Just to recap, a treatment plan is a tool by which the patient obtains the best in terms of their care and ultimately achieves their health related goals. It is key to the concepts of e-Patient and online health management.  A treatment plan is very similar to devising an action plan to help achieve career or other life goals. Individuals using a treatment plan will improve their chances of success and so can pursue their health and lifestyle goals during the course of their treatment.

As with any project, the treatment plan will contains milestones and track an individualâ..s progress towards achieving their defined health and lifestyle goals.    Again similar to any other project, the fundamental basis to the success of any treatment plan is the power of collaboration which in this case, is between the e-Patient and their treatment team. This is what this second article is going to explore.

So what is this Collaboration?

There are four aspects to achieving an effective Healthcare Collaboration

• Firstly there must be mutual respect between the group and this is a key success factor for any fruitful collaboration. The collaboration is more likely to succeed when everyone involves shows consideration and respect for the othersâ.. points of view.  However the e-Patient must respect his support team in the same way they show respect for him and his rights. This follows the â..give all modelâ. of collaborative respect which occurs when individuals or groups offer each mutual respect.
• Secondly, there must be trust between an e-Patient and his treatment team. The e-Patient needs to be confident that his team is trained, experienced and that they have his best interests at heart.  Likewise, the treatment team must trust the e-Patient and accept their contributions as being just as worthwhile and important as the â..expertsâ..
• Thirdly there must be good communication.   For example, a doctor must describe medical terms using simple, plain English terms, however the patient should still perform their own online research so that they understand any medical terms and are able to contribute knowledgeably to any conversation.
• Finally in order to be able to collaborate, the team must find their common ground and shared values.  By using social media utilities, and the interaction within them, common ground and shared values can be developed for participating e-Patients.  This can be a form similar to traditional social interaction; which in plain words is others observing that you look sick, appear pale or are showing some improvement. In the past this has been the foundation for healing going back many thousands of years.

So how does this Collaboration work for an individual?

Letâ..s take John, whoâ..s a line manager at a manufacturing firm. He suffered from lower back pain for the past couple of years and because he spends a lot of time on his feet at work, he really needed to get his chronic pain sorted out or at the very least obtain effective pain relief.   In this example, Johnâ..s treatment team could potentially consist of his doctor, his wife, a massage therapist and close friends offering support.   However the key role in any treatment team is the facilitator.

Role of the Facilitator or Treatment Coach

There are many key tasks that the facilitator will perform. They will assist in defining the goals in the treatment plan. In this example John would set targets for himself and discuss these with his facilitator; the facilitator could then also propose targets for John.   The facilitator will also direct and assist with achieving these goals. In simple language this would be locating relevant health specialists, arranging medical tests and any other networking or professional support required.   The facilitator will assist John in defining these goals logically, and organizing any necessary steps to be able to realise them.  John may share his goals and the treatment plan with his doctor, and likewise John can show any doctor recommendations to his facilitator.

This facilitator may possibly be a trained nurse or doctor but they will be the person who serves as the first point of contact for the e-Patient when receiving treatment and starting any necessary collaboration.  However, virtual healthcare providers such as RehabCoach will provide what is called a Treatment Coach. In this example, a Treatment Coach served as Johnâ..s intermediary throughout his course of treatment and collaboration. He first got started by going online, meeting the Treatment Coach, and coming up with a few goals to get his treatment on the way there and then. The keystone to the collaboration is the treatment plan, as the plan is the measure of the quality of the collaboration. For John, his treatment plan served as the focal point for all of the decision making and collaboration that has taken place. His treatment plan became the place to link his goals to actions, as well as being the common ground for defining and sharing goals with the rest of the treatment team.

How is the progress measured?

Once goals are defined and shared, there needs to be a way to measure Johnâ..s progress toward his goals. This is where what is referred to as a treatment score comes in. The treatment score was used to measure Johnâ..s progress toward his health and lifestyle goals by taking into account what heâ..s has achieved since the initial pain assessment.

Through collaboration, John was able to develop a treatment plan that worked and was able to measure any progress he is made toward his stated health goals.

Whatâ..s happening now?

Well John is now making good progress with his pain management and the chronic pain in his lower back is improving. This is thanks to his treatment plan, his treatment coach and the support from his team. To conclude, John would never have been able to collaborate with health professionals in the conventional healthcare system in the same successful way that he has with this new participatory healthcare model.

