tag:blogger.com,1999:blog-8234447925221638598.comments2023-06-23T06:21:16.423-04:00Christine Kraft's Blog Christine Krafthttp://www.blogger.com/profile/07079954620781376315noreply@blogger.comBlogger193125tag:blogger.com,1999:blog-8234447925221638598.post-67574675246224397932015-08-19T09:34:01.146-04:002015-08-19T09:34:01.146-04:00Thank you, Dave! We can always count on your thoug...Thank you, Dave! We can always count on your thoughtful analysis. <br /><br />I apologize that this reply is so late. I posted back on the same day, but somehow it never made it here. Your comments are always rich with good thoughts and connections.Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-12216838108733481952015-08-09T12:17:36.716-04:002015-08-09T12:17:36.716-04:00For those who don't know, Rushika is one of th...For those who don't know, Rushika is one of the most long-lasting, persistent creators of <i>heart-and-soul driven</i> innovative approaches to primary care. More than a decade ago he was spotted by "Doc Tom" Ferguson, founder of the e-patient movement, and was included in the manifesto he was writing at the time of his unexpected death. This January I wrote about his current company Iora Health <a href="http://e-patients.net/archives/2015/01/the-movement-gets-real-one-of-doc-toms-sightings-gets-28-million-with-iora-health.html" rel="nofollow">on the e-patient blog</a>.<br /><br />Check out what Iora says about <a href="http://www.iorahealth.com/model/" rel="nofollow">its model</a>: <br /><br />"Our care team, which includes a dedicated advocate for each patient, works together to treat the whole person. We see people when they’re sick, but also when they’re well, so that we can keep them healthy."<br /><br />Do click the link for that January post, and when you get there, read the e-patient white paper that it links to, where Doc Tom talked about Rushika's earlier work a decade ago.e-Patient Davehttps://www.blogger.com/profile/16381434866099596466noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-41541380746927606912015-08-09T11:03:47.072-04:002015-08-09T11:03:47.072-04:00Rushika, thank you for reading and posting. Your c...Rushika, thank you for reading and posting. Your company is exciting; you've raised the bar and I love what you and your team are doing! I have many questions and curiosities regarding how business model transformation helps unleash the social capital we agree is blocked systemically. I hope we'll connect in DC or Boston to continue the conversation. <br /><br />Love is a word that sounds careless and conflicted to so many working in a system that values complexity, intervention, precision above all else. The idea of a coach or coaching is more aligned with norms while still promoting radical culture change... A good coach knows that providing space for a patient to experience what hurts before being hurried to heal is compassionate. I like that you are working with coaches so much! Whatever term we use, I agree that it is relationships that matter, this idea that one changes and grows and heals through relationship over time and across the life stages... This is life; the potential for health even in the face of disease. <br /><br />Can't wait to learn more about your team and plans for expanding your reach! <br />I have not stopped investigating and meditating on the topic since writing this post in 2013. You are creating as close a platform to love as is possible in a market-driven system. I hope IORA is wildly successful. <br />Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-3481052180257055522015-08-09T06:58:54.393-04:002015-08-09T06:58:54.393-04:00Christine, I love this post, and agree with your &...Christine, I love this post, and agree with your "diagnosis" but think you don;t go far enough in your "treatment". I completely agree that while many individuals in healthcare show love in their work, the system is toxic to this. At root is the fee for service billing system itself, which turns health care into a series of transactions. The solution isnt to create a billing code for love, but to take away the transactions completely and rebuild the system on relationships. We've been doing this at Iora Health for several years now (www.iorahealth.com) with great results. Thanks again for the post. Rushika Fernandopullehttps://www.blogger.com/profile/09551085208250898634noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-2354915395485270442015-04-21T09:07:44.338-04:002015-04-21T09:07:44.338-04:00Hi Debra! Thank you for reading the post and for y...Hi Debra! Thank you for reading the post and for your wise comment. I hope our paths do cross on the journey. Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-48072629593457364622015-04-21T09:00:07.316-04:002015-04-21T09:00:07.316-04:00A great article. What a well-written reminder to u...A great article. What a well-written reminder to us to take care of ourselves- but not in the self-serving, overly self-focused ways we see implemented. I look forward to watching your journey, and perhaps joining you as well. Thank you.Debrahttps://www.blogger.com/profile/05950195278687827167noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-43106817006951622512015-02-07T08:39:19.625-05:002015-02-07T08:39:19.625-05:00What is fascinating is that the crossing from comp...What is fascinating is that the crossing from compliance and conscious acceptance of uncertainty is something that we have to do again and again. Small ways and big ways. This relates to the idea that there is some developmental mastery involved in the process. It's not one and done ... but could become less threatening over time. There are many warriors out there - the frequent flyers of the health system that could be the master teachers. Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-88525202247466922172015-02-07T08:04:51.135-05:002015-02-07T08:04:51.135-05:00You are so generous to share this story - thank yo...You are so generous to share this story - thank you. <br /><br />I thought of Lisa Adams's use of Twitter to remind people: "Please make a healthcare appointment you have been putting off. Donate blood if eligible. Update your will+medical proxy #mondaypleads" <br /><br />Maybe by sharing our stories we can inspire each other toward better self-care. I've been putting off some appointments. I'll set a reminder to call on Monday, thanks to you.Susannah Foxhttp://susannahfox.comnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-10342366374404074882014-12-18T11:27:25.399-05:002014-12-18T11:27:25.399-05:00Thank you for sharing! Ordered two copies immediat...Thank you for sharing! Ordered two copies immediately -- one to keep, one to give.Susannah Foxhttp://susannahfox.comnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-40299231921352119892014-12-11T16:33:05.896-05:002014-12-11T16:33:05.896-05:00You're a post whisperer! Thanks for reading a...You're a post whisperer! Thanks for reading and for encouraging me. <br /><br />I'll see what the new year brings. Courage is not always what is needed. Sometimes it is a calling. <br /><br />Hoping the year has both for me. Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-80972799964407821142014-12-11T16:16:13.343-05:002014-12-11T16:16:13.343-05:00Brava to you for hitting the 'publish' but...Brava to you for hitting the 'publish' button, Christine! Much wisdom and truth in what you write. *Love* this: "Why continue to watch and wait on ideas that keep women isolated and separated instead of together and collaborating?" Yes, indeed - I'm in! ps - Please hit 'publish' on some of those 'in queue' postings, too! =)Anonymoushttps://www.blogger.com/profile/08277090348629654982noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-18188202158376039072014-12-11T08:45:19.303-05:002014-12-11T08:45:19.303-05:00Such a voice you have, Susannah! I am glad you sho...Such a voice you have, Susannah! I am glad you showed up here.<br /><br />Many thanks for your light and ways. (And especially for the encouragement to publish. That means a lot.) <br /><br />Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-90497764108007746452014-12-11T08:27:41.207-05:002014-12-11T08:27:41.207-05:00I'm in. I'll join you. Thank you for hitti...I'm in. I'll join you. Thank you for hitting publish. Thank you for shining a light on the path.Susannah Foxhttp://susannahfox.comnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-43993796486308785252014-12-02T09:04:04.016-05:002014-12-02T09:04:04.016-05:00You know, somehow I missed this comment back in 20...You know, somehow I missed this comment back in 2007. It is as relevant a question today, seven years later. AND it makes sense to all of us. Doing more is not an end point. In fact, I have walked through this lesson repeatedly as a soul and all I can say is that the primitive instinct to Do rather than to Experience is the source of much suffering. <br /><br />In fact, I would argue that we do and get busy in order to avoid feeling lost. If our lives are predictable and our behavior, reactions, ups and downs are mostly predictable according to the people and core values of our lives, we avoid experiencing a lot of uncomfortable feelings.<br /><br />If you are interested in reading about this idea, I highly recommend you read, The Untethered Soul. I just re-read it over the weekend. Author Michael Singer is truly gifted and penetrates many complex cultural veils that we presume to be law in our lives. Reading the book takes courage but you may see yourself (I did/do) in the pages. From there, small shifts in consciousness -- an improved ability to perceive "doing" at face value -- becomes less anxiety-provoking.<br /><br />As the famous saying goes, it is possible to wander without being lost. It takes practice and a friend. Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-63882258930947096682013-09-29T23:32:08.132-04:002013-09-29T23:32:08.132-04:00Thanks for the thorough and well-written perspecti...Thanks for the thorough and well-written perspective on billing codes Christine.Medisofthttp://www.ironcomet.com/medisoftnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-18741395625826610522013-02-14T10:36:31.142-05:002013-02-14T10:36:31.142-05:00Check out Doug Neill's lively sketchnote for L...Check out Doug Neill's lively sketchnote for <a href="http://cocovillage.blogspot.com/2013/02/sketchnotes-meet-health-innovation.html" rel="nofollow">Love needs a billing code.</a> Imagine if he captured all the comments too... Cool talent. Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-6336980013019822462013-02-03T06:21:19.710-05:002013-02-03T06:21:19.710-05:00Very interesting work and thank you for posting yo...Very interesting work and thank you for posting your comment. As I read over the Charter, I was amazed that by even reading about compassion can introduce comfort and healing. I encourage others to read the Charter.<br /><br />One more thing stood out, it was this specific passage from your About page. This passage touched me because it speaks right to the center of health care's major duality: the conflict between that which we long to be present and that which is increasingly absent in the act of delivering or receiving care. It's as though we're losing a native language or a deep cultural tradition... <br /><br />The passage (with a minor edit in brackets to add emphasis) below:<br /><br />"Despite increasing awareness and hundreds of studies showing the importance of good communication and relationships in healthcare, compassion, caring and healing have diminished. [Yet] As we worked together from our diverse cultures, languages, backgrounds and perspectives to discover why healthcare is losing its human dimensions, we found that medical communities across the world share core human values. We recognized these values, the human dimensions of care, as primary. We developed an ongoing process to define and share these values."<br /><br />I hope the International Charter for Human Values in Healthcare will spread. Keep us posted.<br /><br />The International Charter for Human Values in Healthcare: http://charterforhealthcarevalues.orgChristine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-73726683609931501662013-02-02T23:21:06.225-05:002013-02-02T23:21:06.225-05:00Just found your great post! We like your question,...Just found your great post! We like your question, "So why is there not a billing code to measure the caring potency of a health care encounter?" Caring, respect, ethical practice, and other values are essential to compassionate, safe healthcare.<br /><br />Several years ago, we established an international collaborative effort to identify and promote the human dimensions of care. <br />We’re working to enhance relationships and healing in healthcare, and created the International Charter for Human Values in Healthcare, starting with the capacity for compassion. The mission of the International Charter for Human Values in Healthcare is to restore the human dimensions of care – the universal core values that should be present in every healthcare interaction – to healthcare around the world. <br /><br />We invite you to join us in our work! http://charterforhealthcarevalues.orgValues in Healthcarehttp://charterforhealthcarevalues.orgnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-48138757634741326012013-01-19T07:24:43.850-05:002013-01-19T07:24:43.850-05:00Dave, your observation about "the higher you ...Dave, your observation about "the higher you go in medical training..." sparked two thoughts (not original to me - quoting others):<br />- pediatricians and nurses are the most likely groups to adapt their practices for continual quality improvement (said at a QI symposium I attended)<br />- Patch Adams, MD, expresses the need for love and "feeling taken care of" in his 2010 speech at the Mayo Clinic's Transform event: http://www.youtube.com/watch?v=CdCrPBqQALcSusannah Foxhttp://susannahfox.comnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-55337226863008972872013-01-16T14:09:40.549-05:002013-01-16T14:09:40.549-05:00Here's a sneak preview of something the genera...Here's a sneak preview of something the general public doesn't know about -<br /><br />Next month I'm doing my first management workshop, with one department at St. Luke's Hospital in Boise. In preparation they shared the moving and inspiring video in <a href="http://drpate.stlukesblogs.org/2012/07/19/doing-your-best-dying-with-dignity-lessons-from-an-empowered-patient/" rel="nofollow">this blog post</a> by their CEO, David Pate - a talk at their annual staff meeting with Cy Burr, a patient who was dying (died a couple months later), about the many dimensions of <i>feeling taken care of.</i> <br /><br />I'm working with them on implementing truly patient centered care, starting with what that means. <br /><br />A challenging aspect of this issue for many people, I've found, is that the higher you go in medical training, the more it's about technical information and skills (important, of course!) with less emphasis on care. Care, care, care. Who cares? Take care.