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Medical Education, Medical Schools, Medicine X, Technology

At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school

At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school

med ed panelOne of my favorite talks yesterday at Stanford’s Medicine X was “Fostering Digital Citizenship in Medical School,” where four esteemed panelists talked about the innovative programs they’ve put in place at their institutions.

The physicians joked several times that a good panel often involves controversy or conflict among speakers – but the four of them weren’t in disagreement about much. They all believe that things like understanding social media and knowing how to build one’s digital footprint are crucial skills for doctors-to-be, even if those aren’t an obvious focus for the students themselves. “We can’t expect students to understand” this, said Warren Wiechmann, MD, an associate dean at UC Irvine School of Medicine. “They’re focused on learning core forms of medicine.” (Wiechmann started in 2010 a program to provide each incoming medical student with an iPad and has since added to the school’s curriculum courses on topics such as social media, wearables, and new digital trends in medicine.)

Kyra Bobinet, MD, PhD, who worked alongside Stanford anesthesiologist (and Medicine X executive director) Larry Chu, MD, to develop and teach Engage and Empower Me, an online course that focuses on patient-engagement design, noted that it’s academic leaders’ job to be “forward-thinking” for the students “so they’re so they’re not behind” when they become physicians. And Bryan Vartabedian, MD, who created at Baylor College of Medicine Digital Smarts, a four-year curriculum that focuses on “professionalism, safety, and mindfulness with social media,” agreed. “We’re asking big questions here,” he told the audience. “What does a doctor need to know 20 years from now? Will he (or she) know how to send a tweet? Do we have to be platform-specific [when teaching]?”

A portion of the 45-minute talk was devoted to the difficulty of incorporating new things in a medical school’s curriculum, which is, panelist Amin Azzam, MD, said, already “chock full.” Said Wiechmann: “The big dilemma is what do we take out to put in in?” In turn, many of the schools’ instructions on digital professionalism and literacy come in the form of elective courses.

When discussing other challenges, Wiechmann said the “line ups not very deep” when it comes to leaders in medical school who know about digital media. These topics aren’t “even on the radar” of many faculty-instructors, he said. The panelists also mentioned that the students – most of whom barely remember a time before e-mail, and many of whom consider themselves tech-savvy – don’t always think they need training on digital issues. “In one way they know a lot about technology, but they don’t get how to be doctors,” pointed out Azzam, who developed a University of California elective course that allows 4th year medical students to edit Wikipedia for academic credit. (“We want them to be digital contributors, not merely digital consumers,” he explained.)

Vartabedian said the information that Baylor provides to their students is contextual. Teaching medical students about smartphone use or social media in general wouldn’t be terribly helpful, he pointed out – but it becomes valuable “if you talk about it in the wards.” What should you do, for example, if a patient engages you via Twitter?

The end of the discussion shifted to patient engagement and the need to educate students about just the thing Vartabedian mentioned (i.e. how to interact with patients on social media) and how the e-patient movement works. “I have a responsibility as an educator to put this content [about patient engagement] – more than, say, biochemistry – in front of students,” said Wiechmann.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X aims to “fill the gaps” in medical education, More reasons for doctors and researchers to take the social-media plunge, A reminder to young physicians that when it comes to social media, “it’s no longer about you”, A conversation about digital literacy in medical education, Advice for physicians when interacting with patients online and How can physicians manage their online persona? KevinMD offers guidance
Photo by Stanford Medicine X

Medicine and Society, Medicine X, Patient Care, Technology

What makes a good doctor – and can data help us find one?

What makes a good doctor - and can data help us find one?

Ornstein panelWhile much conversation at Medicine X focused around the doctor-patient relationship, ProPublica reporter Charles Ornstein posed to conference attendees this morning a more fundamental question: How do you find a doctor? “This is trickier than you think,” he said and proceeded to discuss how data can yield helpful information for those looking for (or assessing their current) physician. He outlined some of the information – mostly involving doctor-industry relationships and physician-prescribing practices – that ProPublica has gleaned from federal databases, and he outlined questions that patients might want to ask their doctors about such things. (“So my doctor has a relationship with a company. But how is that affecting my care?” he said.)

