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cChange in Health Care Discussion
cChange Network Team
cChange members develop topics they believe will advance cross-disciplinary, patient-oriented medicine through changing and improving health care provision.

Discussions, news, debate from members and across the media spectrum. See how members are developing networks and building pathways to real change as they share resources, experiences and ideas.

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News Item 1
Patients' Perspective of Computerized Records
General practice consultation today is a three-way interaction between patient, doctor and computer. Studies have shown that the computer’s introduction has concerned some patients. If patients are less frank about their problems in a computer-mediated consultation this may become a barrier to computer use.
Read the results at Ingenta.com
News Item 3
Arden House: BBC Radio Documentary
The documentary re-visits Ellen Langer and Judith Rodin's 1976 study, conducted in a New England nursing home for the elderly, in which residents on two floors would experience some changes in their everyday life. They had no idea that they were introducing factors which could prolong life.
Hear the documentary at the BBC website

News Item 3
Surrender in the OR ... a Patient's Perspective
Aware of the possibility of future and more serious surgery this blogger "...began thinking about all the other trips to the OR and my feelings regarding my patient experiences in various parts of the hospital, emergency, inpatient, SDS, Pre-Op, the OR and Post-OP.
I especially pondered the final surrender."
Read her complete story
News Item 4
Dr Jerome Groopman: The Doctor's In, But Is He Listening?
Jerome Groopman is a doctor who discovered that he needed a doctor. When his hand was hurt, he went to six prominent surgeons and got four different opinions about what was wrong.
Listen to the interview on the NPR website

Collaborative Learning
Collaborative Learning Defined
at the Global Development Research Center.
Women’s Health Resource Library
AMWA and ACWHP are trying to work on curricula in women's health- collecting and writing as needed. This is a trial at cChange in Health Care, to show the possibilities of social networking as a method to work on this.
Pittsburgh Regional Healthcare Initiative: A Systems Approach For Achieving Perfect Patient Care
A look at the PRHI innovative model for health system change based on regionwide shared learning at Health Affairs.
Collaborative Learning

Palliative Care Training
Experience and Attitudes of Surgeons Toward Palliation in Cancer
A survey of general surgeons involving 4 clinical vignettes of patients with advanced malignancies and varying degrees of symptoms at Archives of Surgery.
Health Policy Monitor - A National Training Program in Palliative Care
A study of an interdisciplinary training program developed and implemented in Israel.
Nurses and Chronically Ill Patients: Open Communication is Key
Lisa Copen, founder of Rest Ministries, explores patient/nurse communications.

Palliative care skills training needed for health-care staff in sub-Saharan Africa
ScienceBlog appraises the King’s College London study.
Palliative Care Learning

Diversity in Health Care
Viewpoint: Physician, Know Thyself - The Professional Culture of Medicine as a Framework for Teaching Cultural Competence
from Academic Medicine, Journal of the Association of American Medical Colleges.
A Call to Action to Address Diversity in Public Health Professional Education
Posted at cChange in Health Care.
An Introduction to Cultural Differences
from Geri-Ann Galanti, author of ‘Caring for Patients from Different Cultures’.
Diversity in Health Care

Narrative Health Care
Patient Photos in Medical Charts
A conversation with Steve Bogdewic, PhD at Sound Medicine.
A picture connects a real person to test results and x-ray films but it might risk treatment based on perceptions of age, race or ethnicity.
Viewpoints Concerning Narrative Health Care
cChange in Health Care Members exchange ideas about the concept and practice of narrative health care and its definition.

Patient Photos Spur Radiologist Empathy And Eye For Detail - Science Daily
Including a patient's photo with imaging exam results may enable a more meticulous reading from the radiologist, as well as a more personal and empathetic approach, according to a study presented by the Radiological Society of North America.
‘Health Story Project’ Offers Perspective on "Meaningful Use" Definition
The importance of incorporating the patient narrative into EHR from the beginning.

Getting Doctors To Listen to Patients
Chuck Appleby at Managed Care Magazine - Anecdotal reports and academic research are replete with evidence that patients of doctors who listen well have better clinical outcomes. But there are also plenty of clues that most doctors need to improve their listening skills.
Narrative Health Care

Primary Care for All - A Program for National Renewal
Primary Care for All at cChange
Primary Care for All has created a Member's Page. Visit for details and comment.

Signatures and Funds Petition
Build momentum for legislation
Visit Michael Fine MD website to find out how you can add your voice to the campaign to get the comprehensive Primary Care for All program onto the political agenda.

What the world needs now...
A commentary on Shannon Brownlee’s ‘Overtreated’ from Colin Kopes-Kerr, MD at cChange in Health Care.
Download Delivery System White Paper
A program for national health care renewal from Shannon Brownlee, MS and Michael Fine, MD.

Sick Around the World: Can the US learn anything from the rest of the world about how to run a health care system?
Watch this Frontline program online.
The Cost Conundrum
The New Yorker
What a Texas town can teach us about health care.

Caring and Sharing
Health Management Technology
A technical look at the community care model and the advantage of physicians sharing patient information electronically.
Diversity in Health Care