One human resource manager I know was so impressed with this short video about a Maine cancer patient discussing her cancer, she asked her whole department to take a look at it. Within a week everyone in the 17-person department had viewed it and many had shared it with friends. The video features Chelsey, a young woman who explains the steps she had to go through to get successful cancer treatment. Her suggestions are universal lessons that provide encouragement for anyone going through a health crisis. The human resource manager says if we all could be as strong and clear about engaging our healthcare providers as Chesley, the healthcare system would dramatically change tomorrow.

As an extension to its Speak Up campaign, Joint Commission’s new Know Your Rights campaign further encourages patients and families to educate themselves. The more patients know the better their care and recovery time can be. Several brochures are available for use, and some topics include four things patients can do to prevent infections, what patients can do to prevent medication mistakes, how they can help avoid mistakes in their surgery, and planning follow-up care. The best part is that “there are NO copyright or reprinting permissions required for the Speak Up materials or copy.” The Joint Commission only asks that they be credited as the source of information. Good stuff.

As part of our work, we frequently interact with local employers regarding healthcare quality and the role that organizations can play in addressing this issue. We recently spoke with a human resources director from an organization that has done truly groundbreaking work with regard to healthcare and healthcare quality improvement initiatives. Based on the success and longevity from her organization’s efforts, she was able to offer interesting insight.

“Too often, employees are suspicious of efforts promoted by their own employer,”she said. “When new initiatives are rolled out, the attitude they are met with is often ‘What are they taking away from me now?’ As employers increase expectations for employees to better manage health risks and share more of the costs of healthcare, they also need to be doing more to promote the quality and safety of the healthcare their employees receive.”

To address this issue, her organization – which is based in Maine – found an effective way to “actively influence the quality and safety of care” by participating in the Maine Health Management Coalition. The MHMC is an independent organization that works with providers, insurers, and employers in a collaborative effort to improve the quality of healthcare in Maine. Many states offer similar programs. For more information, visit the National Business Coalition on Health.

Do you ever have the thought “Wow, I’m part of something really big”? I felt this overwhelming sense of mission and purpose last week when I was in Seattle attending the Robert Wood Johnson Foundation Annual Meeting for the Aligning Forces for Quality Regional Market Project. Maine is one of the fourteen communities cited in a report from the RWJF and the Center for Health Improvement that examines how communities can drive and sustain high quality healthcare. I was in a room with leaders from the 13 other communities, as well as national experts such as Dr. Judith Hibbard and Dr. Susan Prows. This three-year grant is not only going to benefit the citizens of Maine, but also the entire country. I will be sure to provide regular updates from my experiences, but if any other grantees are reading this, feel free to submit your own thoughts and experiences for posting.

It got my attention July 3rd when New York Times health reporter Jane E. Brody said: “I consider this book so valuable I plan to keep it on my bedside table should I need it later on." The column, Advice on Dire Diagnoses From a Survivor, highlights important information from AfterShock, the recent book by Jessie Gruman, about what to do when you – or a loved one – receives a devastating diagnosis.

The article became pure synchronicity when on the very same day a leading health researcher in Minnesota told me to look into the important work that the Center for the Advancement of Health (CFAH) is doing to engage consumers in the process of improving health care. The founder and president of CFAH is Jessie Gruman.

Early on, CFAH focused on integrating evidence on health behavior into the practice of medicine. Today, it works through the “traditional news media, the blogosphere, the Internet, professional organizations and health care institutions to raise the visibility and priority of health behavior research in solving health care challenges.” CFAH is also home to Health Behavior News Service producing journalism about new systematic reviews relevant to individuals in making decisions about their health and healthcare.

Consumer-driven health plans - high-deductible plans usually paired with a tax-advantaged savings account such as a health reimbursement account (HRA) or health savings account (HSA) - have been getting mixed reviews in the press recently. While some companies and communities have reported failed attempts at gaining employee acceptance of these, enrollment in CDHPs is increasing in the Milwaukee area. The secret of success? According to The Business Journal of Milwaukee, employees must be educated about the health plans and given some incentive to enroll. “The key to achieving higher enrollment is making sure employees understand how the plan works,” according to Kristine Seymour, president of Louisville, Ky.-based Humana’s Wisconsin market.

Various tools are used to educate consumers about CDHPs. An on-line instrument allows people to determine which plan works best for their family. Additionally, people are taught how to become educated healthcare consumers. As our return blog readers know, consumer engagement frequently is highlighted as a major focus, and is a major aspect of healthcare reform.

Some companies offer incentives, including contributing to the savings accounts. This technique is especially useful if companies want to steer their employees to CDHPs when they are also offered more traditional plans such as PPOs. According to Clark Slipher, a consulting actuary for Milliman Consultants & Actuaries, states “Employers who have stuck with the plan tend to see increased enrollment over time as employees learn more about it. Clients that see higher enrollment are generous with their contributions to spending accounts and have provided good education.”

The future of consumer-driven health plans remains to be seen, but what is certain is that consumers, employers and providers need to work together to improve the value of healthcare.

Reporting on the recent UC San Diego survey of 650 patients who were taking cholesterol-lowering drugs called statins and who reported having adverse drug reactions has touched a nerve. Reuters headlined the story “Docs often write off patient side effect concerns” and explained that the UC San Diego research suggests that doctors will very often dismiss their concerns when patients feel they might be having an adverse drug effect.

