It is time; time to change how you give a diagnosis.

Participatory Medicine, defined by the Society for Participatory Medicine, is a cooperative model of health care that encourages and expects active involvement by all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of care.  The patient role has evolved, therefore the role of a pathologist must evolve too.  Pathologists must start to go above and beyond the diagnosis and become a key advisor to physicians and patients on the prevention of disease, therapeutic treatments, and the progression of disease within patients.

I have written a post before about my dad, a resident of Colorado, who had a liver transplant in August 2009 at Cleveland Clinic (CC).  As soon as he returned home to Colorado, he had to have bi-weekly blood draws for review by his clinical care team at CC.  The initial plan was for my dad’s family medicine office to do the blood draw with kits that were shipped from the Cleveland Clinic’s lab, and package them up in a pre-paid envelope (also provided by CC ) and ship them back to CC’s lab for analysis.  The turnaround time would be about 36-48 hours for the result, plus the cost and risk of shipping the blood to CC.

After trying this out and realizing it was a logistical nightmare, my parents decided to have all the blood work done by the University of Colorado lab, which would post the results within 8 hours to their hepatology patient care system.  My parents could then simply access the results securely online, print and fax them to Cleveland Clinic.   This new process brought the turnaround time to 8-12 hours; saving 24-36 hours over the original method.  Overall, a great example of participatory medicine!

In Pathology, the use of a participatory model is a greater challenge since pathologists rarely interact with the growing numbers of patients they diagnosis everyday.  However transformation to a new model of care must be accepted, and the College of American Pathologists (CAP) has two programs “Transforming Pathologists” and  ”Every Number Is A Life” where the evolving role of pathologists and value of pathology are being advocated for.  CAP says on the transformation website,

…As health care changes quickly and on all fronts, Pathologists must step up and embrace transformation, pursue new roles in the workplace, and re-position themselves as the center of the clinical care team.  This is an urgent call to action and we must take action now. If Pathologists are to survive, we must adapt….Pathologists must have an understanding of their changing role – they must NOT be defined by the tools they use. We have a bright future as researchers/innovators, test providers, interpreters, clinical data integrators, clinical consultants, business developers and practice leaders.

However, pathologists often do not know where to begin.  Try these steps:

1. Identify two or three cases where your role as diagnostician is crucial to the patients care and outcome
2. Arrange a meeting with the primary physician for that patient
3. Discuss your involvement with the clinical team and how you would like to engage with the patient directly
4. Follow through! Do what you say you are going to do. Build credibility with the clinical team and your patients
5. Document your successes and struggles and think about ways to make the process better
6. Share your successes! Click here to share
7. Repeat the process

Proponents of the participatory model of care believe that adoption can increase patient satisfaction, save time, reduce costs, improve care, and lower liability risks for physicians.  Although change is difficult, pathologists must seize the opportunity they have been given! It is time, time to go above and beyond the diagnosis.

In the middle of difficulty lies opportunity.

~Albert Einstein

Are you a patient who has a great story about a pathologist? Share your story today! Click here

Want to learn how to become an organ donor? Click here

A great read on participatory medicine by American Medical News- Participatory medicine:  A high-tech alliance with patients

As I research and prepare to write this post, I refer to my 2.0 arsenal- Wikipedia, Twitter, RSS feed archives, and some old and new blog posts via Google Reader.  In my personal and professional life, I use 2.0 applications constantly to share information and collaborate on the web.

The hot topic of Web 2.0 recently came up when a white paper was published on Aurora MSC’s software, mScope, in collaboration with the Dark Daily titled “Digital Pathology: Pathology Innovators Use Web 2.0 to Boost Productivity and Create Clinical Value.” Although this was an interesting white paper, it specifically focused on the use of their software as a Web 2.0 tool in Pathology.  However, Web 2.0 for pathology is much more than just a Digital Pathology software interface; it’s an enabler to the advancement of personalized medicine.

On Wikipedia I found the following definition for Health 2.0, “…technology as an enabler for care collaboration.” Care collaboration between patients and their MDs is an essential component of personalized medicine, and digital pathology establishes the tools necessary to create a collaborative environment in pathology.   2.0 is empowering patient self care, and driving patients to become more informed and take responsibility for their own well being.  A perfect, yet rare example of collaborative care in pathology was described by Dr. Keith Kaplan in his blog post, “This is Your Cancer.” In this post Dr. Kaplan describes a memorable moment when a patient came to his office and asked to see his slides.  This patient was empowered and determined to become more informed about his cancer diagnosis.  Dr. Kaplan states, “These occurrences also remind me that every number is a life.  Every accession number, order number and slide is a life.”  What happened to Dr. Kaplan may start to occur more often, and to more pathologists.  But rather than waiting for a patient to knock on an office door, pathology departments need to embrace transparency and deploy tools that support better collaboration with their physicians and their patients.  The role of a physician is evolving, and being a care collaborator will make the transition to personalized medicine easier.

Not sure where to start?  Check and see what other hospitals or laboratories are doing.  Many healthcare institutions, like Cleveland Clinic and Mayo Clinic, have created Facebook pages, blogs, patient forums, and Twitter accounts to interact and communicate with the healthcare community.  Become a “friend”, “fan”, or “follow” when you find something interesting, then think about how to bring these types of tools to your practice or laboratory. And of course, there is always the Digital Pathology community which offers blogs like Digital Pathology Blog and The Daily Scan, Digital Pathology groups on LinkedIn, and even social networking with PathXchange.org- a vendor-neutral, not-for-profit professional networking portal for the global pathology community, promoting digital pathology.

Interested in collaborating with me 2.0 style, click on one or more of the tools below.  I welcome the opportunity to network and collaborate with you!

• Facebook Page: www.facebook.com/digitalpathology

• Twitter: DPConsultant or http://twibes.com/DigitalPathology

• LinkedIn: http://www.linkedin.com/in/amandajlowe

• Subscribe to this blog’s RSS feed at feed://digitalpathologyconsultants.com/DPCblog/