Jun5

A Case Study: Unlearning

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“Fail, fail again, fail better.” Samuel Beckett

I have this fear of making mistakes.

I find that I’m always second-guessing and triple-checking myself in most things I do because of that fear. When I do end up making a mistake, I find that I spend about 5 minutes scolding myself and wondering how it could have all been avoided. Let me just say that I find about 10 different ways to answer that question.

But isn’t making mistakes a part of life?

Yes. Everyone makes mistakes in life but it is how you bounce back from those mistakes that defines you. I recently listened to a podcast where the focus was on learning and unlearning. To “unlearn” means to let go of what you have already learned or acquired. To unlearn, you have to be open to letting go of what has been pushed on you for so long, pressing the pause button, and relearning all over again—but this time, the right way for you.

After some research, I decided that the time was right for me to start unlearning a few things—therein began my month of renewing my mind. Here is one thing I’ve “unlearned” thus far:

1. All mistakes are bad.

I recently came across an article in the Harvard Business Review about “The Wisdom of Deliberate Mistakes.” Paul J.H. Schoemaker and Robert E. Gunther, the authors of the article, state that “the resistance to making mistakes runs deep, creating traps in thinking and decision making”—a statement that I wholeheartedly agree with. I believe the No. 1 thing that gets in the way of us being our best creatively is fear. I am learning to call my mistakes “experiments.” We live in a world of trial and error, and sometimes the greatest things can come out of simple experiments. As a wise person once told me, “It’s all about where the creative work is taking you and not where you are trying to take it.”

I have come to believe that in our line of work, especially in the creative department, we shouldn’t be afraid of making mistakes. Embrace it because some of the greatest innovations have come from just the simplest mistakes. Don’t believe me? Take some time and research how one of the antibiotics widely used today—penicillin—was created.

I’m still on my journey of unlearning, and if you would like to learn a little bit more, feel free to reach out!

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May19

Wearable Wonder: Will They Improve Patients’ Quality of Life?

LeanneLakeBlogImageSizedClearly wearables are “all the buzz” in our industry. Soon our Fitbits, watches and the like will become an essential part of connected healthcare, monitoring our bodies and feeding important data about our health to the cloud to be analyzed by our healthcare professionals. More data in, better outcomes come out—it’s fantastic news. But what if these devices can go the next step and actually respond to the data they are monitoring? Can you envision a future where a wearable device can improve our body’s function and a person’s quality of life in real-time? I recently learned about one that just might.

It’s called the WAK, short for the Wearable Artificial Kidney. This wearable innovation has the potential to be truly life-changing for the more than 400K patients with end stage renal disease who are currently undergoing hemodialysis every day in our country.

For the majority of these patients, treatment is their lifeline, but it can also take over their life. Hemodialysis patients receiving treatment in centers spend on average 4 hours a day, 3 days a week completely immobile—tethered to a chair, tied to a machine. Much like chemotherapy, the treatment that is saving them often makes them sick for hours afterward. In the absence of a successful transplant, they will undergo dialysis until the end of their life.

The WAK is designed to help patients get out of the chair and back into life. It is a miniature battery-powered dialysis device that is worn like a tool belt. It is connected to the patient by a catheter, weighs approximately 10 pounds and offers dialysis 24/7. Some experts believe that in a perfect world, more frequent dialysis would yield better control, however this comes with a tremendous burden to the healthcare system. If proven successful, the WAK could improve outcomes and deliver new hope for patients, reducing their time in the chair and giving them the mobility to go about activities of daily life—a more “normal” existence. The FDA fast-tracked the WAK, and it is currently undergoing its first human trial in the United States. Human clinical trials conducted in Italy and London already concluded successfully.

For me, following the progress of this wearable technology is personal. I lost my dad to end stage renal disease and its complications three years ago this June. During the five years he “survived” on dialysis, I watched his body and spirit wear thin. Early on, the dialysis center gave him the personal connection he needed to share with patients having a similar experience, but soon after getting into the three-day-a-week routine, he and my mom longed to get back the flexibility that every retired person deserves. The ability to hit the driving range with his buddies on a Tuesday, attend his grandson’s football game on a Thursday, or even make the trek to NJ to visit me and my family on a Saturday afternoon.

Looking back, I wonder how the WAK would have changed my dad’s dialysis experience and the burden it placed on both him and my mom.

What’s your wearable wonder?

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Also posted in adherence, Apps, behavior change, Culture, Data, Design, Digital, Health & Wellness, Healthcare Communications, Patient Communications, Technology, Wearable Health Technology | Tagged | Comments closed
Jul16

“It’s not a tumor!” Cyberchondria and the Diagnoses That Spawn From It

2287994It’s 7 am; I’ve just awoken. My eyes are adjusting and I’m sprawled in my bed. My mind is not coordinated enough to move my body. Man, I am exhausted, I think. How is it only Thursday? My head kinda hurts. Good God I have to pee. I could probably snooze for like fifteen more minutes, if I shower quickly. Seriously, my head hurts. Right in my left temple. I must have slept wrong. I don’t remember hitting my head or anything. I sit up abruptly. Oh Lord now I’m dizzy. I’m dizzy and I have a sharp pain in my temple. Holy crap what if it’s a tumor, or an aneurism. When I did those brain cancer interviews last year they all said they woke up with headaches. This is that exact same situation. Where’s my iPhone? How do you spell meningioma, two “n”s? No, one “n.” Thanks Google. Okay WebMD…signs and symptoms…yup, here it is. Headache: check. Dizziness: check. Weakness in arms and legs: now that you mention it, I can barely hold this phone it feels so heavy. Blurred vision: that one’s probably next. Yup. It’s definitely a meningioma. I should call my dad. Just tell him I love him.