Ornstein spent a good amount of time discussing the importance of making information – presumably not just information on negative things, such as whether a doctor appears to over-prescribe a certain medication or has ever been disciplined, but also about thoughts on physicians’ care from patients – more widely available.“We all want doctors who are good at what they’re doing clinically, and it’s time for us to stop making that a secret,” he said, before making his closing statement that “Data should be freed so we can make better health-care decisions.”

In the panel session – moderated by our own Paul Costello – that followed, several important points were made. First, Vivian Lee, MD, PhD, MBA, dean of the University of Utah School of Medicine and CEO of University of Utah Health Care, reminded the audience that the “majority of doctors are not bad apples” and can improve on things if given the chance. University of Utah makes patient-survey information publicly available, and she described the six-month period before this service was launched as a time where doctors worked to boost their level of care. Almost every doctor received at least 4 out of 5 stars by the time the rankings went online, she said.

Panelist Carly Medosch, a patient advocate who has had Crohn’s disease for 20 years, expressed support for access to physician data but pointed out that she doesn’t have time to dig through “tons and tons of research” – she not only has a regular job but a second job managing her disease. And “If I’m taken to the ER for a ruptured intestine I don’t have time to ask questions” about, for example, a doctor’s industry relationships, she pointed out. It was an important reminder that access to data alone might not greatly benefit the average chronically ill patient.

Towards the end of the session, the panelists shared their own ideas of what makes a good doctor, with Ornstein listing good clinical outcomes and empathy as two must-haves. Numerous attendees took to Twitter to express their own thoughts, including patient advocate Liza Bernstein, who offered at least 10 criteria. (My personal favorite: “What kind of PERSON are you? Yes, always, top of your field, but are you a #mensch?) Given the complexity of the issue, as outlined during the panel, I think this attendee hit the nail on the head by tweeting:

What makes a good doctor? Medicine is not a monolith. There is no simple, single answer, regardless of data availability.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X aims to “fill the gaps” in medical education, Relationships the theme of the day at Stanford’s Medicine X, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photo of Ornstein (far right) and panelists by Stanford Medicine X

Medical Education, Medicine X, Stanford News, Uncategorized

Medicine X aims to "fill the gaps" in medical education

Medicine X aims to "fill the gaps" in medical education

Larry Chu  - intro remarks - smallWhen conference director Larry Chu, MD, took the stage this morning to welcome attendees to Day Two of Medicine X, few people knew he had big news to share. But moments after summarizing yesterday’s “great discussions,” which show, he said, what can be accomplished when “we pay attention to all voices,” he announced the launch of Medicine X Academy. It’s an umbrella, he explained, for a variety of  initiatives that will take MedX beyond conference walls and “quicken the pace of changing the culture of health care.” With the academy, he and his group will continue building a community and work on filling important gaps in education – with a focus on, among other things:

  • the importance of participatory medicine and the use of social media in patient engagement
  • the use of technology to meet the needs of millenials
  • the development of ways to best serve underserved or aging individuals
  • the inclusion of end-of-life issues in health-care discussions

The academy will offer massive open online courses and patient education programs and will host a new conference – MedX Ed – to occur just before next year’s regular Medicine X event. Noting that MedX has morphed from an annual meeting to a “global movement,” conference speaker Bryan Vartabedian, MD, noted that it’s “very well prepared” to address issues in medical education. “We have a global community of innovators and, most importantly, we have the proper mindset” to enact change, he told the audience.