The e-Patient

An e-patient is a tech-savvy health consumer who wants to make the shift from being a passenger of healthcare to a responsible driver of their health and their treatment.  This person doesnâ..t just want to receive healthcare, but engage their healthcare with medical professionals by being informed. Through the use of the Internet, the e-patient is now knowledgeable about his or her medical condition and is better able to communicate and negotiate with their medical team. An engaged e-patient benefits in two ways: better health choices and medical care, and better relationships with medical professionals. I believe that as online tools become more sophisticated e-patients will take more and more responsibility for their health and define treatment goals on their terms.  Consequently, the treatment planning process is shifting to a collaborative one, requiring that medical practitioners work with patients to make decisions and define treatment goals.

The New Participartory Model

As healthcare shifts towards this participartory model the goal of the e-patient will be to optimize their health and lifestyle goals while receiving treatment. The treatment plan becomes the the tool by which the patient optimizes their care, communication and outcomes. The process of negotiation and collaboration will require several changes not required by the traditional healthcare model. These changes include:

• A chance to build trust through mutual understanding
• Transparency â.. Patient and treatment team can hold each other accountable for action (or lack thereof) when both sides collaborate in developing the treatment plan.
• Progress Tracking â.. With collaboration and a treatment plan, itâ..s much easier to keep track of the progress you are making as a patient in treatment and in reaching health and lifestyle goals.
• Timeliness â.. A treatment plan puts your medical progress on a schedule. There are some health problems, such as chronic pain, that patients cannot afford to have untreated for significant periods of time.
• Social Interaction â.. With the increase in prominence of social media, online interactions demand that both parties share the treatment plan and gather additional opinions.

How to Use a Treatment Plan

With a treatment plan, the e-patient becomes proactive in aligning their treatments with their lifestyle goals.  This is because the e-patient will find it easier to collaborate with practitioners to refine and adapt their goals. Much like how documenting career or education goals increases the chances of fulfillment, a treatment plan acts in the same way with health goals. Thus, the treatment plan becomes a critical tool for any e-patient, as it is the key to aligning treatment goals with the e-patient’s own health and lifestyle goals. By making better choices and e-patients benefits in the following four ways:

1. Although youâ..ve done your part to be proactive about your health, the medical practitioners are still the experts. A treatment plan puts their expertise into practice while accommodating your treatment goals, life goals, and the collective intelligence of your participatory network.
2. A treatment plan holds your doctors accountable and allows you to know when it is time to change members on your treatment team.
3. A treatment plan allows an e-patient to organize all the information he/she has gathered in the research. This organization allows you to accurately report your symptoms and diagnosis without panicking and jumping the gun about having a serious disease.
4. A treatment plan provides solid, actionable steps to fixing your health problem. Itâ..s much easier to be proactive about your health when the steps to be proactive are laid out for you in a treatment plan.
5. Reading from the same document promotes collaboration to negotiate goals and establish health outcome metrics.

Social Media and the Treatment Plan

Social media complements the participatory component treatment planning by building an online community with shared knowledge around a health problem. This give the e-patient the benefit of learning from other patients like themselves. This type of collaboration offers valuable insight into treatments that can’t receive from medical practitioners. Once you are aware of your symptoms and your possible diagnosis, you can figure out what kind of treatment solutions are out there, and how each would affect your life. Sometimes, the best way to do that is to ask other e-patients through a social network who have undergone these different treatment solutions.

This type of interaction via social media and online support groups facilitates collaborative decision making. In tapping into this participation network e-patients can quickly verify online research and navigate the complexity of making the right medical choices. Utilizing social media brings more eyes and brains on your health problem and your treatment goals. For chronic conditions, which are more complex, additional opinions and support can only help you select the best treatment options. Social media, when used successfully, harnesses a collective intelligence to aid in treatment planning and the health decision making process.

A participatory platform like RehabCoach empowers e-patients looking for online solutions that combine technology, personal empowerment, and social media. We believe that participatory, technology-based healthcare is here to stay and for this new model to be successful, e-patients must create and use treatment plans. Both sides of the doctor-patient dynamic become accountable, puts treatment outcomes on a schedule, and is the optimum result of the collaboration and participation between e-patients and the treatment team. e-patients will get the most out of the new participatory healthcare model to optimize care, communicate with the treatment team, and progress toward health and lifestyle goals.

