Consumer Focused Health

Lake Wobegon was a place where “all the women are strong, all the men are good looking, and all the children are above average.”  We all recognize that Lake Wobegon is a quaint fiction; so why then do we act as if our doctors and hospitals come from a place where all are superhuman and there are no below-average doctors or hospitals?

A recent article in the WSJ highlights the benefits of using top-rated hospitals…that by making transparent the success rate of various procedures in Pennsylvania, companies that work with the best performing hospitals find significantly better outcomes for their employees…and save lots of money.

Although at times premium care can be exorbitant, there’s evidence some in Pennsylvania saved money using top-rated hospitals. Hershey Co. offered workers medical coverage based on the state agency’s reported outcomes, and cut the company’s expenses by 50% over several years. The Philadelphia police union’s benefits-management company says it uses the state reports to steer officers to the best hospitals; as a result, it say its costs fall about 17% below those of comparable plans.

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We’ve decided to move to self-hosted wordpress. I just like the ability to customize a lot of elements. Hello new blog url and goodbye pagerank.

Check us out at http://blog.consumerfocusedhealth.com

Can you handle the stream?

HealthStreaming is something that I’ve been thinking a lot about lately. We have all kinds of streams of data that help us make decisions these days: blogs, reviews, recommendations, financial data, etc. When I look at the data we’re gathering on the health side, I see a real disconnect: its primarily billing and clinical data built for doctors, hospitals, and insurance companies rather than the information that would help me to understand and improve my health.

Its not a surprising state of affairs: the consumer is not the customer of health care today, and information is gathered to meet the needs of health insurers, employers, providers, vendors (incl. pharma) and researchers. I would assert that most of this stuff in its current form is useless to consumers.

Yet, if we want to capture the experience and personalization we see in other places in our lives, we need to create the HealthStreaming infrastructure that captures and aggregates the data that actually matters for consumers as we all make our own health choices. As we’ve seen with EMR and PHR adoption rates, platforms like Google Health or Microsoft HealthVault are unlikely to take off until the data we want to use follows us with little effort, and killer apps allow us to use them in ways that transform our lives.

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We are entering an unprecedented season of change for the United States health care system. Americans are united by their desire to fundamentally reform our current system into one that delivers on the promise of freedom, equity, and best outcomes for best value. In this season of reform, we will see all kinds of ideas presented from all across the political spectrum. Many of these ideas will be prescriptive, and don’t harness the power of innovation to create the dramatic breakthroughs required to create a next generation health system.

We believe there is a better way.

This belief is founded in the idea that aligned incentives can be a powerful way to spur innovation and seek breakthrough ideas from the most unlikely sources. Many of the reform ideas being put forward may not include some of the best thinking, the collective experience, and the most meaningful ways to truly implement change. To address this issue, the X PRIZE Foundation, along with WellPoint Inc and WellPoint Foundation as sponsor, has introduced a $10MM prize for health care innovators to implement a new model of health. The focus of the prize is to increase health care value by 50% in a 10,000 person community over a three year period.

The Healthcare X PRIZE team has released an Initial Prize Design and is actively seeking public comment. We are hoping, and encouraging everyone at every opportunity, to engage in this effort to help design a system of care that can produce dramatic breakthroughs at both an individual vitality and community health level.

Here is your opportunity to contribute: continue reading »

As I’ve been working on the creation of a Healthcare X PRIZE to generate a sustainable systemic change, one core element of the answer has become increasingly clear:

You must reward the innovators in order to see those changes scale and continue to improve.

In the debates on health reform, you can’t just look from the macro perspective and say waste exists and should be eliminated. No one will voluntarily take a pay cut, and all of that waste is someone’s pay.

Instead, we must reward those that do a better job; the companies that we want to grow because they offer us higher quality, better prices, or both. Those companies need to benefit by being able to grow market share, selling products at an attractive margin, or both.

As we evaluate the various health reform proposals out there, the question that should be asked is: how are we setting this up so the person who’s solution best meets the described goals can increase their profits and scale their solution?

Unfortunately, most of the reform proposals out there focus on unilaterally cutting reimbursement (without giving increased profits to those that deliver better results) and distorting the market through mandates. Neither will put in place the sustainable incentives needed to drive increased efficiency over time.

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The world in general has shifted as the internet and accompanying data transparency has made communication and coordination easier across boundaries.

The view that a single entity is required to execute a given task is no longer a given in a world where smaller companies can use outsourced services to appear much larger and large companies outsource everything to smaller companies.

Take for example, Dell. Dell has become primarily an aggregator which allows customers to customize their computer primarily by giving them access to all the options in the supply chain through an easy-to-understand user interface and through the experience of running all communications through that one company’s brand.

Who are the aggregators in health care that help us similarly understand our choices and make appropriate selections? That entity does not exist today in the consumer world…it has been filled by payors in the employer world.

As we move to a world that increasingly must organize around the individual, who will be the aggregators that make health easy to understand for the consumer and allow them to make the best decisions for themselves?

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Just wanted to see who else was going to be in DC for the World Health Care Congress. Just flew in today– X PRIZE will be announcing an initial prize design for a potential $10M Healthcare X PRIZE (with WellPoint CEO, Bill Bradley, and Newt Gingrich).

Anyone else in town?

Been wrestling with an interesting question of late as I help to develop a Healthcare X PRIZE– what do we want our health system to actually accomplish on a global scale (ie what should our incremental health dollar accomplish?)

If we are what we measure, what should we be measuring to determine what return we’re achieving for our healthcare dollar?

What metric would you use to highlight the improved outcomes of a better-performing health system?

Some thoughts I’ve heard:

• Death
• Major morbidity
• Hospitalizations
• Sick days
• QALY
• % “passing” President’s Fitness test

What do we want our health dollar to buy? Appreciate your thoughts!

Apologies for the silence…its been an interesting start to the year.

As some of you know, I’ve taken a new role with the X PRIZE Foundation…they offered me an amazing role in designing a X PRIZE for healthcare– finding the market failure in the health sector that can best be solved by a competition for a $10M+ prize.

The mission is amazing…define a competition to showcase competitors that will definitively improve quality while reducing costs. The execution will be challenging– defining the appropriate scope of this particular prize where teams can clearly understand the start and finish lines and a clear winner can emerge.

At present, we’re looking to define the best space to start, so please let me know if you would like to share your insights on addressable issues that would make for a good competition.

HealthShoppr.com continues to grow…we’ve seen an amazing growth in massage therapists posting profiles over the past 6 weeks and look forward to continuing to push the boundaries of transparency and personalization in finding a best fit health professional.

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Quick note to mention we were selected as one of the top 100 health policy blogs!

Happy New Years to all!

We’ll get back to policy issues shortly…