Friday, September 2, 2011

Start with the Children #2

What would a curriculum to teach children about our healthcare system look like?  I'm thinking the audience is an 11th or 12th grade health class.  I figure that we get about 8-12 classes in a typical term, depending on the school system, each about 45-55 minutes long.  One of the challenges mentioned on today's #HITsm chat was the fact that engaged patients are still "the elite".  My thesis is that we don't teach the right skills to people.  Building upon my first Start with the Children post, I'm wondering if there is something that can be done about that.

Your rights (1-2 classes):
  • Rights to obtain medical records from your healthcare provider and to keep your health information correct, private and secure.  
  • Class assignment, write a letter to your healthcare provider requesting a copy of your records.  
  • Determine if your healthcare provider is aware of and participating in meaningful use.
  • Your rights to obtain emergency treatment.
  • Your rights to protest decisions about necessary treatment with your insurance company.
  • Your right to a second opinion.
  • Your rights to obtain health insurance.
Visiting your Doctor (3 classes):
  • What are the different types of medical professionals and what do they do?
  • What are vital signs and what do they say about your health?
  • How to report signs and symptoms effectively.
  • Asking questions
    • How will this treatment affect me?
    • What other treatment options are there?
    • How will the results of this test affect my care?
    • What is our plan?
  • What to do if you don't agree with your doctor.
  • How to read your medical records. 
  • Picking a doctor or hospital
Dealing with your insurer (2 classes):
  • Picking an insurance plan
    • What kinds of plans are there, and how do they differ?
  • Determining what treatments are covered and what are not
  • How to communicate with your insurer.
  • Pricing treatments and tests
  • Handling Disputes
Dealing with your pharmacist (1 class):

  • Not sure what to include here.

Dealing with an employer (1 class):
  • What to tell an employer about your health, what they can ask and cannot. (maybe covered in your rights)
  • How you employer might be able to help you with healthcare issues.
  • Healthcare related benefits and their value
If someone wants to help me develop a curriculum for my hometown, I'd be happy to approach the school superintendent with it. I think it could also be used for adults with a few modifications.  Any takers?


  1. What kind of "funding" (amount, structure?) would it take? -Pete (@e_Cntr)

  2. Definitely a great idea. My only concern reading the post is that it is quite ambitious. This is a complicated slate for most health care professionals, let alone a room of kids more interested in their iPhones than their teacher. How can we simplify the message?

    One possible angle to get them listening is to reinforce how hot the health IT industry is. This may work better with college kids who are hearing about how bad the job market is. What do you think?

    Great topic and worthy of more discussion!


  3. If a 9-year-old can get exited about getting and correcting their medical records, surely a high-school student can as well. College is great, but not everyone gets to go to college. You are right, the key will be getting them to engage, but I know it can be done. One possibility is to get community professionals teach the class.

  4. Eggy,
    I know I need a grant writer, a lawyer, a GP, and a curriculum developer, as well as someone to help with communications to community and physicians in the area. I don't know how big the project really is. Later would need a writer and maybe eventually a trainer if it takes off to make it reproducable in other communities.

  5. And if possible, I want to bring @ePatientDave and @ReginaHolliday to my community -- but that would be icing on the cake.

  6. Dear Keith,

    I think basic skills in navigating the health care system is a good idea - it's part of the pediatrician/family physician dialogue that happens with adolescents in the exam room, but is far to brief/limited. For example, in the EHR world, parents can be surprised to find out about age of consent laws only when the PHR of their child becomes inaccessible at age 12-13-14.

    I think those skills would transcend the medical record system policy at the time, and hopefully people won't have to write a letter to their doctor to get their medical records in the future!

    I'd also suggest that the life skill of accessing the health care system is also co-mingled with the life skill of accessing the financial system, including insurance and health insurance. It would be great to partner with un-biased leaders in that world (who I know exist) so that children emerge from able to manage their health and financial affairs. And as we all know, when one is failing the other is usually, and vice versa,

    Thanks for the stimulating post,


  7. Note to self, add a class on " using the internet". Duh!

  8. Hi Keith --

    Cool idea -- I like it. My suggestion would be to frame it as being not just about the health system, but about health more broadly. Some schools may already offer health class, in which case this could be linked to that. I'd like to help drive home the point that so much of health depends on what you, the individual, do on a daily basis--how you navigate the health system is of course crucial, but so are choices about smoking, drugs, sex, food, exercise, etc.

    I saw an episode of Jamie Oliver's Food Revolution in which he had adults with serious chronic conditions and resulting disabilities come into a class of high schoolers and tell their stories. The message about making good choices on a daily basis hit home pretty hard.

    I would also add that "health" shouldn't always be framed as "avoiding bad things". If you address health broadly for teenagers, you should emphasize the good -- how taking care of yourself and your body (with assistance from the health system) means you can look your best, do your best in sports, do better in school, etc. Kids tend to think they are invincible, so they may not be overly concerned about losing their health--but they may get motivated by the idea of being their own "personal best."

    Thanks for a great post and discussion,


  9. I had a "health class" in high school, it actually wasn't too bad. But i never learned about the system...

  10. Some comments from an S4PM member (which I'm adding here so they don't get lost in the shuffle):

    Good start on a curriculum here, Keith… although I think 11th and 12th grade is far later than it should be.

    Two ideas to add/edit:

    Under Asking Questions – I would add “Prepare questions prior to appointments”

    And, perhaps under pharmacist – I would teach kids how to read prescription labels, how to double check that they’ve been given the right drug in the right dose, and how to figure out if there are potential conflicts with other drugs, or foods, or ?

  11. This is a really great idea Keith!
    We need to raise the healthcare literacy rate and this is a good 101 start with the right age group

    I have some suggested bullets for "Dealing with your pharmacist (1 class):"
    - what are the roles of the people in the pharmacy
    - What does the pharmacist do
    - What does a technician do
    - What services can a pharmacy provide
    - Picking a pharmacy
    - different types of pharmacies (independent / chain / compounding etc)
    - How do I interact with the pharmacist / pharmacy staff
    - How does my pharmacy interact with my doctor
    - How does my pharmacy interact with my insurer
    - what is the difference between a generic drug and a brand drug

    Great idea!