The news got those in the audience (many of whom had barely had their first sip of coffee) buzzing. “Very cool – New #MedX ED conference will translate ideas into actionable parts of medical education,” wrote one attendee on Twitter, adding this was a necessary thing. “This is bigger than just ‘walking the talk’,” agreed another. “We’re going to change the future of health care.”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Relationships the theme of the day at Stanford’s Medicine X, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photo by Stanford Medicine X

Medicine and Society, Medicine X, Patient Care, Technology

Relationships the theme of the day at Stanford's Medicine X

Relationships the theme of the day at Stanford's Medicine X

Larry Chu long shot

Medicine X began today with a theatrical bang as quotes from past speakers filled the main presentation hall and flashed across on the stage against an electrifying soundtrack. In welcoming both old and new friends to the conference, Larry Chu, MD, associate professor of anesthesia at the School of Medicine and executive director of the conference, repeated a sentiment from last year’s event, saying, “You belong here with us – we all care about health care.”

Stanford’s premier conference on emerging health-care technology and patient-centered medicine, the event attracted more than 400 patients, health-care providers, technologists, researchers and entrepreneurs to engage in moon shot thinking about the future of medicine and health care. Several hundred more watched the conference webcast.

“We’ve seen information technologies transform lives in so many ways; now it’s time to harness this power to improve health,” Lloyd Minor, MD, dean of the medical school, told the audience in the morning. He encouraged attendees “to think big” and to use their time at Medicine X to identify collaborators to take their ideas from concept to reality.

Collaborations and relationships were the theme of the day, with sessions focused on how engaged patients and their doctors can become the medical team of the future, how the pharmaceutical industry and patients can work together in the drug discovery and clinical trial process, how chronic-disease patients use self-trackers as a sort of partner in their care, and how developers of digital technologies are collaborating with those who might not have an obvious voice. As one Twitter user commented, “Most common words at #medx conference so far: transparent, engaged, relationships, connected.”

Medicine X continues tomorrow and Sunday. If you’re unable to attend the conference in person, you can participate in plenary sessions virtually through a high-quality streaming webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference; you can follow our tweets on the @SUMedicine feed or follow the hashtag #MedX.

More news about Stanford Medicine X is available in the Medicine X category. 

Previously: Stanford Medicine X 2014 kicks off todayCountdown to Medicine X: 3D printing takes shapeCountdown to Medicine X: Specially designed apps to enhance attendees’ conference experience and Countdown to Medicine X: How to engage with the “no smartphone” patient
Photo by Stanford Medicine X

Medicine X, Stanford News, Technology

Stanford Medicine X 2014 kicks off today

Stanford Medicine X 2014 kicks off today

Medicine_XMedicine X, Stanford’s premier conference on emerging health-care technology and patient-centered medicine, kicks off today on campus. The three-day event opens with a keynote from Daniel Siegel, MD, clinical professor of psychiatry at the University of California-Los Angeles, titled “Interpersonal Connection, Self-Awareness and Well-Being: The Art and Science of Integration in the Promotion of Health.” During the talk, he’ll discuss his approach to developing a healthy mind, an integrated brain, and empathetic relationships.

The conference is being held at the Li Ka Shing Center for Learning and Knowledge. This year’s program will spotlight the relationship between physical and mental well-being with three breakout panels. Additional presentations and panels will focus on the medical team of the future, the use of self-tracking tools to improve chronic disease patients’ health, opportunities for the pharmaceutical industry to partner with patients in the drug discovery and clinical trial process, and ways to connect with “no-smartphone” patients — those who don’t have the access or resources to fully engage with health-enhancing technologies.

If you’re unable to attend the conference in person, you can participate in plenary sessions virtually through a high-quality streaming webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference. You can follow our tweets on the @SUMedicine feed or follow the hashtag #MedX.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: 3D printing takes shapeCountdown to Medicine X: Specially designed apps to enhance attendees’ conference experience, Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings, Countdown to Medicine X: How to engage with the “no smartphone” patient and Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation 
Photo by Medicine X

Medicine and Society, Medicine X, Technology

A call to make digital-health technologies available to everyone

A call to make digital-health technologies available to everyone

In light of my conversation last month about the “no-smartphone patient,” I found this recent Forbes piece on the need to develop culturally sensitive digital-health technologies of interest. Contributor Rob Szczerba writes:

In recent years, technologies involving smart phones and data analytics have become an essential component of how healthcare is delivered throughout the world.  Moreover, some believe these tools hold special promise for people from poor communities, seniors, and ethnic and racial minorities.  In some cases, people from these groups are more likely to have chronic conditions that can be expensive to treat in the short- and long-term.  Unfortunately, many of the innovators developing health technologies are not well-equipped to understand the special needs of these groups.

