Pathology supporting chronic disease management: It's not all about the numbers!

I like numbers and I like words and stories, and I like them both the same.

The drive to prove the good practice of medicine through numbers and targets has almost lost us the art of words and stories. We can’t measure the healing powers of words; does this mean they don’t count?

Pathology can provide us with a number. We can make sure we test for that number and ensure that we move that number to target. Here we have someone with ischaemic heart disease; they have a cholesterol of 3, that’s great! That’s well in target. But what’s the story?

The story is not the story we think, and it starts from the very outset. When we started talking to patients about their annual chronic disease reviews, we found this....

Patients are called into their GP practice to have their annual heart disease monitoring review. They are asked to make an appointment for a blood test. No-one has told them what blood tests they will have done. They have their bloods taken. ‘I had loads of bloods taken’, ‘they test for everything don’t they?’, ‘I think they even pick up cancer’

Patients aren't really sure what the blood tests are for, and they start making up their own stories....

Not knowing what the bloods are for, or what they mean, creates stories that can make their health worse; or distract them from important health issues.... ‘My cholesterol is 3, that means my fat is good doesn't it?That means I don’t need to lose any weight...’

For pathology, ensuring that a number leads to good conversations and good stories that can help patients on the path to good health is as important as generating a correct and accurate number.

Supporting patients to know what blood tests they are having. Supporting patients to understand what the blood tests are for and the meaning of the result starts the story off on the right footing. And if the story starts off on the right footing, everything downstream has a chance of success. What chance is there of supporting a patient to lose weight, when their cholesterol is so good!

Supporting users to consent patients for blood tests every time: What test? Why? What it could mean? What it does mean. Supporting users to embed this into written information at annual review- recall letters, consent and reporting.

Stories count as much as numbers.