Imagining better outcomes for T1D with #MakeHealth

This post originally appeared on Diabetes Mine.

Forty-five makers, thinkers, designers and doers gathered in Cincinnati for a two-day meeting to kick off “Phase Zero” of a new initiative to imagine a new system of care for people living with Type 1 diabetes (T1D). The best way I can describe the group is that everyone was “game,” meaning up for anything, silly or serious.

I will leave the official accounts of the event to the hosts, the C3N Project and T1D Exchange. But I can share a few vignettes.

Pain Points

We were assigned to tables of 8 people, one of which was a PWD or parent of a child living with T1D. Our first exercise was to identify specific challenges and opportunities in the health care system, based on their experience.

A mom of two children with T1D in my group took us through a typical day, midnight to midnight, as our designated scribe attempted to take notes. The ideas were flying by so quickly that three more people grabbed Sharpies and Post-its in attempt to keep up.

When we categorized the 50+ ideas, the “communications” cluster was the biggest one. She pointed out that she is able to keep in touch with her kids and the pharmacy via text messaging, but clinicians take up to three days to return a phone call – a complete failure to recognize the real-time decision-making needed when managing diabetes. How might we change that?

Testing, Testing

Each non-PWD participant was given the opportunity to test their blood sugar before lunch and then try to calculate the carbs of what they were planning to eat.

We were each handed a OneTouch Ultra 2 meter, an alcohol prep pad, a lancet, and a test strip. We listened carefully to the expert PWD at our table and proceeded to mess up anyway, inserting the strip upside down, not squeezing enough blood out of our fingertips (the side of the finger, that is, thanks to her advice that pricking the finger pad really hurts), etc. I failed to hold the strip steady so the blood could get sucked in correctly and had to do it again. We laughed and knew that this was a tiny – miniscule! – part of the experience of living with T1D. But it was a great hands-on exercise.

Vice Advice

We broke into different groups to brainstorm ideas for tackling a specific challenge. My group focused on how to help kids be self-sufficient while also keeping them safe.

We came up with the idea of a peer support group akin to the Gay-Straight Alliance or LGBTQ clubs that exist in many schools – anyone can be part of it, not just PWDs.

Our vision is to make it cool to be supportive. We had a lot of fun dreaming up features like a “Vice Advice Hotline,” a safe, authoritative information source for teens with T1D who want to know the pros and cons of marijuana vs. alcohol, for example, but can’t exactly ask their parents or clinicians. And since teens often have a dark humor about their situation, we came up with a few names: The Chronic;The Living Dead; The Try Anyway Club (as in: we’re all going to die, but let’s try anyway).

Happiness

One of the most powerful moments happened on Day Two, when we were talking about patient-reported outcomes (PROs) and what kind of data we would like to collect and include in the T1D conversation (regardless of whether it would be for home or clinical use).

Someone suggested we consider tracking “happiness” and asked for examples of effective mood measures. A PWD spoke up with the request that we focus instead on measuring the burden that he and everyone with diabetes carries.

He said that the weight of constant measurement, calculations, shame and blame, needing to plan ahead for every situation – including the TSA screening later that afternoon – is a very personal burden that sits on top of his relationships at home and at work. He already knows that is what most affects his happiness. He doesn’t need anyone to quantify it for him. Instead, he needs help quantifying and lifting the burden. He wants to be able to forget about diabetes for a few hours. Then he can take care of his own pursuit of happiness, thank you very much.

If you’re interested in learning more about the event, check out Joyce Lee’s Storify of the #makehealth tweets. If you would like to contribute, you can join the Glu community and/or join the C3N Project’s LinkedIn group. And stay tuned to the C3N Project and T1D Exchange sites for future updates.