Dr. Beatrice A. Golomb of the University of California at San Diego told Reuters Health: "Physicians seem to commonly dismiss the possibility of a connection. This seems to occur even for the best-supported adverse effects of the most widely prescribed class of drugs...Clearly there is a need for better physician education about adverse effects, and there is a strong need for patient involvement in adverse event reporting."

The Consumers Union prescription drug blog picked up the story, as did MSNBC. The related MSNBC Health message board titled “Felt dismissed by your doctor?” begins to show that there is a lot of frustration on the part of consumers. While complaints are more likely to surface in such a forum, it is not surprising to see the robust reaction if the percentages found in the study hold for other physician/patient interactions regarding side effects (only 39 percent said their physicians said such a connection was possible.)

Everyone knows that the multiple stakeholders involved in healthcare reform all have their own opinions on the subject, and that the disparate opinions are not always compatible. Many also agree that the status quo is not sustainable. So what is to be done? Many stakeholders and groups of stakeholders are attempting to alter the marketplace and industry by instituting policies, procedures, and changes that they feel will improve the system. Some make the changes TO others, while some make the changes WITH others. Either path is difficult, but the process can be as important as the end results.

The Houston Business Journal reported recently that “In response to last year's controversial decision by some major health insurers -- including industry giant Blue Cross Blue Shield of Texas -- to rate and rank doctors based on several criteria, the Harris County Medical Society has launched a survey that allows doctors to publicize their opinions of insurance companies.”

Dr. Michael V. Kelly II, president of the Harris County Medical Society, states that, "The goal of this initial survey is to recognize the areas of good performance and uncover issues that need to be addressed by the health insurance companies." This development is huge – physicians have spent years at the mercy of insurance companies who tell them what tests they can run on their patients, and how much they’ll be compensated for their services.

But what is really important here? The message is really that collaboration, negotiation, and transparency are three elements (certainly not all) that are needed for a successful outcome, because no one likes things being done TO them without their consent. “Doctors are up in arms not because they are being rated, but because they don't know what the ratings are about”, says Dr. Michael Speer, a neonatologist at The Methodist Hospital and former Harris County Medical Society president. “One physician will get a terrible rating from one company and a glowing rating from another company," he says. "Physicians want their data out there, but they want it to be accurate.”

In the blog hospital impact, Nick Jacobs in his entry “Marketing” states “we hear, everyday, the little whispers about skill level. Perception is reality, and unless or until total and complete transparency becomes the guiding light of health care, we will be in the same boat that we were in before "Consumer Reports."

“Bring on open communication, just don't let some of the major, existing evaluators take the lead. They are from a different paradigm, a world where, many times the twisted, interpreted detail is the basis for a pronouncement that has no bearing on the reality of the care.”

Collaboration and transparency will ultimately benefit all stakeholders – physicians, insurance companies, hospitals, and most importantly consumers – and improve the system. Until then, caveat emptor – “Let the buyer beware.”

Cnn.com offers an educational section entitled “Empowered Patient,” and one recent article entitled “Five ways to find Dr. Right” highlights the similarities between the relationship with one’s significant other and that of one’s physician. Both are extremely intimate personal interactions, so why would we choose to be with the person who isn’t “the one?”

Dr. Vicki Rackner, a professional patient advocate, states: "I consider the doctor-patient relationship to be as intimate as a life partnership. There are lots of nice people out there, but you would not want to marry most of them." Below are the five ways to find Dr. Right:

1. Date before you get married. Schedule a time to just talk with a new doctor, or go with a problem of limited scope.

2. Check them out on the Internet. There are many web sites that share objective information on doctors – state licensure boards, independent non-profits, health insurance plans, etc.

3. Check out the family. A doctor is sometimes only as good as his or her office staff, physician assistants, etc. It’s vital that you feel comfortable with everyone in the office.

4. Ask your friends to fix you up. Ask a friend who thinks like you do who he or she recommends.

5. Go with your gut. If a new doctor makes you feel uneasy, trust your instincts. You need to have full trust in the person who is responsible for your health.

Please visit the full article, as it offers lengthier explanations for each of the five above suggestions. We all deserve “the one.”

It is likely that most healthcare consumers and patients feel that their doctor’s sage advice is based on years of medical school, and then residency, followed by private practice. For the most part, this is true. Doctors know more than we do because of their years of expert training and experience. But, a recent article in CNN.com’s Empowered Patient column informed parents when pediatricians’ recommendations are merely opinions and not based in medical fact.

In the article “When it’s OK to question your pediatrician’s advice,” Elizabeth Cohen highlights five parenting issues “where there’s plenty of room to disagree with the pediatrician.” These areas are:

1. Don’t pick up your baby in the middle of the night
2. Baby should be at home with mom
3. Don’t give your baby “triple nipple confusion”
4. Your baby must eat solid foods by 6 months
5. You must take the pacifier away

Dr. Robert Needlman, co-author of the latest edition of Dr. Spock's Baby and Child Care, states, “If you're not sure if you're getting fact or opinion, ask. You can challenge your pediatrician along the lines of saying, 'That advice you gave me doesn't feel comfortable to me. Can we talk about some other options?’"