Category: Health Care

Snap Judgment on Gladwell

In an earlier post, I did a review of Malcolm Gladwell’s The Tipping Point, about social epidemics and how they spread. If you’re looking for provocative thinking that will challenge how you view reality, particularly in the social sciences, you could do a lot worse than reading Gladwell, either on his blog or in one of his books.

Fast Company has a good profile, including one of the best lines about market research that I’ve read: “I think we would all be better off if focus groups ceased to exist.” (That point is substantiated in Blink by the story of All in the Family and the Mary Tyler Moore show, which the focus groups hated.)

Blink: The Power of Thinking Without Thinking looks at rapid cognition, both in its positive and negative manifestations, and how sometimes too much data gives the illusion of a better choice, when in reality the essential information is much simpler and often comes by way of the unconscious. His stories include:

  • How art experts sensed a fraudulent statue almost instantaneously, when scientists examining it for months with sophisticated technology were fooled.
  • How a “love lab” expert can analyze an hour of a couple’s interaction and predict with 95 percent accuracy which ones will divorce within 15 years (and with 90 percent accuracy based on just 15 minutes of tape.)
  • How the immense planning of the US military was defeated in a war simulation by a shoot-from-the-hip sparring partner in the lead-up to the Iraq war.

I’m going to focus on a couple of medical applications, though:

  • How listening to snippets of surgeons’ interaction with patients can predict which ones will be sued for malpractice (Hint: those who weren’t sued spent, on average, 3 minutes more in conversation with patients…and their tone of voice was more pleasant and engaging). The skill level or training of the surgeon had nothing to do with it…and this difference was spotted by listening to just 40 seconds of conversation for each surgeon.
  • How Cook County Hospital improved service and survival among ED patients with chest pain by boiling the factors to be considered in determining whether to admit the patient down to four:
  1. Is the ECG abnormal?
  2. Is the patient having unstable angina?
  3. Is there fluid in the patient’s lungs?
  4. Is the systolic blood pressure below 100?

The Goldman algorithm using these four factors was tested against physicians doing their best by using all of the tests and data available, and the algorithm was 70 percent better at spotting people who weren’t having a heart attack. It was also better at identifying those who were having a hear attack. The doctors left to their own devices guessed right between 75 and 89 percent of the time; the algorithm was 95 percent accurate.

Sometimes more information gives the illusion of a better decision, when the reality is there are a few factors that really matter. The extra information may just be clutter.

And, to tie the two together, if you can make the judgment that a patient isn’t having a heart attack based on just a few questions and one test, that frees up time for deeper interactions with the patient about what is wrong. Then maybe you will be less likely to get sued.

Pediatric Anesthesia Presentation on Media Relations

Dr. Will McIlvaine from Childrens Hospital Los Angeles, Jen Gentile from NBC’s Today show and I are giving a presentation today at the Society for Pediatric Anesthesia Winter Meeting in Phoenix.

We had a great time discussing this morning in preparation for the presentation, which you can download below.

Presentation in PDF form

I’ll have more to say afterwards; we’re looking forward to the give-and-take of Q&A…and I welcome the discussion to continue here as well.

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Medicine and Media

…is the topic of the presentation Jen Gentile from NBC’s Today show, Dr. Will McIlvaine of Children’s Hospital Los Angeles and I will be giving at the Society for Pediatric Anesthesia meeting in Phoenix this week.

The focus will be conjoined twins in the media, with which Dr. McIlvaine has had experience as a health care provider, Jen has as a TV producer, and I have in media relations, being the bridge between providers, patients and journalists in three cases in the last year.

I’ve been looking forward to this for some time, but the picture below gives additional reason to look forward to being in Arizona.

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Mayo Clinic InTouch Launches

This is a project I’ve been working on for some time, starting from the early discussions of what should be included in the service, to the public roll-out, which will be announced in a news release from Garmin, Ltd. this morning.

Today’s Minneapolis Star Tribune has an extensive feature (click here to read in its entirety), which begins…

Nagging headache? Neck pain? Now you can check your symptoms along with stock prices on your cell phone.
The Mayo Clinic is rolling out a health information service today that soon will be available via most major cell-phone carriers. For $2.99 a month, subscribers who sign up for Mayo Clinic InTouch can get first-aid tips, watch health videos or find the closest emergency room on their cell-phone screens.

Digital Cyclone is the Minnesota-based Garmin subsidiary that developed and is distributing the application through the major wireless carriers. Here’s the Digital Cyclone page with more information on how to order.

And here’s the post on this blog I’ve been using to show journalists what the application is all about, in the pre-launch phase. It was previously password-protected, which is a very convenient way within WordPress to have a public blog that has portions that are private. It’s a way to pitch exclusive or semi-exclusive stories and have rich-media assets, without developing an expensive press kit. And it’s neat to be able to use new media to tell the story of a new media application.
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New Wireless Health Application

This information is provided on an Embargoed basis for background consideration, and is not to be published until Thursday, Feb. 22. For more information or to schedule interviews, email Lee Aase at Mayo Clinic (aase.lee@mayo.edu) or call 507-266-2442.

