eHealth » consumer-directed health care

Health Care is Coming Home

John Sharp — Fri, 29 Oct 2010 02:45:49 +0000

In the New England Journal Journal of Medicine this week, a perspective article by a Cleveland Clinic physician, promotes the future of home care. Dr. Landers notes five major forces driving healthcare to the home.
1. Aging of the population
2. Epidemics of chronic disease
3. Technological advances
4. Health care consumerism
5. Escalating health care costs

In the conclusion of the article, he notes this as a long term trend perhaps taking decades. My view as a technology optimist, is that the combination of these forces will result in a faster pace of change with high tech home care being an integral part of the medical home.

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Patient-centered Care – Let citizens manage their health

John Sharp — Sun, 21 Dec 2008 07:41:00 +0000

In a well-written post about the problem with healthcare, Dr. Kenneth H. Cohn talks about his recent personal experience with a medical problem while he was between PCPs. Sounds like a nightmare but that’s what too much of healthcare is today. Specifically, he identifies these problems as presented by the Health Finance Forum:

The (non)-system does not encourage social benefit, such as access to care.
It does not reward wellness or high-quality care.
It creates financial instability by adding cost and complexity to health administration, rewarding high-cost practices and focusing on expensive sickness-focused interventions rather than wellness.

He suggests some solutions:

Stop the insurance company micromanagement; it adds not only cost and complexity
Let citizens manage their health with their physicians through a variety of channels, such as website interactions that do not force us to drive to our doctor’s office for prescriptions when we are in acute pain and know what we need to do to recover.
Design systems using interdependent, rather than fragmented, processes, that improve patients’ healthcare outcomes, rather than tolerating arbitrary rules that exist for the convenience of insurers.

Great ideas – read the whole post.

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Consumer-Centricity

John Sharp — Thu, 06 Mar 2008 08:09:00 +0000

Jane Sarasohn-Kahn posts a commentary on the HIMSS 2008 conference identifying significant themes which came through in this monster conference-exhibition of 28,000. The these include:

openness – of code such as Microsoft’s promise to open their API to HealthVault and Google doing the same for Google Health, others also demonstrating interoperability
security – privacy protection, Google Health (is it secure enough), World Privacy Forum
consumer-centric – not just from the big guys but also Allscripts and Relay Health

A good summary of a big event – worth reading.

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Shopping for Care Packages

John Sharp — Tue, 05 Feb 2008 08:26:00 +0000

Another start up is moving into the consumer-directed healthcare space with an offering of shopping for carepackages. Carol.com offers a wide range of services but currently only in Minnesota. What is a care package? It is the packaging of healthcare services into bundles, such as, evaluation for asthma, laser vision correction, health and wellness classes and any service a consumer is willing to pay cash for. Will it catch on? I think it certainly will, maybe gradually at first but it will go national. Consumers will likely adopt this friendly term and be on the lookout for a health care shopping mall like this.

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Consumerism in Health Care – Future Directions

John Sharp — Fri, 04 Jan 2008 08:04:00 +0000

In doing some digging on this topic, I found an article from Health Affairs from 2005 which calls for a new direction.
“Consumerism appealsto the widespread and legitimate desire for a more transparent,flexible, and personal system and provides a salutary counterbalanceto the organizational hypertrophy and opaque administrativemechanisms of the managed care era.” The article goes on to recommend marrying the best of supply-side and demand side competition in health care to produce a new model.

“Different consumer-centric benefit designs andprovider-centric network designs will be appropriate for differenthealth services, depending on whether utilization is stronglyconsumer preference–sensitive, provider supply–sensitive,both, or neither.”

“Differentforms of organization may offer the best combination of cost,quality, and convenience for different services depending ontheir clinical and technological characteristics.”

Check out the charts which describe some of these models: Benefit and Network Designs , Alternative Forms Of Provider Organization.

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Consumer-Centric Health Care Congress

John Sharp — Sat, 10 Nov 2007 03:09:00 +0000

Video interviews are available from this congress being held in Washington, DC. One of the most interesting is Bridget Duffy, MD, who acknowledges the need to appeal to consumers who have the ability and initiative to shop for healthcare and how healthcare providers need to be transparent about outcomes.

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Patient Advocate Blog

John Sharp — Wed, 25 Jul 2007 07:25:00 +0000

A recently launched blog by George Van Antwerp, focuses on consumer-directed health care and process improvement in healthcare. His perspective is from a consultant from the pharmaceutical industry but his thoughts are broad and deep. The most recent post is a summary of a Wired article on healthcare costs noting that the average family spent “$1,361 (3%) on health insurance and $405 (1%) on prescription drugs”.

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Patient as Driver

John Sharp — Thu, 07 Jun 2007 07:54:00 +0000

Wayne A. Sensor is CEO of Alegent Health, Omaha, Neb. has written an article on the Most Wired website on “Taking the Wheel: Empowering Users to Make Informed Health Care Choices.” He utilizes the concept of patient as driver to draw attention to what he calls the last frontier for consumers, healthcare. “We must surround consumers with the information they need to complete the value equation: price plus quality equals value.” Adam Bosworth could not have said it better. Alegent has on their homepage two key tools which he would describe as patient empowerment tools

MyCost – to help consumers understand their deductable and other out-of-pocket costs
Quality Reports – detailed scorecard by disease

Every health system and hospital will be following leads like this to survive in this more transparent healthcare market where cost and quality will drive business.

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Two Perspectives on Consumer Directed Healthcare

John Sharp — Wed, 09 May 2007 07:40:00 +0000

Dr. Bill Crounse of Microsoft writes about If Wal-Mart did Healthcare to compliment his recent post on If Disney did. He draws a scenario of no insurance coverage for medical costs under $5000 – “healthcare would behave like other industries were it not for the perverse effects of traditional insurance programs on the supply side of the business.”

On the other side is e-Care Management quoting a study that shows that those with chronic conditions do worse on CDHP, not surprising, since skipping appointments or medication to save money could easily result in a hospitalization.

No simple answers here – healthcare may act like a business and may need to change incentives, but incentives should move toward the best outcomes, not just market forces.

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Quicken Health offered to Cigna Members

John Sharp — Tue, 01 May 2007 06:49:00 +0000

The San Jose Business Journal reports that Cigna will offer their members Quicken Health from Intuit at no charge. Similar to the personal finance version of Quicken, it allows the member to download claims information and organize medical expenses. Quicken already has their Medical Expense Manager in version 2.0 but the website indicates that Quicken Health is coming soon. Oriented toward Health Savings Account customers, the product will also allow downloading and organizing of medical records. Will this mean some kind of connection to the major EHR/PHR vendors? Quicken Health will also be offered by United Healthcare and others.

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