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.

• 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.

• 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.

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

“Different forms of organization may offer the best combination of cost, quality, and convenience for different services depending on their clinical and technological characteristics.”

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

• 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.

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.