Healthcare in a land called peoplepower: Nothing about me without me

Tom Delbanco, Donald M. Berwick, Jo Ivey Boufford, P. A. Edgman-Levitan, Günter Ollenschläger, Diane Plamping, Richard G. Rockefeller

Research output: Contribution to journalReview articlepeer-review


In a 5-day retreat at a Salzburg Seminar attended by 64 individuals from 29 countries, teams of health professionals, patient advocates, artists, reporters and social scientists adopted the guiding principle of 'nothing about me without me' and created the country of PeoplePower. Designed to shift health care from 'biomedicine' to 'infomedicine', patients and health workers throughout PeoplePower join in informed, shared decision-making and governance. Drawing, where possible, on computer-based guidance and communication technologies, patients and clinicians contribute actively to the patient record, transcripts of clinical encounters are shared, and patient education occurs primarily in the home, school and community-based organizations. Patients and clinicians jointly develop individual 'quality contracts', serving as building blocks for quality measurement and improvement systems that aggregate data, while reflecting unique attributes of individual patients and clinicians. Patients donate process and outcome data to national data banks that fuel epidemiological research and evidence-based improvement systems. In PeoplePower hospitals, constant patient and employee feedback informs quality improvement work teams of patients and health professionals. Volunteers work actively in all units, patient rooms are information centres that transform their shape and decor as needs and individual preferences dictate, and arts and humanities programmes nourish the spirit. In the community, from the earliest school days the citizenry works with health professionals to adopt responsible health behaviours. Communities join in selecting and educating health professionals and barter systems improve access to care. Finally, lay individuals partner with professionals on all local, regional and national governmental and private health agencies.

Original languageEnglish (US)
Pages (from-to)144-150
Number of pages7
JournalHealth Expectations
Issue number3
StatePublished - 2001


  • Electronic medical records
  • Employee satisfaction
  • Patient satisfaction
  • Shared decision-making
  • Volunteerism

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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