Health Boost: Story-Sharing Kiosk For Hospital Patients Coping With Illness Set To Launch

If you were really sick, with cancer, let’s say, or a debilitating eating disorder or heart condition that put you in the hospital, would you want to hear from other patients like you? Would you feel better sharing your story? A growing body of research suggests you would.

That’s the idea behind the SharingClinic, a kiosk stocked with a collection of audio clips from patients facing a range of illnesses. It’s set to launch as an interactive exhibit at the Massachusetts General Hospital Paul S. Russell Museum in January. The goal is to ultimately move the listening kiosk into the main hospital.

The project was born out of frustration with a medical system that no longer has the time to really listen to patients, says Dr. Annie Brewster, an MGH internist who’s been developing the listening kiosk for the past four years. Brewster (a frequent contributor to CommonHealth) is also the founder of Health Story Collaborative, a non-profit that helps patients and caregivers tell their own medical stories for therapeutic value.

Patients visiting the SharingClinic can choose from a range of story types and perspectives. (Courtesy: Tara Keppler, graphic design)

Patients visiting the SharingClinic can choose from a range of story types and perspectives. (Courtesy: Tara Keppler, graphic design)

Ultimately, the MGH kiosk will offer a range of storytelling from different perspectives: hospital patients, their families and friends, doctors, nurses, psychiatrists and others. A touch screen allows listeners to select stories by diagnosis, by theme or by perspective. Listeners will also be able to comment. Currently over 100 clips are already collected, and the process is ongoing. The software, designed in collaboration with computer programmer David Nunez, previously at the MIT Media Lab, allows for easy, regular addition of new content. A downloadable app is currently in development.

“SharingClinic will take on a life of its own, constantly growing and changing, shaped by story sharers and listeners,” Brewster said. Listen to few sample clips:

Why did she embark on all this? Brewster says: “Facing illness can be scary and isolating, and hospitals an be alienating. Our goals are to empower and connect individuals facing health challenges — to remind people that they are not alone — and to improve the culture of the hospital through storytelling.”

Brewster herself is involved in the audio collection and editing process, but has also recruited other providers to help; her goal is to transform the culture of the hospital through storytelling. So far, she has an MGH chaplain and two MGH social workers helping with story collection. Eventually, she envisions having an actual story-sharing “clinic” at MGH — a dedicated physical site, open at a regularly scheduled time, where patients and providers can come to share their stories. She hopes to staff this “clinic” with other healthcare providers across disciplines — doctors, nurses, mental health professionals and chaplains. Story clips will then be plugged into the kiosk, where they can be shared with any visitor to the MGH museum, part of the MGH campus.

“It would, of course, be ideal to have time for such story sharing within medical visits, but I don’t see this happening at any time soon given the structure of the health care system today,” says Brewster. “Because of this, we need to create other opportunities to share, feel listened to and feel like we are contributing to a collective conversation about illness and healing.” Continue reading

True Transparency: Doctors Who Admit Errors, And How To Help Them

A patient who had a different operation made things very clear...

It’s easy to be snarky. I confess that when I posted this story last November about a Mass. General surgeon who admitted performing the wrong operation on a patient and analyzed why, my headline began “Oops!” But the truth is, of course, its incredibly courageous of doctors to admit their mistakes publicly, to break the medical omerta.

The topic is timely today because of a new Harvard study finding that most doctors will face a malpractice lawsuit at some point — and interesting work under way in Massachusetts to encourage medical apologies. The Patrick administration, too, supports making admissions and apologies easier. And the American Medical Association’s has just posted an inspiring piece on three doctors who came clean before their colleagues, including Mass. General’s Dr. David C. Ring and Dr. Jo Shapiro of Brigham & Women’s.