But just as Arnold said, it’s not a tumor. And while that example might be a tad exaggerated, I’ve certainly had this type of half-awake, neurotic, cyberchondria once or twice in my life. Though the above situation was more likely caused by one too many glasses of wine and a refusal to admit to a hangover.

Nevertheless, the concept of self-diagnosis is an ever-growing phenomenon in this digital age. According to a survey conducted by The Pew Research Center, over 35% of Americans in 2012 had gone online to diagnose themselves, and more than a third never confirmed that diagnosis with a doctor. What’s worse: some 30% of self-diagnosed women have admitted to purchasing and consuming medication for their supposed illness, without a consultation. That’s the part that shocks me. Sure, I might convince myself I have a pet-dander allergy, but that does not mean I trust my diagnostic abilities enough to assault my leg up with an EpiPen.

But it does happen. And those working in the healthcare industry appear to be the worst culprits—after all, we live and breathe this stuff; it shouldn’t be hard to tell if we have chronic migraines, or insomnia, or endocarditis, right? Our increased level of knowledge mixed with a splash of arrogance is just enough to convince us that there is little a PCP’s gonna tell us that we don’t already know.

And while the hyperbolic, often terminal, self-diagnoses are more my style, physicians say they are more concerned with the prevalence of under-diagnosis among systematic Googlers—as we all know, convincing oneself that a rash is just a rash, or numbness is just an innocent side effect can have irreparable effects.

Now, I’m a huge proponent of self-education and using today’s technology to our advantage—in fact, I think it sparks productive dialogue when information is brought into the doctor’s office—but as cliché as it sounds, I cannot emphasize enough the need for a professional diagnostic assessment. Trust me; the $15 copay is worth it.

Think of it this way: your doctor is your agency of record, but for some reason, you’ve decided to do your own brand website, aka diagnosis. We all know from AOR experience that your doctor is going to take one look at that diagnosis and say, “Damn, this is a mess; I wish they’d just paid me to do it.”

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Feb28

How Can Self-monitoring Best Support Behaviour Change?

3907691Some of today’s biggest public health challenges, such as obesity and  heart disease, can be linked to personal lifestyle decisions. Governments have tried tackling these issues with smoking bans and taxes on high-fat foods, with moderate success. However, personal health behaviour change is needed to make a significant, lasting impact. Can self-monitoring of health information be the answer?

Studies in diabetes, hypertension, medication compliance and weight loss have shown that patients who successfully self-monitor their activities and set personal goals enjoy improved health outcomes and better adherence to treatment 1-6. We now have an abundance of apps and wearable technology at our fingertips to comprehensively track numerous aspects of our lifestyle, analyse results and observe improvements over time. These self-monitoring tools can then be easily integrated into social health networks so that we can share experiences, track our progress against that of our peers, and give and receive advice on how to succeed.

It is estimated that there are more than 40,000 health and fitness apps available. But with this bewildering variety of choice, how can we know which ones will encourage lasting behaviour change?

Easy does it

The apps which make the process of data upload as effortless as possible for the end user are the ones most likely to catch on in the long-term. Devices that automatically record data and synchronise it with online analysis programmes in real time provide a seamless transition and are not hampered by general forgetfulness or lack of time.

Keep it simple

Health information needs to be engaging, and simple enough to be universally accessible. The average person is likely to find sorting the data that matters from what doesn’t time-consuming and intellectually daunting—in fact, many patients who have to actively monitor a condition like type II diabetes don’t always fully engage with self-monitoring for these very reasons.7

Be realistic

Establishing aspirational but realistic goals and providing reinforcing feedback can help bring self-monitoring systems to life and make them personally meaningful.  A recent study into self-monitoring to improve diabetes treatment found that the main concerns patients had with the system were disappointment with unmet expectations and difficulty fitting the programme into the demands of daily life. 1

Collaborate

Ideally, fitness or health tracking app developers should collaborate closely with specialist healthcare providers and device makers as well as social scientists who understand how to bring about behaviour change. Such cross-fertilisation could result in truly useful tools that track fitness alongside other health metrics, such as blood sugar levels or medication adherence.

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1.  Barlow J, et al. Self management approaches for people with chronic conditions: a review. Patient Education Counseling 2002;48:177–87.

2.  Benhamou PY. Improving diabetes management with electronic health records and patients’ health records. Diabetes Metab 2011;37(Suppl 4):S53–6.

3.  Dennis EA, et al. Weight gain prevention for college freshmen: comparing two social cognitive theory-based interventions with and without explicit self-regulation training. J Obes 2012;2012:803769.

4.  Parker R, et al. An electronic medication reminder, supported by a monitoring service, to improve medication compliance for elderly people living independently. J Telemed Telecare 2012;18:156–8.

5.  Ralston JD, et al. Patients’ experience with a diabetes support programme based on an interactive electronic medical record: qualitative study. BMJ 2004;328:1159.

6.  Wagner PJ, et al. Personal health records and hypertension control: a randomized trial. J Am Med Inform Assoc 2012;19:626–34.

7.  Choose Control Survey. Choosing to take control in type 2 diabetes. Available at: http://www.diabetes. org.uk/Documents/Reports/Choose_Control_report.pdf (Last accessed May 2013).

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