Rohit Bhargava and Fard Johnmar, co-authors of ePatient 2015, describe this problem as “multicultural misalignment.”  They warn that digital health technologies, such as mobile and wearable devices, will be much less effective if they are not optimized to account for differences in age, gender, culture, ethnicity, knowledge, and literacy.  They believe that preventing multicultural misalignment is vital, suggesting that we must work hard to ensure “health innovations benefit all segments of society.”

As a reminder, Stanford’s Medicine X conference – where this topic will be discussed – begins tomorrow.

Previously: Countdown to Medicine X: How to engage with the “no smartphone” patient

Events, Medicine X, Stanford News, Technology

Countdown to Medicine X: 3D printing takes shape

Countdown to Medicine X: 3D printing takes shape

3D printed handFrom customizing lab equipment to assisting in surgical planning to developing models of proteins and pathogens, 3D printing is helping to reshape biomedical research and health care. This year, Medicine X (which kicks off one week from today) will explore the transformative force of the technology during a range of panels and demonstrations in the “3D Printing and the Future of Medicine” session.

During the session, attendees will have the opportunity to learn more about health-care related 3-D printing applications at the “3-D Experience Zone,” which will showcase technologies from leading manufacturers. Attendees can learn about surgical applications of 3D printing from 3D Systems; find out how 3D Hubs is creating a global community by connecting owners of 3D printers with those who want to utilize the technology; and see how Occipital’s 3D scanning hardware for the iPad is supporting patient care. Additionally, they can discover how Artec creates a 3D full-body scan in a mere 12 seconds and enjoy chocolate and candy from the ChefJet food printer.

The session will also feature two Saturday-afternoon panels titled “Diverse Distributed & Design-Driven” and “Innovation Implementation,” with the latter exploring:

…some of the challenges and issues to consider in this brave new world. Will the FDA approve printed food, pharmaceuticals, and medical devices? How can 3D printing startups include patients in their design process? What are the public health implications when almost anyone can print biomaterials from the comfort of their own home? And once we ensure public safety, how can we make 3D printing affordable and accessible for all?

Darrell Hurt, PhD, computational biologist and project lead for the National Institutes of Health 3D Print Exchange, is among the panelists, and Monika Wittig, director and co-founder of Live Architecture Network, will moderate the discussions.

“As a designer, I am thrilled that this conference continues to widen the view of valuable cross-disciplinary collaborations. This is decidedly the aspect that I found most profound during my first Medicine X experience,” said Wittig. “My hope is attendees leave this session feeling a heightened awareness of 3D design and production technologies and the many realms of potential engagement in health sectors including prototyping, globally-distributed production and mass-customized design.”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience, Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings, Countdown to Medicine X: How to engage with the “no smartphone” patient and Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation
Image of 3D printed hand from Medicine X

Events, Medical Apps, Medicine X, Stanford News, Technology

Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience

Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience

Figure 3 - BlanketLast year’s Stanford Medicine X conference explored ways in which technology could be used to augment the attendees’ experiences. During breaks between sessions, organizers used specially developed software to transform television screens set up in the lobby outside the main auditorium into interactive spaces where participants could exchange ideas. On one screen, attendees used their mobile phones to text their reflections on previous sessions or respond to prompts such as: “What’s your dream for health care?” The texts appeared as yellow sticky notes on a virtual corkboard. Another screen served as a digital journal where participants could text comments about what they learned and have them displayed to a wider audience. As people walked up to the screen to read the contextually relevant content, they naturally started conversations. In an effort to bridge the divide between the people who were physically present at the conference and those who were watching the live-stream from other locations, an additional screen broadcast tweets from around the world in real time.