The piece begins with a heartbreaking story of a Seattle nurse whose dosage miscalculation led to a baby’s death — and to her own suicide. (A recent study found that doctors have about double the usual suicide rate to begin with, and major medical mistakes triple their suicide risk, amednews reports.) And the piece ends with some of the efforts, in Boston and elsewhere, to help medical staffers who have made errors:

Supporting physicians when things go wrong

Few physicians talk publicly about their medical errors, but a growing number are benefiting from programs dedicated to helping doctors deal with the emotional turmoil that often comes in the wake of adverse events.

Jo Shapiro, MD, helped start the Center for Professionalism & Peer Support at Boston’s Brigham and Women’s Hospital in October 2008. There are 55 physicians and other health professionals at the hospital trained to offer emotional support to peers involved in cases of patient harm.

“When there’s any kind of adverse event that we hear about, one of us will make an outreach call to the physician involved,” Dr. Shapiro says. “We ask them simple questions like, ‘How are you doing? How are you feeling? Is there anything I can do to help you?’ ”

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Report: Cost Of Care Varies Widely, Depending On The Hospital

A new report says MGH was reimbursed about double the rate of Cambridge Health Alliance for C-section deliveries

Why, you may ask, is the price tag on a C-section $5,000 at one Boston-area hospital and $10,000 at another?

A new report from the state Division of Health Care Finance and Policy on medical cost trends doesn’t offer the answer, but it does document numerous cases in which certain hospitals are reimbursed by insurers at far higher rates than others despite comparable levels of care, The Boston Globe reports. For instance:

Cambridge Health Alliance was paid less than $5,000 each for 55 caesarean sections performed in 2009, while Massachusetts General Hospital was paid more than $10,000 each for 483 caesarean deliveries that year, state officials found.

They said it was unclear why insurers paid some hospitals dramatically more, since officials found no obvious differences in quality of care, and their analysis allowed for instances in which hospitals treat sicker patients.

Disparities in payments were first documented by Attorney General Martha Coakley’s staff last year, which concluded after an investigation that the highest paid hospitals had more market clout, some because of their brand names, but that they were not necessarily providing better care. The new report, which the governor’s office planned to release to the public today, mirrors Coakley’s initial findings.

How much hospitals and doctors are paid and whether those payments are justified are central issues as the state and private insurers search for ways to control soaring health care costs.

Among the other findings:

— Prices vary significantly state wide for inpatient and professional services as reported by the AG last year
–The differential in rates ranges from a 3 fold to a 6-7 fold variation depending on the service.
–Tertiary care hospitals account for the highest proportion of prices above the state median price
— Medicaid and Medicare pay less than private insurers
— Providers with the highest percent of Medicaid patients often receive the lowest commercial rates
–There is little measurable variation in quality

This cost variation report was released with a companion report on insurance premiums. (The analysis found that “private group health insurance premiums in Massachusetts increased roughly 5 to 10 percent annually over the two year period [2007-2009] when adjusted for benefits. However, the Consumer Price Index increased by only 1.7 percent nationally and 2.0 in the Northeast region over the same period, signaling that the rate of increase in the cost of health care far outpaces the rate of inflation.”)

The reports were released in advance of hearings on health care cost trends, which are scheduled to take place between June 27 and June 30 in conjunction with the attorney general’s office.

Mass. First To Ban ATVs For Kids Under 14

Notice to the tens of thousands of Massachusetts families with All-Terrain Vehicles: If you were ever foolhardy enough to let children ride your ATV, those days are over.

Amid the flurry of bills passed at the end of July was one that, as of Oct. 1, makes Massachusetts the first state in the nation to declare ATVs off-limits to children under 14, the bill’s backers say. The law is nicknamed ‘Sean’s Law’ for an 8-year-old boy, Sean Kearney, who died in 2006 after an ATV accident. Sean had been on a playdate and his parents had no idea he’d be riding an ATV until they got the emergency call telling them he was on his way by helicopter to Massachusetts General Hospital for Children.

Sean Kearney died at age 8 in an ATV accident

Dr. Peter Masiakos, a surgeon who treated Sean there, helped push for the law. “The worst part of my job is telling a parent that they’ve lost their child,” he said.
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