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I’ve just attended John Moore MD’s “defense,” as they call it – his presentation of the results from his PhD thesis project at the M.I.T. Media Lab.

The project has participatory medicine written all over it: it’s about

Developing the role of the patient

using an “apprenticeship” approach
to the patient/clinician relationship

enabled by technology that makes it easy
to stay aware of how you’re doing.

I hope to write more about it in the coming weeks, as I learn more and his thesis is published. For now, I want to start with a couple of quick notes:

  • This project was about chronic conditions, to develop patient skills at self-management. (Specifically, Moore ran trials for diabetes and hypertension.)
  • The “apprenticeship” model (specifically cognitive apprenticeship) strikes me as the most powerful and empowering approach I’ve seen to developing real competence.
  • To develop competence at anything, any apprentice needs to know how they’re doing. This requires a new kind of data system. The open source platform CollaboRhythm was used to collect data and to host patient feedback apps, on smartphones, tablets, whatever.
  • The results presented were impressive. He’ll share his whole slide deck later, but here’s one example: at Joslin Clinic, hemoglobin A1C  improved 3% in 3 months. For comparison, the industry norm (standard of care) is a 1% improvement in 12 months.
    • The increased cost in clinician time was just $200 per patient, suggesting that this really was transferring clinical value to the patient.
  • I didn’t grab the numbers for the hypertension experiment but it too supported Moore’s thesis, that real clinical improvements can be achieved through health IT.
  • The apprenticeship model reflects the idea that the patient’s own abilities get developed, then s/he achieves “master” status – and goes on to mentor other patients.

Much work remains to be done to see how well the benefit persists. I’ll post more information as I get it.

Again, what grabbed me – what made me sit right down and the reception and do this post – was the apprenticeship approach, supported by really effective use of data and tools to present it to patients in meaningful ways.

Note that CollaboRhythm is open source, which means all kinds of vendors can develop additions to it.





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