What if Don Draper had to Sell Wearable?

I'm a big fan of Mad Men.  Unfortunately, I'm old enough that it feels like my youth.  But beyond that, it’s an interesting window into another culture, America in the 60's.  I'm also intrigued by Don Draper's ability to sell anything, to make products that might kill you have emotional stickiness.

Why Google Glass.....
when you can put monitors right on your eyeball

Watching the show I've often transfixed by the technological changes in the last 50 years.  They use cord phones as their only way to communicate.  If Don wasn't in the office or at home, he couldn't be found.  In a recent episode, a computer was introduced to the office.  One of the characters was literally driven mad by the incessant hum emanating from the control room.  In contrast, we are constantly connected, always available, and soon to be, always monitored.  My question, how would Don Draper sell wearable technology?  How would he make it sticky?

I want to live forever, but I won't.  No matter what I do, my time is finite.  Ultimately it comes down to what I'm willing to give up today in terms of personal freedoms and additional anxiety (yes, the decision to monitor brings my frailties to my consciousness), in exchange for some benefit tomorrow. Ideally I would live an stress free world and then drift off in my sleep.  Unfortunately most of us spend part of our lives with a constant companion, a chronic illness, in our later years.

In order for wearable to truly take off, it will need some message, something that addresses our base instincts rather than simply offering something cool.

I don't want to be monitored.  I want to live without worry as long, and as comfortably as possible.  If he were to sell me on wearable, what would Don say?

Rural Mental Health in America

By Margo Kulseth, MLIS, Information Specialist

May is National Mental Health Awareness Month. But what does awareness mean? Who lacks awareness, and how can we rectify it?

Our societyin general lacks awareness about the factsof mental illness. One in four of us will experience mental illness in a given year. If you think you aren’t affected, consider that mental illness costs our country hundreds of billions of dollars each year for things like medical care for the uninsured, disability payments, and lost productivity.

The medialacks awareness and often contributes to the stigma surrounding mental illness and its siblings, substance abuse and suicide. How could we be fully aware about mental illness when we hear about it only in the wake of tragedies like school shootings and other acts of violence? This type of sensationalism in reporting is misleading. In fact, the majority of people with mental illness are not violent.

Many individualssuffer in silence due to lack of understanding or shame about admitting to a problem. Mental illness is not to be blamed on the patient any more than other medical conditions. Yet it is the stigma that prevents many from seeking help and receiving treatment. This problem is magnified in rural areas where neighbors know each other well and don’t want themselves or their vehicles to be seen at “that” clinic (if mental health services even exist in their area). The alternative is to drive great distances for treatment.

Our health care workforce lacks awareness about how to treat mental illness. Because of the lack of mental health services and providers, especially in rural areas, many people, if they get treatment at all, receive care from their family physician who is usually not optimally trained in this type of specialty care. It is often difficult to recruit and retain clinicians in rural areas, and mental health specialists are no exception. One solution is to use telemental health, which is long-distance counseling and treatment via teleconferencing or video conferencing. In a crisis, individuals may seek help in the emergency room, where, if the need is recognized and properly diagnosed, patients are still unable to be admitted or transported by ambulance to the nearest psychiatric facility, which may be full or simply too far away.

Police officers, who are often the first responders in a mental health emergency, especially in rural areas, lack awareness about how to recognize and handle people with mental illness. Again, the media tells tragic stories of police using force against someone who appeared dangerous, only to learn later that person was experiencing psychosis and unable to think clearly or act appropriately. One way this is being addressed is through crisis intervention team (CIT) training, which provides techniques and skills for dealing with this type of situation.

Staff at correctional institutions lack awareness about mental illness. Estimates are that 44% to 64%of inmates at jails and prisons in the US are mentally ill, and many are not getting treatment, prompting some to refer to our correctional institutions as warehouses for the mentally ill. Even those who enter the system while receiving treatment may be denied ongoing care while incarcerated.

