Noting that I’ve written about a wide variety of health and biomedical research issues, someone recently asked me about the focus of this blog. My response was that my goals are two-fold: First, to present synthesized information – created by combining different sources and analyses – in ways that provide new perspectives on important issues so that people have both broader and deeper understanding of these issue. And second, to reach multiple audiences with this information and perspectives so that the spectrum of healthcare stakeholders can better communicate and understand each other. Which is just stating in a different way what I wrote in my first posting, that the reason I started this blog was “to provide stakeholders of all types, (such as patients, clinicians, administrators, payers, researchers, regulators, legislators, etc.) a forum for discussing healthcare policy issues. The focus of these discussions will be about how the development and use of innovations can effect clinical and economic outcomes.”
I view these two goals are complimentary, since together they help people crystallize insights about issues and make them more able to consider what specific actions would be most productive.
Sometimes my analyses take the form of questioning how information is presented to different stakeholder groups, and how that could be done more effectively. For example, in the last two days I saw that the FDA notified a company about selling two unapproved over-the-counter medicines (asprin plus nutritional supplements), and issued a warning about a banned ingredient in a food product (Mexican “vanilla”). The challenge for the average person is to first hear about this information, so they can be aware of any risks, and second, to put it into a context useful for them – such as the potential problem with “Mexican vanilla” if they are taking blood thinning medicines.
For both these situations the FDA issued a press release and notices intended for consumers. Newspapers generally pick up these stories, and print them in ways that appropriate for the scope of the issue – usually a few inches on an inside page. My concern is that some people who should know this informaiton might not be made aware of it because the FDA’s very broad mandate and limited resources means that different outside advocacy groups and the media need to spread the word. Certainly better internet communications and increased FDA funding should help improve this, but as I’ve said before, I think there needs to be broader evaluations of how people get their health informaiton and what they do with it.
We clearly have a health information gap this country – and if this gap was in medical technology or military capabilities then the general public, the media, and politicians would be more engaged and upset. Thus, the challenge for our country is to expand our discussion of the development and delivery of useful, (some would say actionable – but I don’t like that word), information to people so they can change the decisions they make that affects their health and wellness.
Another example of communications challenges involved the start of Medicare’s new system for paying physicians in the early 1990s. While the methodology was very complicated – and is still somewhat contentious – the communications issue that rankled many physicians was how the new system was described as distinguishing between what were called “cognitive” and “non-cognitive” services. What this really came down to was differentiating between health care delivery involving a procedure, (like an operation), and testing, talking and prescribing. As you might imagine, surgeons were not too pleased to be told that what they did was “non-cognitive.” The reason I raise this old example, is that one of the major challenges facing the US healthcare system is the shortage of primary care clinicians. And I can imagine that there will be some communications challenges with both patients and clinicians about how to improve this situaiton in the future. While any policy changes might not pit surgeons v. non-surgeons, it very well might find specialists and primary care clinicians at odds over terminology, status, and of course….. money.
So those have been my goals for this blog, and a couple of examples of the challenges of communicating health related information to different stakeholder groups. I hope that my postings have at least partly fufilled my goals, and from the comments left here, the emails I’ve received, and direct feedback from readers, I think there’s been some success. I will continue working to build on those successes, and if you have any comments or suggestions, please let me know – either as a comment here, or via email.