- Treatment of illness or disability.
- Healing power or quality
This is part 4 of a 4 part interview series (see previous here and here and here) in anticipation of the upcoming Health 2.0 Conference. This fourth and final interview is with Joshua Seidman, PhD from the Center for Information Therapy.
Joshua Seidman, PhD
Center for Information Therapy
4720 Montgomery Lane, Suite 210
Bethesda, MD 20814
For 18 years, Joshua Seidman, PhD, has been on a quest to improve health care quality—first by influencing health plans and provider behavior, then shifting to a grassroots approach by activating consumers. He saw the fusion of these two strategies in information therapy (Ix)—the timely prescription and availability of evidence-based health information to meet individuals’ specific needs and support sound decision making. Before launching the independent, not-for-profit IxCenter in 2001, he worked at NCQA, the Advisory Board Company, and the American College of Cardiology. His doctoral research at Johns Hopkins School of Public Health involved the development of a tool to evaluate the quality of health information on the Internet and an assessment of what Web site characteristics influenced health information quality.
“Creating a WIxRED environment to enable next generation patient centered care”
How did you become involved with the Center for Information Therapy?
I have been interested in health care quality for a long time. I initially worked with health plans and providers in a top down approach to quality. This was some of my work at NCQA where I was involved with several in depth projects looking at the information tools available to chronic diseases. We found that there were tremendous gaps, on all sides, in the effective use of time, patient-centered, and effective information. We could see, but there was no framework to deliver, how valuable timely, personal, and relevant information could be in the delivery of high quality care.
After wrapping up that project in January 2000, I left to work on the same quality problem but this time from the bottom up by engaging consumers. We had connected with the folks at Healthwise, who had executives who were talking and writing about information as a form of therapy. We worked with them to help launch the Center for Information Therapy in October of 2001. They continued to be a big sponsor and enabled us to transition to a fully independent organization in January 2006.
We currently have three models of funding for the Center:
- Annual Conference (typically held in Park City each October).
- Ix Action Alliance Membership program
- Grants from both government and private sector organizations
I have been really fortunate to be on the forefront of content creation, information delivery, and have been grateful to watch it develop to the degree it has during a relatively short window. We are hopeful to continue to build on this momentum so that information therapy to be embedded seamlessly with each care interaction.
What is the Center focused on in 2008?
We have three primary thing that we are focusing on:
- #1 – Patient Centered Health Information Technology (PCHIT). This meme has become a major theme at Ix. We have been blown away by the responsiveness of our members and other constituents who are interested in the idea of patient centered technologies and communication tools.
- #2 – Ix Killer Apps. We are also intent on building out additional “Killer Apps” for Ix such as pre-vist, after-care, and shared decision making tools that enable information to be shared, discussed, and understood. We are currently building subgroups of interested parties to continue to work on these subjects within the framework of Ix.
- #3 – Categorization of Ix Methodology. We are also continuing to add to our collection of peer reviewed research, understanding about effective use of Ix, and cataloguing the tremendous breadth and range of innovation within this field of study. We publish a current research briefing every six months, and have encouraged additional prospective studies to be conducted to determine the true value of Ix.
Can you share some concrete examples of Information as Therapy in action?
- Visit Prep. We know from the extensive time we have spent with clinicians and patients in real clinical settings, that the average visit is 16 minutes and that 6 topics typically covered. We want to maximize this very limited time for both the patient and the physician through appropriate planning. We can demonstrate superior interactions with the education tools we have developed.
- After Visit Summary. We also know from our research that 40-80% of the information relayed to the patient is lost between the time of discharge and arriving back home. We have found that we can reverse that memory loss by effective capture and contextualization of the information so that people can understand it clearly. We believe this creates a continues cycle of care versus episodic interactions that feel like a clinical driveby.
What Health 2.0 tools do you use among your own membership?
I had started blogging at the end of 2006 as a means to share and disseminate information. However, when we started the PCHIT blog I really began to understand the power and the implications of blogging. I began connecting with people we would have never met previously and we were able to share our ideas in ways previously uncontemplated. It also began serving as an online repositiory of our collective best practices.
We also have used video feeds and webinars extensively. We have a monthly membership webinar wherein we bring in a wide range of industry experts and allow everyone to tap into the experience. We have folks from nearly every industry and discussed topics ranging from PHR to Insurance to Care Delivery to Best Practices. It has been tremendous because we can have a great event and then it is captured to be repurposed in a multitude of effective ways.
What are the main information gaps that you see?
There are so many gaps that remain all along the information continuum (pre-diagnosis through end of life care). There remains some great opportunities to present targeted information at the right moment in the care process. We see some specific opportunities for better decisions aids for high costs procedures for preference sensitive conditions (such as low back pain).
You have spent a lot of time in actual physicians offices as part of your efforts. What things have surprised you the most?
Most of our time has been spent with safety net populations. I guess many of the delivery challenges I was aware of, but to answer the question the thing that surprised me most was how difficult an environment it is in which to delivery optimal high quality care. There are so many barriers, inefficiencies, and inequities fully ingrained in the system that I can now better appreciate why and how things are the way they are. This does not deter me, however, from trying to make it better. I am now just a more informed, and more respectful, health care reformer.
How did you get involved Health 2.0?
I guess you can say that I have been in this space since its 1.0 inception (laughs). Actually, Matthew started coming to our conference and blogging live from the event. I got to know him from interviews, from his insightful posts, and also from a commonality of trying to improve health care. I guess specifically I started paying much more attention once we started to see the reach and impact of our own blog, and then of course, after all the buzz the first Health 2.0 Conference generated I determined to come and find out what was going on.
How do you define Health 2.0?
I don’t know that I have a definition so much as how I describe what I think Health 2.0 is all about and how it relates to my work at Ix. Health 2.0 to me is all about targeted search, social network, and the integration of these with other real patient centric experiences of managing and optimizing health.
What do you see as the promise of the Health 2.0 movement?
My hope is that we constructively use these tools and technology to intelligently redesign the system. I think it would not be successful if all we do is blow up the current system and create more chaos. I see the promise of effective constructive change with the disruptive forces of Health 2.0 to positively impact and enhance the current delivery system.
What do you want to get out of next week?
I am hoping to be really stimulated to think differently, see new perspectives, and to really have some food for thought. I am particularly interested in the nexus of Health 2.0 and the current primary care delivery systems. How do we effect constructive change within the entrenched restraints of the current system.