This year, conference organizers have developed three iPhone apps for Medicine X based on Apple iBeacon, a Bluetooth-powered location system. “When we heard about the iBeacon technology, it was clear that it would fit really well into a conference setting as well as being useful for allowing people to interact with the large-screen displays,” said Michael Fischer, a PhD student in computer science in the MobiSocial Lab at Stanford, who helped develop the app. “We brainstormed all the possible ways that the iBeacon technology could help people participate in the conference and came up with some ideas that we are excited to test out at the upcoming conference.”

In anticipation of this year’s conference, I reached out to Fischer to learn more about how the apps will further enhance attendees’ experience at Medicine X. Below he explains how they will facilitate networking among participants, allow them to provide feedback or rate speakers and serve as a sort of “flight-attendant call button.”

Can you briefly explain how the apps work?

One app allows us to extend the Wellness Room, so that people can request items without having to go to the room and miss part of a session. The Wellness Room provides special amenities, such as warm blankets or a place to rest, to assist patients in managing their conditions during the conference. The room was designed to help patients physically attend the conference who might have otherwise not been able to. For example, a previous ePatient attendee had a medical condition called cryoglobulinemia, which causes proteins known as cryoglobulins to thicken if the ambient temperature drops too low. If this were to occur, it could lead to kidney failure and would be life threatening. So it’s crucial for this patient to keep warm. Using the iBeacon technology we were able to develop a system that allows people to use an iPhone to request a blanket or other item be delivered to their seat. There will be iBeacons on all the tables in the room so that the phone will automatically know where you are sitting. All the requests will be forwarded to a volunteer who will bring the item directly to the table.

Another app will be used during the breaks to help people get to know each other. The application works by displaying short bios on a nearby TV screen. In this way, the screen acts as a type of watering hole that people can gather around. When new people approach, their bios will be added to the screen. When a person leaves the proximity of the screen, the bio will be removed. We’ll have multiple screens set up around the conference. Our hope is that people can find a group that they might not yet be familiar with. The service is opt-in and people can switch to and from stealth mode at any time. Conference-goers will also have the option to forgo this app altogether.

Lastly, we have developed a feature that will be used at check-in. We want to create an experience that will surprise and delight people from the moment they step into the conference. There is a tradition at Stanford during freshman year that when you first come to your dorm, the dorm staff yells out your name. It is pretty big surprise and makes you feel part of the community instantly. We wanted to replicate that experience as best we could for the conference.

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Events, Medicine X, Stanford News, Technology

Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings

Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings

Those unable to physically attend next month’s Stanford Medicine X conference can participate in the event through the Global Access Program, which brings high-quality streaming video of the conference plenary proceedings, live photos and other updates to viewers’ desktop or mobile device. More details on the webcast can be found on the Medicine X blog:

The Global Access team is led by Emmy-award winning television producer Bita Nikravesh Ryan and 2013 Stanford-NBC Global Health Media fellow Hayley Goldbach. Our photography team includes Academy Award-winning documentary filmmaker Theo Rigby, speaker portrait photographer Christopher Kern, and our special venues photographer Yuto Wantanabe.

This year’s Global Access team also welcomes inventor and cancer researcher Jack Andraka.

To participate in the program, you will need to register on the conference website.  Keep in mind that the live stream does not include coverage of breakout sessions, pre-conference workshops, Master Classes or the IDEO Design Challenge.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: How to engage with the “no smartphone” patient, Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Health Disparities, Medicine X, Stanford News, Technology

Countdown to Medicine X: How to engage with the "no smartphone" patient

Countdown to Medicine X: How to engage with the "no smartphone" patient

When I saw the full agenda of the upcoming Stanford Medicine X conference, the name of one of the panels – “The ‘No Smartphone’ Patient” –  jumped out at me. The conference is focused on the ways new technology intersects with health care, and it’s heavily attended by researchers, health-care innovators, and patients who strike me as likely to never leave the house without their smartphone or tablet. The topic seemed a curious thing for the organizers to offer.