<br /><br />One challenge is that sometimes the best way to care for someone is to NOT do services for them. In a satisfaction-driven world that works out fine; in Fee For Service, it's a fail. FFS is a great Satan in the context of care.e-Patient Davehttps://www.blogger.com/profile/16381434866099596466noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-55864642444413787652013-01-16T13:48:46.250-05:002013-01-16T13:48:46.250-05:00Coincidentally, @MarkHurst at Creative Good blogge...Coincidentally, @MarkHurst at Creative Good blogged on something very close to this topic yesterday. He approached the topic from the UX perspective, but acknowledges, "This 'genuine human interest' goes by different names, and it’s certainly not exclusive to the fields of customer experience and interaction design. <br /><br />His post: http://creativegood.com/blog/what-is-career-in-user-experience-really-about/<br /><br />____<br /><br />BONUS: In his post Mark points us to a physics teacher's extraordinary personal story. That story illustrates "the force that is 'greater than energy… greater than entropy.' <br /><br />A must see that brings the conversation full circle, heart-shaped.Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-88101922690313469642013-01-16T13:34:36.071-05:002013-01-16T13:34:36.071-05:00I'm pretty sure I'm not the first to say &...I'm pretty sure I'm not the first to say "the *experience* of being cared for" - I picked up the idea somewhere, I know ... maybe I adapted it from a more general customer service principle: "Who gets to say whether the customer got good service? It all comes down to whether the customer FEELS LIKE they got good service."<br /><br />The very principle itself - service - involves being *of* service; subordinating one's own view to that of another.e-Patient Davehttps://www.blogger.com/profile/16381434866099596466noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-16387186684038980672013-01-16T11:31:55.816-05:002013-01-16T11:31:55.816-05:00Carolyn, thank you for your thoughtful post. The w...Carolyn, thank you for your thoughtful post. The work of Montori sounds truly amazing, but the stat that so many are still discharged without an appropriate plan truly demoralizing. The space is riddled with such dualities. <br /><br />Eye rollers aside, at a certain point it must become simpler to get a helping hand.Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-60444978922342739242013-01-16T09:51:44.516-05:002013-01-16T09:51:44.516-05:00Thank you Christine for this inspired and inspirin...Thank you Christine for this inspired and inspiring challenge to seek "a more loving system end to end, one that is as big for love as it is in love with big data." As a patient, I heartily applaud this. But as a realist, I can already imagine the eye-rolling among many physicians in response to it. <br /><br />For example, I've been following (and cheering!) the work of Dr. Victor Montori and his Mayo Clinic team who are working on the concept of Minimally Disruptive Medicine - an approach that examines the "burden of treatment", or how the "work" of being a patient can often exceed capacity to cope. It's a concept that asks docs to look at the whole patient, not just the 10 o'clock appointment. <br /><br />Yet even as Montori et al try hard to spread the wisdom of such compassionate assessment, at the same time we're reading shocking stats from the Center for Advancing Health that 91% of hospital patients are being sent home with NO discharge plan. Where is the love in that reality?<br /><br />We're reading in theheart.org that one of the reasons that a shockingly low percentage of heart patients are being referred to cardiac rehabilitation is that "doctors are in the business of prescribing drugs, not prescribing exercise" - despite the known longterm health outcomes associated with rehab. Where is the love in that reality?<br /><br />As much as I'd like to see a billing code for love, even more important to me is convincing doctors to show true caring and concern about their patients by following the treatment protocols that already have billing codes.<br /> <br /><br /> Carolyn Thomashttp://www.heartsisters.orgnoreply@blogger.comtag:blogger.com,1999:blog-8234447925221638598.post-49784693704385817742013-01-16T09:25:43.217-05:002013-01-16T09:25:43.217-05:001. Agree, but am sorry the extent to which the fee...1. Agree, but am sorry the extent to which the fee-for-service model has its talons in;<br /><br />2. So many "ifs and whens" bundled within this statement; what can we do today? Can we give something away for free that gives people an authentic feeling of being cared for?;<br /><br />3. The phrase "the experience of being cared" for is a wonderful turn of phrase, Dave. Love that.<br />Christine Krafthttps://www.blogger.com/profile/07079954620781376315noreply@blogger.com