If you surf the news on the web, then youâ..re bound to run into at least one story a week that disparages the use of social networks like Facebook and Twitter. The most recent story came from the UKâ..s Mirror, which cited a scientific study showing that Facebook is conclusively leading Britons to become fatter, thanks to the copious amounts of time that Facebook users are spending in front of the computer screen, absorbing the minutiae of their friendsâ.. wall posts while neglecting a healthy diet and exercise.

One third of the typically Britons signing on to Facebook are purportedly gaining an average of seven pounds in their first months of using it, and are also claiming that they are missing healthy meals in order to stay connected, opting instead for fast food and other unhealthy dietary choices.

Similar studies indicate that the overuse of Facebook and other social networks â.. now dubbed as Facebook Addiction Disorder (FAD) â.. can account for students achieving 20% lower school grades, as well as numerous crises for adult users, such as relationship conflicts, antisocial behavior, and narcissism.

And yet, in spite of all the negative press, there are almost 750 million people using Facebook alone!

Fortunately, this gap that exists between the popularity of online social networking and the reported addictive, unhealthy behavior that surrounds it is being filled by a new generation of social networks that are geared towards healthy lifestyles, 24/7 pain management, and information sharing that is leading to productive use of time spent social networking.

Say Hello to the Health Management Participation Platform

Now, social networks like Facebook and Twitter have forged a path for participation platforms that allow people to communicate and share information in dynamic new ways. This same concept is now being applied to health management: just in the same way that Facebookâ..s platform can help people connect socially via the internet, a health management participation platform can in turn connect key players in peoplesâ.. health and pain management, leading to faster, more effective treatment options.

A health management participation platform basically takes all of the positive elements of social networking â.. 24/7 communication, instant feedback, network building, and status updates â.. and applies to a health-related setting where the focus is no longer on passively observing the ins and outs of peoplesâ.. every lives. Instead, the power of social networking is used to give people in search of pain management options a wide range of information, resources, guidance, and feedback on how to treat their own pain or illness.

For example, if a person is suffering from lower back pain, the Internet alone offers little in the way of actionable help. Sure, you can type, â..lower back painâ. into Google and receive millions of search results that will explain what lower back pain is.

But for the person suffering with lower back pain, what they are looking for is an effective pain management treatment.

At the touch of a button, the health management participation platform gives people suffering with chronic pain instant feedback on their condition. A Treatment Liaison â.. someone who helps a person manage their treatment path â.. communicates with the patient on a daily basis and gives feedback on the actions that the patient has taken to treat their condition. At the same time, a flourishing social network of other regular people who have suffered with the same condition can instantly offer their own experiences, successes, and failures in dealing with the same issue.

Adding to this, the health management participation platform also puts a library of articles, peer reviews, medical overviews, and other valuable resources relating to pain management at a patientâ..s fingertips. Because all of this support and feedback is contained within the social network of the health management participation platform, it becomes a viable social network for individuals to participate in on a regular basis, whether they are in pain or simply looking to improve their physical well-being.

Using the Power of the Score To Improve Your Health

While communication would seem to be the hallmark of all social networks, scoring, reviewing, and commenting is another popular dynamic that participants in social networks are drawn to participate in. On Twitter, you have the â..re-tweet.â. On Facebook, there is the â..like.â. On YouTube, you can both â..likeâ. and comment on videos. Because of these interactive features, dialogues, conversations, and sharing ensues that on these social networks sometime lead to stressful interactions.

On a health management participation platform, however, this type of interaction can be the difference in feeling better or not.

Rather than allowing users to simply impact the score and popularity of some kind of content, users of a health management participation platform seek to impact their own score â.. a kind of â..health scoreâ. that gives on-the-fly, quantitative feedback on how their treatment is going.

Everything that a person does in the social network, from reading articles to following the treatment pathway set up by their treatment liaison, impacts their health score. In this way, a person becomes highly motivated to raise their score, since they know that, by doing the right things to impact their score, they are also impacting their health and well-being also.

Valuable, Virtual Feedback On Pain Management

So many of the interactions that take place on Twitter and Facebook are indeed superfluous and shallow. Many people often feel as though there are no real dialogues going on â.. just hundreds of millions of people who are talking to themselves. What is lacking in these social networks is a purpose for the interactions. While the pretext might be to make friends and create high quality relationships, all in all, the positive elements of social networking are being lost to the novel nature of the technology.

