Interviewed Evan Falchuk, President of Best Doctors, on their product allowing consumers to get additional information and options regarding diagnosis and treatment options.
The interview took place at the World Health Care Congress and both a podcast and a transcript lay out the conversation below.
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Evan Falchuck
Best Doctors
Only 2% of consumers are currently using a PHR, according to Revolution Health CMO, Jeff Gruen at the World Health Care Congress on a panel with Graham Pallett (Carol) and Jeff Rideout (Health Evolution Partners).
So why are these tools not being used?Some initial thoughts:
- Awareness
- Concerns around security and privacy
- Data needs to be “easy” and ubiquitous
- Compelling or “killer” apps
Interest in the PHR is clearly renewed, with consumer oriented development occurring due to efforts by tech titans Microsoft (HealthVault) and Google (GoogleHealth). The real question is whether this is technology leading the wagon or if there are real unmet user needs creating opportunities that the technology can begin to address.
There are clearly different (and competing) objectives for PHRs from the consumer, provider, and payor perspectives.
Consumers have a number of different needs that could be addressed by a PHR:
continue reading »
Sat in on an interesting lunch discussion with Michael Howe, CEO of MinuteClinic. The topic was delivering consumerism, and the delivery mechanism of the retail clinics for relatively well defined, limited scope primary care concerns has certainly been innovative and popular, with thousands opening (or planned) across the country.
The discussion took an interesting twist, when a representative from Eliza, the medical communications company, started to talk about how consumer communications are increasingly effective when targeted to customer segments and pre-expressed preferences.
This brings up an interesting crossroads– as evidence-based medicine increasingly pushes a singular “best practice” based on clinical trials and statistical evidence, the rest of the consumer environment is moving toward personalization/ mass customization where consumers are increasingly given a personalized solution that meets their own niche wants/needs. As consumers are increasingly asked to be participants in their own care, will the paternalistic best practice based on one scientist’s approach to a population become the norm executed via “cookbook medicine” delivered by less trained providers (who may not be able to question conventional wisdom later reversed) or will we see increasingly decentralized flexibility of guidelines to optimize for a particular individual’s situation and demands?
My guess? Nobody complains about the lack of adherence of consumers in consuming soft drinks, cigarettes, or other acquired tastes…
This post is cross-posted at the World HealthCare Blog.
George Halverson, Kaiser Permanente’s CEO gave a keynote earlier today at the World Health Care Congress in Washington DC. The statistics he gave were compelling. The opportunities, also, really interesting. From a consumer perspective, the prescription he wrote was not– heavy on centralized best practice reminiscent of the socialistic economy.
The issues today are pretty clear– we are focusing our resources heavily on the sickest individuals.
Even more compelling are the stories of conflicting interests, where an institution such as Virginia Mason is able to significantly reform health costs through better treatment up front (in this case imaging)– only to find a 30% revenue cut putting the institution at a disadvantage in being able to meet payroll and overhead expense.
But these innovations, although they lowered costs and seemingly were good for patients, hurt Virginia Mason’s bottom line. For example, “the big employers saved $100,000 in the first year. But Virginia Mason fell into the red on the average migraine case, instead of breaking even as before.”
I’ll be liveblogging next week on both this blog and as a guest blogger at the World Health Care blog. Should have an interesting mix of podcast and commentary on consumerism and health.
If you’re in DC, please stop by and say hello.
Jonathan Kellerman sparked a firestorm of comments with his op-ed in today’s WSJ, titled The Health Insurance Mafia.
His premise, which I’ve been arguing for a while, and which Dr Rich has written about eloquently as Covert Rationing, is that insurance, rather than solving the problems of cost, creates much of the problems we see today.
Health insurance companies are already an oxymoron– they neither are about health nor insurance– instead they have become a redistribution vehicle for transferring money from the healthy to pay for chronic care of the sick and end-of-life “heroics”.
The Nytimes has an interesting article on the emergence and implications of Tier 4 “co-pays” for medications– bringing a percent of drug cost into the co-pay equation for expensive medications.
With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.
For example, here is a sample Tier 4 explanation from BCBS NM.
What is a 3-Tier or 4-Tier prescription drug plan? continue reading »
As we think about the increasing sophistication and technological instruments we bring to medicine, we’ve increasingly neglected the human/ psychological components of healthy behaviors.
For example, how much of a difference can primary care docs make on smoking in a 6 minute visit? And when smokers resist the temptation, what is the impact on the rest of their health?
“There is no question that smoking affects the epidemic” of obesity, said Dr. Neil Grunberg, a psychologist and neuroscientist at the Uniformed Services University of the Health Sciences in Bethesda, Md.Smokers who quit, he noted, gain about 10 to 12 pounds on average, in part because they crave sweet foods and carbohydrates. In addition, Grunberg said, smokers’ metabolism slows after they quit.
Medicine to McKinsey to Main St