On Monday, I wrote a blog post entitled Creating Better Health trying to pull together themes from patient education, the e-patient movement, discussions at the Mayo Clinic Center for Social Media and the Learning Creative Learning class at MIT.

Tuesday, I had a meeting with people from a health care foundation to talk about messaging around health care. It struck me how much money and effort is spent marketing unhealthy products, and how little effort is really spent encouraging Americans to live healthier lifestyles. Wednesday was mostly devoted to health disparity issues, and this morning started off on a similar note.

Then, this afternoon, I had a fascinating discussion that really helped pull some of this together. It seems like so much of patient education is about imparting information to patients. You have diabetes. You need to exercise more. You need to eat less sweets. It also seems like so much of this 'patient education' fails because patients aren't compliant with what their doctors are telling them.

Some of this may relate to health equity issues. Are the doctors imparting information providing information that is culturally aware? Perhaps they've been trained and think about difference between latino patients and caucasian patients. Yet perhaps this is too blunt a tool. My friends of Venezuelan descent are quick to point out how different they are from our Puerto Rican, Mexican or Argentinian friends. For that matter, there are similar differences between Italian-Americans and Irish-Americans, and then you get to families like mine. On my side of the family, there is English, Scottish, Irish, French, Dutch which has been mixed together for generations. We have certain traditions around food and family gatherings. On Kim's side of the family, there is Italian, Irish, English and Russian, some of it much more recently arrived in the United States and mixed together. There are a different set of traditions. As a family, we try to mix all of this together that into something that is uniquely part of our family.

A couple of us have specific dietary concerns related to our health so meals and traditions are created that specifically relate to our cultures and our health conditions. My wife takes great pride in her ability to create great meals that meet all the family requirements. Every family is different. How do other families create meals that meet the specifics of family tradition and health needs? This probably is something that needs to be created by the family, and not imparted by medical providers.

When you look at people confronting major health challenges, they gather at online sites, where they share experiences and ideas, where they discover, together, aspects of their diseases, perhaps information that the medical community has yet to discover. This seems to be constructivist learning about health which is far different from most patient education. The patient support sites, are, in certain ways, massive open online courses (MOOC).

As an alternative to traditional patient education with low compliance rates, can we design massive open online courses where patients with more common and in some cases less threatening diseases can participate in shared learning experiences that result in better health? It seems like an interesting challenge.

Related to the MIT MOOC, I have set up a Google+ community LCL Health. If you're interested in exploring this further, please join us.