Health’s Great Challenges are hot topics this week

At TEDMED 2012, conference Delegates and TEDMED Live attendees voted to choose the top 20 Great Challenges, the most pressing, pervasive and complex issues the nation is grappling with in health and medicine. They chose well, apparently. Conversation on many of the Challenges — the goal of the program — was lively both among the TEDMED community at at large, including features on blogs and in major news media.

David Mayer, MD, vice president of Quality and Safety for MedStar Health, wrote about Challenge #5, Eliminating Medical Errors, on his blog, “as this is a problem that persists despite the hard work of many of us who have dedicated our careers trying to prevent,” he writes. Educating students and residents is critical to reducing error, he says, not only to hit the ground running with good training, but in offering fresh perspectives on the issue. A contributor, Kare Anderson, made waves with the piece, How Hospitals Can Stop Killing So Many Patients. Medical errors are the third leading cause of death in the country, she cites, and suggests that patients demand accountability and transparency, and then do as much comparison shopping as possible before selecting a hospital. We’ve heard it before: We spend more time shopping for a television than for a doctor, even though the stakes are, of course, incalculably higher.

End-of-life Care, Challenge #3, garnered much attention thanks to an op-ed by Bill Keller in The New York Times, “How to Die.” Keller wrote about an in-hospital hospice protocol in the U.K. that offer an alternative to the sometimes invasive and painful, and often fruitless measures, that accompany our last days here in the U.S. End-of-life care is a huge cost issue, Keller writes:

“….a quarter or more of Medicare costs are incurred in the last year of life, which suggests that we are squandering a fortune to buy a few weeks or months of a life spent hooked to machinery and consumed by fear and discomfort.”

Yet we should approach dying with dignity more out of concerts for the patient and his or her family, he says — a kinder way of death — than out of fiscal prudence, which will ultimately make palliative care more popular and culturally acceptable for the American public as well. On a brighter note, TEDMED’s new consulting clinical editor Pritpal Tamber, M.D., director of Optimising Clinical Knowledge — which helps organizations implement established clinical know-how — wrote on his blog wrote about what’s needed on all fronts to manage these daunting hurdles we face:  an inspiration immersion, leading to a badly needed healthcare reinvention.  Welcome, Pritpal!

Share your thoughts: How can we better manage end-of-life care?

Modern medicine has extended the life expectancies of many terminally ill Americans. In turn, prolonging lives can mean incurring more intensive care and the associated costs.

In 2010, Medicare paid $55 billion for doctor and hospital bills during the last two months of patients’ lives. Quality end-of-life care requires balancing the input of doctors, families and patients themselves. And making crucial end-of-life decisions can take physical and emotional tolls on patients and their loved ones.

How should we help people manage end-of-life care choices to maximize individual well-being and minimize social cost? Ask experts and join our interactive conversation now on how to manage this Great Challenge in health and medicine.

How can we better support caregivers?

An estimated 44 million people provide full-time or part-time care for the elderly,disabled veterans, new mothers, the injured, the sick — a problem that eventually impacts everyone in the nation.

Caregivers have few tools, few support systems and receive minimal, if any, training for these responsibilities. What innovations can we develop specifically to support the caregiver community?

Ask a collected team of leaders on the issue — from a caregiver to a psychologist — about how we can better manage the crisis, at

Patient as consumer: What does it mean for healthcare?

Patient empowerment can be a double-edged sword. From hospitals and insurance companies to doctors and patients themselves, much of the medical system increasingly treats patients as “customers” or “consumers,” terms that some people love and others hate. If patients are customers, does that mean “the customer is king” or does it mean “buyer beware” — or both?

If patients retain their traditional role, does that mean doctors are in charge? Are both in charge somehow? How is “power” shared among all stakeholders and how should it be shared?

The changing role of the patient was voted the number one Great Challenge in health and medicine by the TEDMED community in 2011, one of 20 complex issues with broad impact that needs cross-disciplinary understanding and discussion to manage.  Join the online interactive Challenges community now to share your thoughts on patient engagement and to ask questions of thought leaders in the field.

The challenge: More affordable medical innovation

New medical tests, treatments and devices are often very expensive when first introduced. Eventually, market forces bring the prices down. However, since most patients don’t pay for healthcare out of their own pockets, they don’t want to wait.

How can we achieve more innovation, more affordably?

Patients disproportionately demand the latest, best medical products and services immediately — often, even if the demanded good is of marginal relevance to their condition. Leaving out questions of universal access and rationing, how can we make more medical innovations more affordable, more quickly, for more people?

Which proven strategies from Silicon Valley, the Moon landings, the Manhattan Project or other successful models could be applied effectively to achieving faster, yet less costly innovation in health and medicine?  Join the boards on the TEDMED Great Challenges web site to share strategies and ask questions directly of leaders in the field.

Great Challenge #2: Managing chronic diseases

Chronic disease is America’s leading cause of premature death and disability. Heart disease, cancer, respiratory illness and certain others are among the most costly and common health problems, yet they are often among the most easily prevented and controlled.

How can we innovate better approaches to help patients prevent, manage and treat their chronic diseases and achieve better outcomes?

Stop by the boards on TEDMED’s Great Challenges interactive community to share your ideas and ask questions of thought leaders in the field.

Can we eliminate medical errors?

All humans make mistakes. Doctors and nurses are human; they make mistakes. All systems are imperfect. Medical professionals use systems.

Errors by medical professionals and systems are inevitable (unfortunately, they send 2.4 million patients to hospitals yearly and are directly linked to 200,000 annual fatalities). Regardless of methods used to detect, prove and compensate for medical errors, how much better can we do in reducing or eliminating medical errors and what areas should we focus on to get the best improvements?

TEDMED’s Great Challenges program is a forum to discuss pervasive, broad-based issues like these that demand collective understanding and action to manage. Join the online community to share your thoughts and to ask questions directly of experts on the issue.

New Great Challenges minisite offers chance to interact with health experts

Phase Two of TEDMED’s Great Challenges Program is underway, featuring a new interactive minisite where readers can interact with thought leaders on some of health and medicine’s most vexing and complex issues.

How can we achieve more innovation, more affordably?

Earlier this year, the TEDMED community voted to select the top 20 Great Challenges, pervasive, broad-based problems that demand inter-disciplinary discussion among the entire TEDMED community, and collective action to manage. TEDMED assembled a team of experts in each area to field questions  and comments from the web, Twitter and Facebook. The team’s responses will be posted online and within a series of live events to be announced later this year.

First up for discussion:

  • The Role of the Patient
  • Managing Chronic Diseases Better
  • Coming to Terms with the Obesity Crisis (Adult)
  • The Caregiver Crisis
  • Eliminating Medical Errors
  • Achieving More Medical Innovation, More Affordably
Visit the site at to join the conversation.