The Society for Participatory Medicine enthusiastically supports this new, transformational initiative from the Robert Wood Johnson Foundation: Flip the Clinic. (Don’t you love the logo? Turning the clinic on its ear?)
It’s utterly engaging and empowering to patients, because it puts information in the hands of the patient and family – outside of the clinic visit, where we can study it at our own pace. Plus, it radically re-optimizes the “face time” of the visit, by offloading (or “pre-loading?”) an important part of the visit: knowledge transfer from clinician to patient. The clinician prescribes information for us to learn before the visit, based on the topic of the visit – so we spend our face time asking questions, instead of wishing after the visit that we had more time.
At the bottom of the FlipTheClinic home page is a list of “ally” organizations. We’re one:
The Flippin’ future: clinics, classrooms, everything
Followers of new ideas in knowledge – particularly education – will notice the similarity with Khan Academy’s Flip the Classroom movement. This Forbes post in 2012 (this is not new!) does a great job of summarizing the classroom version; note its parallels with the clinic version:
- More one on one time with teacher
- Students learn at own pace (compare that with the time pressures of an office visit!)
- Encourages Mastery
- Levels the playing field
- Addresses absenteeism (not much parallel here – or is there?)
- Excellent diagnostic tool
- In education this means the course computer can detect who needs help. We’re not there yet in Flip the Clinic, but I’d bet my house that we’ll be doing it: if we have good patient information systems based on the classroom systems, we can use the same “uh-oh, these ones might need help” algorithms.
- Students teach students
- Ahem … e-patients have been doing this with each other for decades in what Susannah Fox calls peer-to-peer healthcare. In this aspect we’re way ahead of education!
- Involves parents
- In medicine this shows up as “lets family and caregivers help.” How often we’ve heard about someone who comes home from an appointment – family asks “What did the doc say?” and the patient shrugs: “Not much” or “I’m not sure.” Flip the Clinic lets everyone involved view the same patient information material.
Autonomy, flexibility and resources at home: empowering
An important dimension of this transformation is that it puts trusted, establishment-approved information in the hands of the patient and family, before and after the visit. This is a natural compansion to the OpenNotes project, which demonstrated that patients do better in many ways when they have home access to their doctors’ visit notes.
[In the above paragraph, ardent fans of our movement surely had alarm bells go off at the phrase “establishment-approved,” because no source – including the establishment – can be counted on to be perfect; as SPM co-founder Gilles Frydman said in 2010, “All knowledge is in constant beta.” But that’s a separate problem: Flip the Clinic is a major step that will help many people move to the next level.]
Both Flip and OpenNotes are supported by the Robert Wood Johnson Foundation. It’s no coincidence that RWJF also sponsored our founder “Doc Tom” Ferguson’s seminal e-Patient White Paper, e-Patients: How They Can Help Heal Healthcare, which is on the right sidebar of this blog, in English and Spanish.
In my book Let Patients Help I said “People perform better when they’re informed better.” A new era is arising, in which medicine truly begins to take advantage of new technology and methods from other industries. I say, hallelujah.
Thanks Dave! We are thrilled to have you and S4PM on board with Flip the Clinic. Together, we will make it easier for everyone to let patients help!
Agree with Thomas–thanks for the support and fantastic post. SPM will be a great Flipping ally.
> great Flipping ally
I think a meme has been born. Love it!
I also support and like the Flip the Clinic idea, especially after my own forays into Flipping the Classroom by replacing some lectures with videos and handouts.
I hope that part of this effort includes Flip the Waiting Room, since the waiting room is a great place to provide education and to guide aspects of the appointment that is being waited for. One possible approach is not to provide a list of questions or boxes to check, but to scaffold someone in creating their own list.
I also wanted to mention that in my course, Mobile Health Design, students designed apps for use in a doctor’s office. One of the best examples was an app to use with a Pediatric Allergist, for both intake – what can a parent capture in text, photos, and video and share with a doctor – and education, since typically one parent comes with a child but there are other parents, grandparents, teachers, siblings, and babysitters who need education. I would like to see Flip the Clinic include how technology can be used by patient and provider together much like the designs of my students.