2:45 - 3:05 pmSaturday, September 28
LK 130
We need to flatten the healthcare hierarchy
LK 130
We need to flatten the healthcare hierarchy
Six Until Me
Director of the Office of Integrated Healthcare Research and Policy
We need to flatten the healthcare hierarchy, and the way is not paved with shiny, new … useless applications often created with the patient in mind but the patient is nowhere to be found. While great... Read more


We need to flatten the healthcare hierarchy, and the way is not paved with shiny, new … useless applications often created with the patient in mind but the patient is nowhere to be found. While great if an application is downloaded, to improve patient outcomes, it needs to be practical, inspiring, and worth using. Patients need to help from the beginning not just as an end user.

Patients deserve whole person comprehensive health care. They deserve health care that is much more proactive rather than reactive. They need to be empowered to demand this kind of care. And they need the tools to help facilitate their ability to receive this care.

Bells and whistles don't improve patient care - people do. How can we, as a system manned by people and caring for people, remember to include people in these processes?

In order to effect change in healthcare, we must do it systemically. We must recognize that just introducing a new, shiny technology into the fray will not solve all of our woes and make us all the better. We must start to consider how we can change the clinical delivery of care, the operational structure that support that clinical model, and the financial models that surround all and allow for sustaining the innovation. Most efforts, however, do not address each of these areas simultaneously. The irony is that this fragmented approach perpetuates fragmentation.

This presentation will tackle the issue of healthcare transformation from two perspectives: the patient’s perspective and the system and policy perspective. Using technology as one enabler of change, this dynamic presentation will ask the audience to consider how their respective efforts can help advance patient-centered care and not further fragmentation or perpetuate a false healthcare hierarchy. The audience will be challenged to see beyond developing an app for an app's sake, and instead will be inspired to create a technology-based way to improve health outcomes and lives – all focused on the patient.

By flattening the healthcare hierarchy, we open up the door for more seamless collaboration between patients and providers. Together, this team can lead the country in healthcare transformation.

Question:  How can social media be used to bring stakeholders together?
Answer:  To illustrate the kinds of collaboration that are needed, we will look to technology tools like Twitter, where patients and doctors alike are coming together to discuss relevant issues (#dsma diabetes chat, #bcsm breast cancer chat), or the development of applications that encourage patient/doctor interactions, versus serving as a conduit to further splinter. Social media is a great "uniter" in healthcare for patients and providers. It is unprecedented how much connection has been made between patients and providers with healthcare through social media. These connections have led to substantial collaborations that have created products for the larger healthcare field (e.g. presentations, journal articles, consultations) . Further, consider the role of apps with patients and providers and how these apps aim to better connect. For example, some apps now ask patients to track their mood so they can share with their provider how they felt that week. Or, what about “patient portals” that encourage patients and providers to “engage” through emails – sharing lab results and status updates. Do these various “connectors” actually enhance patient engagement or are they further pushing a technology wedge between patient and provider? We believe that social media holds the promise for better bringing stakeholders together if done correctly and for the right reasons.

Question:  So you don't want an app for an app's sake; what do you want?
Answer:  Applications should actually address a stakeholder's need.  Our discussion will highlight frustrations that currently stem from the patient and provider community around apps that focus on diseases rather than people. We, the larger healthcare community, want apps that help unite us, defragment us, and make us healthier. We want apps that are created with the patient in mind not just about dominating market share and being the hottest app out there.

Question:  This seems like a huge challenge, flattening this hierarchy. Can we actually accomplish this?
Answer:  Yes, but the first steps must be bold, and consistent. This is not a time for timidity. This is not a time for pilots. Patients, providers, and policymakers need to be working towards the same goal, which is the improved care of the patient – of the community.  Patients need to be encouraged, and empowered, to put their health at the center of their healthcare and to voice their goals to their health care providers. We need to create communities of solution where we listen to what is working now for our communities rather than what we think might work.  Providers need to be supported clinically, operationally, and financially in their efforts to best care and collaborate with patients.  Policymakers need to recognize that we need to better support a healthcare system that we all want and deserve, and not the system that we have. If the system starts to value health more than revenue, we can make progress towards radical transformation. Ultimately, a flattened hierarchy will be seen when we recognize that only through the collaborative team of providers and patients working together are outcomes improved and overall healthcare costs seen.

Kerri Morrone Sparling has been living with type 1 diabetes for over 26 years, diagnosed in 1986. She manages her diabetes and lives her life by the mantra “Diabetes doesn’t defineme, but it helps explain me.”

Kerri is a passionate advocate for all-things diabetes. She is the creator and author of Six Until Me, one of the first and most widely-read diabetes patient blogs, reaching a global audience of patients, caregivers, and industry. Outside of her blog, Kerri’s work can be found at diaTribe, dLife, and in diabetes outreach like JDRF’s Countdown magazine, in addition to her extensive diabetes YouTube channel. Well-versed in social media and its influence on patients, Kerri presents regularly at conferences, advocacy events such as BlogHer, Digital Pharma, Doctors 2.0 & You, SXSWi, and diabetes-specific events hosted by advocacy chapters. She currently works full-time as a writer and consultant.

Kerri and her husband, Chris, live in Rhode Island, USA with their daughter. She can be reached by email at kerri@sixuntilme.com, or on Twitter at @sixuntilme.

Dr. Ben Miller is an Assistant Professor in the Department of Family Medicine at the University of Colorado Denver School of Medicine where he is the Director of the Office of Integrated Healthcare Research and Policy. He received his doctorate degree in clinical psychology from Spalding University in Louisville, Kentucky. He is principal investigator on several grants and contracts related to comprehensive primary care and mental health integration. He leads the Agency for Healthcare Research and Quality’s Academy for Integrating Behavioral and Primary Care project as well as the highly touted Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE) project.

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