Below is a video demo of an application called Mayo Clinic InTouch that is being launched this month, available on several of the largest US wireless carriers that serve more than 184 million users.

The application is developed and offered by Digital Cyclone, with content licensed from Mayo Clinic, MayoClinic.com and the Joint Commission on Accreditation of Healthcare Organizations. In addition to representatives from Mayo Clinic and Digital Cyclone, Sprint/Nextel has a spokesperson willing to be interviewed about adding the application to its services.

The video below is a three-minute demo of some of the application’s key benefits, which are available for $2.99 a month. And at the bottom of this post I share a true story from my family that illustrates how others will find it helpful for theirs.

The application has several sections:

  • First Aid: What to do right away, and what NOT to do, to treat common illnesses and injuries.
  • Emergency Room Finder: When you’re away from home and have a sudden need for medical care (other than life-threatening emergencies, for which you should always call 911), Mayo Clinic InTouch helps you locate nearby JCAHO-accredited ERs and Urgent Care facilities…either by entering the city or zip code or, in advanced phones, by automatically locating you and giving you the distance to nearby facilities.
  • Symptom Checker: Guidance on when over-the-counter and home remedies are advised (and what those are), and when you need to seek professional medical help.
  • Health Alerts: News you need to know.
  • Health News Videos: Starting with Sprint, the application offers over 100 brief educational segments in 20 categories, from Alternative Medicine to Women’s Health. More carriers will add video over time, as will more timely analysis of breaking news and what it practically means for consumers.

[youtube=http://www.youtube.com/watch?v=1YkDSjclEws]

Here are some additional screen shots from the application:

And here is a story from this weekend, of how I used the application to advise my daughter and son-in-law, likely saving them hundreds of dollars. I share it with their permission.

My daughter Rachel called early (6 a.m.) Sunday morning and awakened my wife Lisa with a concern about her husband Kyle and his twin brother, Michael, who both had come down with severe stomach cramps and vomiting. They had gone out to eat together Saturday night, while Rachel was at work. Kyle and his brother had been up most of the night.

Rachel and Kyle are newly married (within the last six weeks) and don’t yet have health insurance; they needed to know whether they should see a doctor right away, or whether it would be safe to wait. They also needed to know what to do to help relieve the discomfort, and what NOT to do.

Rachel had called the local ER and was told, “You probably should bring them in.” That was the “safe” advice to give. So I pulled out my cell phone and launched Mayo Clinic InTouch, starting with the Symptom Checker. It said that in cases of nausea and vomiting they should…

Contact your doctor if:

  • You’re unable to drink anything for 24 hours
  • The nausea or vomiting lasts more than two to three days
  • You become dehydrated — you feel weak or dizzy, you have excessive thirst, a dry mouth, and little or no urination
  • You vomit blood or black material

Based on the fact both Kyle and Michael got sick at the same time and had dined out together the previous evening, we thought it seemed likely the cause might be food-related. So we looked under the First Aid section and found “Food-borne illness.” We learned that symptoms typically include diarrhea, nausea, abdominal pain and sometimes vomiting, and generally occur within hours after eating contaminated food. The young men had three of the four symptoms, and First Aid offered the following advice:

If you develop food poisoning:

  • Rest and drink plenty of liquids.
  • Don’t use anti-diarrheal medications because they may slow elimination of bacteria from your system.

Food-borne illness often improves on its own within 48 hours. Call your doctor if you feel ill for longer than two or three days or if blood appears in your stools.

Dial 911 or call for emergency medical assistance if:

  • You have severe symptoms, such as watery diarrhea that turns very bloody within 24 hours.
  • You belong to a high-risk group.
  • You suspect botulism poisoning.

Now we were feeling pretty confident they didn’t need to make a trip to the emergency room, but just to be safe I got up, went to the computer and did a search for “botulism symptoms” and found an article on MayoClinic.com that quickly made it clear this wasn’t botulism. So, they decided to just wait it out.

As a postscript, we got a call from Rachel later in the afternoon, with the news that the worst appeared to be over. The Mayo Clinic InTouch program had saved them a trip to the emergency room that may have cost $200 or more, and also gave them the peace of mind that it was safe to wait.

The wireless carriers say this is a unique health application. It will help subscribers take appropriate care of themselves and their families. Many will find it worth the cost solely for the peace of mind,and even with insurance co-pays, it will pay for itself if it saves users an occasional urgent care or ER visit.

Update: Here is a link to other Mayo Clinic health information products, including books and newsletters.

Also, here are links to where the application can be purchased for Verizon (need to search for Mayo Clinic) and Cingular phones. Digital Cyclone will have a site available soon for all carriers served.

First posted Feb. 7. Updated with family story on Sunday, Feb. 11. Updated with links to Cingular and Verizon sites February 20. Release planned Feb. 22. Service is scheduled to launch on Sprint on Feb. 23. Password protection for post removed 8:30 p.m. CST February 21.