally go see a physician. As soon as we arrived home, we would pick up the phone and share with the diagnosis and recommendations with our friend.

Original Crowdsourcing.jpg

Today, it is even faster. We have access to more people. Instead of being able to call and talk to one person, we can instantaneously go to Dr. Google, input our symptoms, and come up with a self diagnosis in seconds.

We can now turn to blogs, websites, Facebook, Twitter, Instagram, Pinterest, and many other sites to connect with people and get their opinion. We can connect with medical societies, hospitals, online physicians, and quacks. We can even connect with children posing as medical professionals.

Modern Crowdsourcing.jpg

We can input out our signs and symptoms into a search engine and easily receive a diagnosis.

The diagnosis may not be correct, but we can receive one none the less.

We want an answer to our “What” question. (post here: Diagnosis Is King) Since we have immediate access to the internet, friends, family, and colleagues, we crowdsource their knowledge to alleviate our own anxiety.

To arrive at an answer to the “What” question.

Even though magazines like Wired, Inc, and the cool startup culture of Silicon Valley are known for their crowdsourcing endeavors, patients have always used “crowdsourcing” when it relates to their diagnosis.

Patients created crowdsourcing. Healthcare just never acknowledged it.

As I mentioned during the #JACR discussion, if the “insiders” of healthcare can begin to leverage technology to disseminate and leverage all of the medical knowledge globally, in a crowdsource manner, maybe we will bend the cost curve. Increase access, improve wait time, and decrease patient anxiety.

Maybe, just maybe, healthcare “insiders” will finally learn from what is already happening outside the four walls of their own organizations….

Patients always have, are today, and always will crowdsource their diagnosis.

Don’t ignore the crowd. The crowd is full of your patients. Join the crowd. Listen to understand, not to respond. The crowd will tell you what they need.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek

~CancerGeek