Our legislatorslack awareness. Some states have cut back on funding for mental health care. Creigh Deeds is a Virginia State Senator who was stabbed in the face by his son with mental illness just before his son took his own life after seeking treatment and being turned away due to lack of available inpatient services. Senator Deeds’ face bears the scars of the attack. His personal experience and the resulting disfigurement, combined with his position of political power, provide some hope that his ideas about how to address the mental health care crisis in his state and in America will be given serious attention and result in positive action by our lawmakers.

There is good news! Our country as a whole is gaining awareness about mental illness. The Affordable Care Act will give millions of Americans access to affordable health care, which includes mental health and substance abuse coverage. There are a number of other major initiatives in progress designed to strengthen the mental health of all Americans, including some targeted to specific at-risk populations such as military service members, Veterans, children and rural residents.

So what else can we do? We must keep advocating for those who are not receiving proper mental health services for one reason or another. We must educate the public, service providers, and lawmakers and create a better plan for addressing the current crisis in our country. And we must integrate primary care, mental health, and all other medical services by working together, collaborating and embracing telemental health opportunities for the good of the patient.

Advocate.

Educate.

Create.

Integrate.

Collaborate.

To raise your awareness of mental illness, please visit the following websites as well as those linked in the text above for more information:

Mental Health America (MHA), formerly known as National Mental Health Association

MentalHealth.govfrom the US Department of Health and Human Services (HHS)

National Alliance on Mental Illness (NAMI)

National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), a component of the US Department of Health and Human Services (HHS)

Substance Abuse and Mental Health Services Administration (SAMHSA)

Portals Are for Cattle, Personal Health Records (PHR) Should Be for People

There seems to be confusion around the term Portal and Personal Health Records (PHR) in healthcare.  Let me explain.

Portal displays or communicates with a practice or network

Portal is a hospital's attempt to improve customer service.  A typical portal allows you can log on to your hospital, see your records, schedule a visit, or possibly message your in network provider.  Compared to the days of fax and phone it’s clearly a step forward.  And it works as long as this is the only place you go for care.  However, unlike cattle, most people don’t tend to stay inside hospital fences.  People wander from hospital to hospital, clinic to clinic, sometimes going to a doctor in network and sometimes going to one out of network. Portal is limited tool for a single hospital or network.

PHRs are something else entirely.  Fundamentally, they are owned by patients.  The record collects all care, irrespective of the health system.  It is not a tool for marketing, tethering you the patient to a particular set of providers, but rather an organized way to tell others about you.  Ideally, a PHR would leave room for patient self report.  Healthcare systems seem to forget that most of health occurs at home.  Hospital records leave no room for patient self report.  Personally I feel how patients feel about themselves day to day, whether their happy or depressed, has far more to do with their health and outcome then whether they took their medicine or lost weight.  A true PHR would collect information across the continuum- from hospital to home, across all providers.

An ideal PHR would gather all information for the patient
and put it into the cloud

Without an effective digital tool, many patient’s literally resort to a shoebox for their PHR. Particularly for those with a chronic disease, there is a clear need.  So why hasn’t the market provided one?  Attempts have been made.  Both Google (Google Health) and Microsoft (HealthVault) literally spent hundreds of millions of dollars in what were largely failed efforts.  In part, this was do to a failed business model based on…. advertising.  Hospitals initially looked to leverage Microsoft’s HealthVault, but got stuck in their old ways of thinking by reverting to “portal” built on top of HealthVault.  For all their outward mission based altruism, in the end hospitals are businesses.  They have a hard time thinking beyond I win/you lose mentality and tend to look for market differentiators rather than collaborative strategies to deliver better care at a lower cost.  Too bad.  Can you imagine the first hospital to offer a true PHR?  Sure it would help their competitor by collecting records for the patient, but do you really think it would work equally well across providers.  The first hospital would do well by doing good.

With the new federal mandates it’s time to stop spending on fences (portals), and start thinking about continuum (PHR).  Grabbing patients via insurance plans or Accountable Care Networks will only go so far.  To actually improve care at a lower cost a true PHR, a patient owned record managed by a hospital would provide huge value for all stakeholders.  At the very least, we should stop referring to portals as PHRs, something they’re not.