Posts Tagged ‘consumer-directed health care’

Curing the Trust Crisis in Health Care

April 20, 2007

Daniel A. Shore from the Harvard School of Public Health speaks on this topic at the Cato Institute tomorrow (4/20/2007). He has editted a new book on the topic as well, The Trust Crisis in Health Care. Here are some of the main points:
“- systemic conditions that lead to medical errors, and remedies for promoting quality of care.
- outdated modes of doctor-patient communication that hinder compliance.
- novel modes of interaction to improve satisfaction. – patient-centered care and metrics to evaluate its presence or absence.
- media communication and miscommunication, and new standards for medical reporting.
- clinical insights applied to the use of human subjects in biomedical research.
- recommendations for revising medical school curricula and strengthening the peer-review process in medical journals.
- practical strategies for decreasing the lingering discord between patients, providers, and health plans.”

While not directly related to Heath IT, the implications are there – EMRs and PHRs cannot succeed as long as their is an atmosphere of distrust between physician and patient.

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Health Care Hustle

March 23, 2007

The website of the organization Working America has launched the Health Care Hustle – an opportunity to share stories online by health care consumers who feel the impact of the broken health care system here. Many of the stories are submitted anonymously by the uninsured or underinsured and low income.  As you might expect, these are stories of high deductables, expenses driving people to bankruptcy and relying on emergency room care. The site also gives the user the opportunity to write one of the Hustlers – big pharma, insurance industry, greedy corporations, and Bush and company generating a standard letter email promoting the groups issues.

Unlike other consumer websites which encourage rating doctors and hospitals as good or bad, this site is focused exclusively on what’s wrong with healthcare. Maybe it will provide fodder for legislators to promote change in health care financing and delivery.

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Liberation from Health Insurance Companies?

March 8, 2007

Although this article from VentureBeat is from January, it is still timely. In addition to focusing on Revolution Health, he cites other players such as, MedBillManager and also an article from Business Week in Nov. 2006 which gives a good summary of the PHR business. TauMed which is a medical advise site and the startups in the health search field are also mentioned (Kosmix and Healthline). He notes that “Revolution Health will offer telephone-consulting and digital-record services free for a year, to those who sign up within 90 days. The company says it eventually will charge $100 or so a year for a subscription to premium services.” WebMD’s plan for a PHR are also noted.

Sounds like a crowded field which will need to sort itself out. Like the many players in the dot-com boom, not all will make it. The question as always is, who has the best business model that consumers are ready for?

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Public Reporting and Transparency

February 15, 2007

In a new report from the Commonwealth Group, the lack of transparency in health care is  addressed in detail. They note that public reporting of outcomes will:

  • inject competition in health care
  • help providers benchmark against each other
  • encourage insurors to reward quality and efficiency
  • help consumers make informed choices.

They also note that public reporting adds value but must be designed carefully.
I might add that consumers need education on how to interpret health outcomes since there are currently many ways to report outcomes.

Overall, I recommend reading at least the executive summary.

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Shopping For Price In Medical Care

February 10, 2007

Consumers for Health Care Choices reviewed two articles from Health Affairs on self-pay in health care. The first article titled, “Self-Pay Markets In Health Care: Consumer Nirvana Or Caveat Emptor?” (full text available) discusses a study of Lasik eye surgery and dental Crowns as examples. The consumer group notes that Lasik providers fall into three market segments: “highly credential “premium price” surgeons, high-volume discounters, and a mid-level that falls in between”. They note that about half of patients come in through marketing but the other half is largely word of mouth. And the premium price group “are the ones most focused on quality, asking about technology, safety, and
outcomes, but also about ‘customer service amenities’.”

In Vitro Fetilization is another example given. Conclusions overall: “For consumers who do take quality into account when shopping, comparing quality across providers is more easily done in some self-pay markets than others.” The Health Affairs article goes on to recommend better comparison tools which adjust for case complexity in quality outcomes.

The second article is “Shopping for price in medical care: Insurers are best positioned to provide consumers with
the information they need, but will they deliver?”

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Rate Your Cardiologist

January 30, 2007

Vimo.com is a relatively new Web 2.0 offering which is in the Consumer-directed healthcare space. Specifically, it gives pricing for medical procedures and allows users to rate physicians and hospitals.  For a heart month promotion (an to increase the number of ratings on the site), they are offering to donate $1 for each physician rating to the American Heart Association.  The amount of data pulled from various sources is impressive. Cost data by procedure including average price, negotiated price, whether the hospital is above or below the average. For physicians there are ratings but also integration with Google maps for location. Nice job overall.

My question is, what is the value of these ratings to consumers? Will consumers embrace this practice the way they have for consumer items? Or will these rating sites become places for complaints to be aired rather than the best physicians and hospitals to be spotlighted? The competition between rating sites (see for instance, Revolution Health) will be worth watching. Will there eventually be a site which aggregates comments from these rating sites?

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The Future of Health Savings Accounts – 2007

January 9, 2007

Will HSAs grow or wither in 2007? According to a new study by Vimo, there are some black clouds on the horizon (sorry for the mixed metaphors). “The report also shows that funds on deposit in the average HSA are roughly half
of what is required to cover the typical health plan deductible for these consumers.  Both findings hint at disturbing trends that may jeopardize the “Consumer-Driven Health” movement.” Park of the issue may be employee awareness that HSAs could actually decrease their total compensation. This is a trend to watch.

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2007 – The Year of the Consumer in Health IT

January 4, 2007

In an article by Joseph Conn in Modern Healthcare, “In health IT, consumer’s role on the rise“, he quotes the president of HIMSS saying “I think you’re going to see more and more development around tools for the consumers, especially from employers, trying to use the consumer to be the vehicle to bring about change in healthcare.”  Citing the Dossia project and other employer-sponsored PHR and eHealth initiatives, the question remains as to whether the consumer will trust their employer or insurance company to deliver their health information. Also, the push for quality data from consumers will drive new developments in comparison tools for hospitals and providers. Patient-focused treatments driven by advances in genomics will begin to bring pay-as-you-go treatments back to medicine. He concludes the article with a quote on privacy and the need for trusted entitites (physicians and hospitals) as being the brokers of these services.

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Consumer-Directed Health Care Should Include Privacy

October 2, 2006

In a report on transparency on privacy issues by Jane Sarasohn-Kahn on iHealthbeat discusses the AMIA report on secondary use of health data, the author cites the constructive uses of such data for medical research. Educating consumers about this use is essential. “We cannot expect consumers to engage in the brave new world of consumer-driven health care without their expecting – and getting – privacy protections that stick.”  Tying consumer-driven healthcare and these secondary uses of data is important in empowering the consumer to take ownership of their data including allowing its use for research.

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