Data | Danny van Leeuwen Health Hats - Part 4

Data can motivate change. Changing data requires a change in life and work flow.

By Advocate, Caregiver, ePatient, Clinician, Leader, Informaticist, Consumer No Comments
This fifth in a series of posts about health data thinks about the value we get from that data.  In my last post I said, The best data has value because it reflects or motivates action. Action to improve health and wellbeing of and reduce cost to individuals and populations. Action to improve life flow of persons at the center of care and work flow for people who work in health care agencies.   
Let’s think about times when data helped motivate action. At few years ago I weighed almost 200 pounds.  My primary care physician turned the computer screen toward me and showed me a graph of increase in my weight since I started seeing her 4 years before. A very dramatic line graph of weight increasing from 160 to 198 pounds. OMG. No wonder my new pants were getting bigger and I went from a belt to suspenders (I still have no behind to hold up my pants-the new weight did not give me more of a butt). I was motivated to lose weight. I kept a running spreadsheet of my weight, tracked my calories, changed my eating habits considerably, and lost 35 pounds in 2 years. Hurray. Data motivated me to start losing and keep losing. I bought several hand-made vests from Etsy to celebrate. Now they’re almost too tight again. Although I’ve tracked my weight since, tracking the data didn’t keep motivating me to keep the weight off.
When I worked for St. Peter’s Addiction Recovery Center in Albany, NY, managing the care of CDPHP members with behavioral health benefits, we saw that our rate of outpatient 30 day follow-up after inpatient addictions treatment was less than 30%. Outpatient follow-up is a HEDIS measure of NCQA (The National Committee for Quality Assurance accredits health plans). This Outpatient Follow-up measure made sense to us because we knew that a person’s success with sobriety was strongly associated with going directly from inpatient to outpatient treatment. Our Follow-up rate of less than 30% embarrassed us. It motivated us to make significant changes in our practice. We made sure that people in inpatient care had an outpatient appointment before they were discharged.  We stayed in touch after discharge to make sure they had transportation and child care to get to their appointment and if they didn’t make it, we recontacted and helped further.  The Follow-up rate increased to 75%. The data was meaningful, we looked bad, wanted to be better, and were willing to make significant changes to workflow. Increasing the score made us feel good about the changes we made. I don’t know if the Follow-up Rates are still so high. I’ve lost touch.
The moral of these stories is that meaningful data can motivate change.  Going from bad to good is pretty easy (Good to great is much harder). In either case changing personal or population results requires doing something really different about work flow, life flow and habits. Adding education, training, teaching is a weak intervention and usually doesn’t move the dial much. Sustaining improvement is a whole other challenge.

What Data Isn’t. It’s not hope. It’s not getting better or worse.

By Advocate, Caregiver, ePatient, Informaticist, Consumer One Comment

Data is not health and wellbeing. It’s not getting better or worse.  It’s not hope. It’s not trust. It’s not kindness.  It’s not community. It’s not peace. It’s not ……

Data is at least once removed. It’s an adjective or an adverb. Health is a noun or a verb. Data informs health. It describes it: some aspect of health getting better or worse, changing over time.  People change over time. Always. The best data tells us if that ever-changing is OK or not OK. Data at it’s best has value because it reflects or motivates action. Action to improve health and wellbeing of and reduce cost to individuals and populations. Action to improve life flow of persons at the center of care and work flow for people who work in health care agencies. (The Triple Aim) Wouldn’t it be nice if we spend twice as much of our combined health care time and dollars on action to improve as we spend on data?!

Fitting data into life’s flow- a vexing dilemma

By Caregiver, ePatient, Clinician, Leader, Informaticist, Consumer No Comments

This third in a series about health care data thinks about how data fits into the life flow of people. We collect data because we want to, need to, or are forced to. People observe their own health journey (life) and remember stuff: How I feel, how much I weigh, how much I eat, how far I go, how much pain I’m in, when I have to be somewhere, what it takes to get there, how much I spent or owe…. We may write it on a piece of paper, on a list, on a form or type it into something, or a machine captures, stores it and may display it or print it out.

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What is Health Data? An Introduction for Anyone

By Caregiver, ePatient, Clinician, Leader, Informaticist, Consumer, Family man 2 Comments
I took a week off.  I unplugged to attend the memorial service for my mom. Thanks to readers who inquired about my absence, worried if I was OK.  I’m OK.

This is the second in a series of posts about Health Data, Health Information, and Health Wisdom. The first in the series can be found here. This is my 170th post. I starting in July 2012. I have over 2 thousand readers reading this blog as subscribers and in Twitter, Facebook, and LinkedIn from many walks of life and experiences with health care. Many wear more than one hat. Most are patients, some are family and friend caregivers, some are professionals and caregivers by trade, and some work in health technology. This series of posts is geared to everyone. I delight in trying to write for everyone. Considering health literacy while writing helps me organize and clarify my thoughts.  I welcome comments and suggestions. Please send them to me at danny@health-hats.com or @healthhats.

Health data takes a pulse, tells a story, reviews a life, describes a group of people, and links cost to that health journey.

The pulse, represents the natural, and un-natural, changes a body experiences  – higher blood pressure, lower blood pressure; more weight, less weight; happier, sadder; steadier, shakier, pain, fear, anxiety, relief, feeling respected or alone – on and on. Some pulses are felt, seen, heard, sensed, smelled, timed, and some are electronic (lab tests, x-rays, apps etc.).  The most common form of pulse data is the list, a continual pulse over time: medications taken or not taken, minutes or hours of activity, wounds cared for, mood changes… The list can be in your memory, on scraps of paper, in a spreadsheet, on an app, in an Electronic or Personal Health Record, anywhere. People in your team, including you, take different pulses. Most different is that yours are often felt from the inside out, while everyone else’s is from the outside in. This inside/out business is really important. You are the only one who takes pulses from the inside. You are the only one who experiences what you experience. However, it’s all data about the same thing – you.