However, once you are able to leverage a social network for making a truly positive impact in your life, then the time and attention paid to it becomes invaluable. Someday, viable social networks will enrich virtually every facet of our lives, much in the same way that health management participation platforms are offering a new form of effective pain management.

Here are some ways a parent who has a child with scoliosis can simplify interactions with their medical support team.

Scoliosis Exercises and the Power of E-mail: Many of the pain management exercises associated with Scoliosis treatment were developed by Chiropractors and Physical Therapists, and are used in conjunction with spinal adjustments. The power of e-mail is now allowing parents to quickly and easily distribute diagrams and information regarding these exercises to school nurses, teachers, coaches, and other members of their childâ..s health network so that, in the event of a chronic pain flare-up, an adult can assist and monitor their childâ..s stretching and exercising.

Doctor Visits and Filled Prescriptions at the Touch of a Button: Parents these days sometimes need to be in two places at once, and mobile technology is now making this a virtual reality. If a child with Scoliosis needs to leave school for an immediate visit to their Doctor or Chiropractor, logistics can be made between parents, the school nurse, and doctor via mobile phone or texting, cutting down the time it takes to get a child out of excruciating pain. But even Doctors are getting in on mobile technology as well: if a prescription needs to be filled, doctors can now use their Blackberry or iPhone to electronically send a prescription to your local pharmacist, so that all a parent needs to do is make a quick stop at their pharmacyâ..s drive-through to pick up their childâ..s prescription.

Using Digital Photos and Video to Get a Better Perspective: No one understands a child better than their parents. Thatâ..s why mobile video technology such as the iPhone 4â..s FaceTime is giving parents of children who suffer with Scoliosis the ability to examine and communicate with their children remotely, allowing them to ascertain the severity of a chronic pain flare-up and take appropriate action. Now, parents can observe their children on their smart phone, find out exactly what is ailing them, and instantly communicate this to their Doctor or treatment provider. Or, if there are any external symptoms, a school nurse or coach can take a quick snapshot of the symptom and send it to parents and doctors, providing visual information of the childâ..s condition.

A Mobile Tech Checklist for Creating a Chronic Pain Treatment Network

If you are a parent whose child that suffers with a chronic pain condition like Scoliosis, it is essential to leverage mobile technology to give them the best pain management possible. The following is a quick checklist for how to use mobile tech gadgets you need to interconnect all of the treatment providers and teachers into an effective health network:

• Work with doctors and pharmacies that are online: digital medical reports, prescriptions, and appointments are easy to send and distribute in case of an emergency.

• Get a video-ready smart phone: More and more smart phones are coming equipped with video capabilities. If your school nurse doesnâ..t have one, consider buying one for your child as well so that you can have a two-way video conference should a scoliosis flare up should occur.

• Build and maintain an up-to-date e-mail list: While texting is becoming more and more popular, the vast majority of people â.. including health professionals â.. use e-mail on a daily basis. Create a health-based mailing list on your e-mail server that includes doctors, chiropractors, pharmacists, teachers, coaches, and family members who comprise your childâ..s health network so that messages can be sent out quickly and easily.

Please feel free to comment on how you are currently using social media to get support, or share novel ways to supplement the above strategies.

Of the many chronic pain conditions found in children, none requires more hour-by-hour treatment and monitoring than Scoloiosis.

While Scoliosis is not a widespread chronic pain condition in children, it does affect a relatively high percentage. A recent study conducted by the National Association of Arthritis and Muskoskeletal and Skin Diseases (NAIMS), found that “of every 1,000 children, 3 to 5 develop spinal curves that are considered large enough to need treatment.” And the forms of treatment needed to effectively minimize the chronic pain and mobility issues associated with Scoliosis are wide-ranging enough to make it difficult for parents of children to manage, especially when school is in session.

However, the recent developments in mobile technology is now empowering parents, doctors, schools, and other treatment providers to create powerful communication nodes that allow parents of children with scoliosis and other chronic pain conditions to act and react to their immediate conditions and adjust their pain management and treatment accordingly.