Once I read the full description of the Sept. 5 talk, though, it made complete sense. Part of Medicine X’s aim has always been to empower patients to be proactive in their care and to contribute to the discussion on how technology can be used to improve human health. So if a significant chunk of the population is low-income and/or has limited access to health-enhancing technologies, it would be prudent for stakeholders to determine how to improve that access and how, exactly, to give those so-called “no smartphone” patients a voice.

Intrigued by the topic and wanting a preview of the discussion, I reached out to panelist Veenu Aulakh, executive director of the Center for Care Innovation (CCI), which develops patient-engagement innovations and provides support to the state’s safety-net providers (community health centers, public hospitals, and public health clinics). After noting that almost one-third of California’s population is considered underserved and vulnerable, Aulakh talked with me about what’s been done for underserved populations in recent years, how she believes the digital divide among various populations is shrinking, and what those attending “The ‘No Smartphone’ Patient” panel can expect to learn.

At Medicine X, you’ll be discussing some of the cultural, social, and economic barriers that prevent certain patients from fully engaging with health-enhancing technologies. Can you provide a hint of what those things might be?

There are a number of barriers for patients to fully engage with health-enhancing technologies. The solutions that are created today are often not built for low-literacy, non-English speaking patients. Having solutions in Spanish and written at less than a 4th grade reading level are critical for getting solutions adopted. In addition, many of these technologies are often introduced to patients via their health-care providers, and the solutions are not created at a price point that either safety net health systems or patients can afford. Also, the solutions need to be more reflective of the realities of patients lives – folks are extremely busy and don’t have a lot of time to hand-enter data or engage with technologies that don’t provide immediate value. If we’re going to get patients (and their providers) to use effective technologies, we need to make sure that they can see immediate benefits if they are to use these technologies regularly. Lastly, the smartphone penetration rate in low-income populations still isn’t at a level where it would be useful for most safety net providers to broadly offer smartphone solutions to their patients. As this changes, the adoption rate of health apps and similar technologies may rise as well.

Do you foresee a time when patients who currently face such barriers can become part of the e-patient movement?

I think there are already many vulnerable and underserved people who would consider themselves part of the e-patient movement. Health centers are now beginning to e-mail with patients, inviting them to participate in texting programs and starting to roll out other e-offerings. However, for more patients to join the e-patient movement, we need to reduce the barriers. As more patients move to smartphones, I believe we’ll see a shrinking of the digital divide. According to Pew Research Center, as of January 2014, 47 percent of low-income people had smartphones. As this number continues to increase, this will help low-income patients be active e-patients (assuming language, literacy and cost issues are addressed).

CCI works to bring various health-enhancing technologies to California’s low-income patients. What are some of the patient-engagement techniques you’ve seen delivered in recent years?

We’ve seen everything from building strong patient and family advisory groups who give input to clinics on how to better design care systems that are truly patient-centered, to launching efforts to hear from the patients about their needs through surveys, focus groups and ethnographic research. Many clinics are also starting to implement texting programs to follow up with patients between visits with appointment reminders, or send education reminders for patients with chronic diseases. They’re also starting to use remote monitoring devices like home blood pressure and blood glucose monitoring. The funding environment (and the limited resources of both clinics and patients) have hampered wide-spread adoption of these types of solutions, but clinics definitely see the value in engaging patients – with both high- and low-tech solutions.

How have your group and other safety-net providers involved patients in developing these techniques?

Many health centers have developed patient and family advisory groups to provide feedback to design these programs. Other clinics are beginning to use the principles of design thinking to better understand the needs of their patients and going beyond the traditional patient experience surveys to hear the real voice of their patients. However, much more work needs to be done to make this the standard of care.

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