How E-mail, Texting, and Digital Cameras Give Parents Mobile Pain Management Power

Because Scoliosis features a broad spectrum of severity, there is an equally broad range of treatments and pain management approaches that enable children to function in school and social settings as normally as possible. Whether a child suffers from Non-structural (functional) or the more serious Structural Scoliosis, chronic pain remains a day-to-day problem that must be addressed quickly and efficiently.

While only the Scoliosis brace or surgery are the only proven corrective treatments for Scoliosis, other treatments such as chiropractic medicine, electrical stimulation, dietary supplements, and exercises have proven to be valuable pain management treatments for Scoliosis sufferers. Mobile technology and communication is now allowing parents to communicate and direct these treatment on the fly, whenever or wherever their child is experiencing chronic pain.

The convergence of technology and social media through the use of enabling technologies such as smart phones raises the following questions:

1. How can parents leverage technology such as smart phones to help them ease the logistical complexity of aligning services from different medical stakeholder’s
2. Why is social media best suited to providing a workable collaborative solution
3. How must social media platforms change to address these challenges.

In our next post we will explore answers to the questions above.

Let’s take Lucille, a hypothetical financial analyst who’s very busy with her career in the heart of Paris. She’s in need of fibromyalgia pain relief so she can continue working hard and progressing her career. Lucille has done some research on fibromyalgia and foods, but doesn’t have much time to experiment or to prepare meals for herself.

So, Lucille utilizes Super Marmite to find home cooked meals and to learn about which foods provide her pain relief and which don’t. But, Lucille doesn’t only to lead a healthier lifestyle, she also makes health connections through Super Marmite, meeting people and tapping into the collective intelligence of her community. These connections encourage Lucille to lead a healthier lifestyle while accommodating her job as a financial analyst.

But, what Super Marmite lacks is the ability to track and to align treatment goals with her diet. Sure, Lucille is educated and can make a guess at how she’s getting better, but she certainly isn’t a doctor or a pain specialist. Something like a health management participation network, would be a better fit for Lucille’s needs.

RehabCoach provides a framework for enabling users like Lucille to create a support network with a shared interests in the same health and treatment goals. Our network can help her to get better and help her to know that her efforts are having results on her fibromyalgia pain. Given Lucille’s busy schedule, it would be difficult to track results without the support network. Her efforts would be reflected in a treatment score, where results can be seen and goals can become attainable.
If we’re willing to participate in technology-based food service, then why not participate in technology-based health? ZSR6S6QZZUMS

Upon reflection of her experiences, she advocates for a step-by-step process of chronic pain management when in those “hard places”, where minds are clouded with intense pain and emotion. When the minds of those in need of pain relief and physical therapy are not thinking straight, they may not always be rational, informed patients to make important health care decisions. It is under these conditions that social networks are best suited to help those manage the varied and complex group centered ambient interactions required to react too, anticipate and prevent pain.

For example, the decision to take pain medications for carpel tunnel relief, or lower back pain treatment, requires answers to several key questions: How much medication should I take per day? When should I start? When should I stop? How will I know if I am addicted to my medication? Answering these questions may need a social network in order to promote and to ensure shared and informed decision making for every step of chronic pain treatment.

A shared participation network, according to Gruman, embodies several values that ought to be held by all involved in this shared participation network, such as physicians, treatment coaches, even other patients suffering from chronic pain. Values include:
•Patients and caregivers understanding evidence, using it to help them weigh their options, discussing it with their providers, and their providers doing the same in return.
•Patients are explicitly invited to participate in the decisions about their care (even if that participation consists of delegating decision-making to a caregiver or physician).
•The opinions and preferences of patients – informed by their understanding of the evidence –shape and determine the tests they take and the treatment they undergo.

Compounding the complexity of managing pain is the fact that people with chronic pain are twice as likely to suffer from depression and anxiety than those without. So it’s a chicken or the egg type of question. Are the psychological issues the causal factor in the “chronic nature” of the pain, is the for example “depression” a result of the pain, or is it a vicious circle? Either way, the ability to regularly check-in with others to help nudge you into making the right choices is the best strategy for maintaining treatment continuity and consistency.

Why go through pain management on your own while having mental health issues? A social network involving shared participation in this process is an excellent way to overcome the obstacle of making a good decision while in pain, in getting positive feedback about decisions and treatment, and in addressing the issues surrounding the use of pain medications as treatment.
Utilizing a social network to find a treatment that affects all aspect of life and well-being can ensure that shared, participated decisions are made about pain relief and pain medications.