8:00am, Keynote Regina Herzlinger, Professor @ Harvard and author of Who Killed Healthcare: Very good, thought provoking and at times funny presentation. If you ever get a chance to hear her present, do it!
Key points made:
- Need to move to Consumer-Driven Health Plans (CDHP).
- CDHP’s are crippled until we, as a country are able to provide cost and quality transparency.
- Sees the role of government as similar to that of the SEC – set the guidelines and a clear regulatory structure and then get out of the way.
- She’s a big fan of Switzerland’s healthcare program.
8:50am Panel Session: Giving Out Grades, Online Ratings of Physicians: Consumer’s Union, Angie’s List nd HealthGrades up on the stage. Some initial statements by the panelists, nothing really new out of Consumer’s Union or HealthGrades. Angie, of Angie’s List fame, the company recently rolled-out a physician rating service (hmm, wonder how doctors feel about being rated along side the Joe the Plumbers of the US), Angie readily admits that they are very much in beta for developing the physician rating service but already are seeing a tremendous amount of interest among their members.
Moving into Q&A with the panelists, hoping for something insightful.
HealthGrades, when they first started, had a lot of push-back from hospitals. That has completely changed as CMS is now doing hospital ratings and hospitals themselves are doing self-reporting of quality metrics, even publishing such ratings in local papers. Goes on to state that a the physician level, we are still very early in the rating game but foresees that like hospitals, physician ratings will become pervasive.
Based on the discussions, we are much farther along in rating hospitals than rating physicians. Pitched a question at HealthGrades based on personal experience and they did admit that it is still early (they introduced the physician service about 1yr ago). HealthGrades now has ~600K consumer provided physician ratings and are getting nearly 1,000 new ratings/day.
Consumer Union does not rate physicians at this tme and is looking for free consulting device on how they might provide such a service. As mentioned earlier, Angie’s List is in start-up, beta mode. Some of the safeguards that Angie’s provides is that no comments can be made anonymously, that they do have systems in place to insure that someone does not “game the system” and they send an email to a provider when a new rating/comment has been posted.
10:30am Clay Shirky Presenting: Basically an extended version of what Clay presented last week at Health 2.0 conference. Difference here is that he is presented to a much different and smaller crowd (plenty of physicians and academics at this event). Not quite as warm, on the edge of their seats, receptive audience as last week.
Argues that technology spreads socially. Thus one needs to observe social communities and what is being adopted then develop the capabiltiies for information flow that leverage what is popular for a population subset. Clay stated this in response to a question on addressing the digital divide. Simply, populations where use of computers/Internet is not prevalent, the cell phone is pervasive. Thus, we need to rethink ways to delver health information to these mobile systems (e.g., lab results, appt. scheduling, etc.).
3:00pm, Panel Session on the Consumer as Payer: Discussion is all over the map, which may be partially due to the panel make-up (Findlay from Myca Health, CEO at Dovetail, Dr. Gruber from J&J and CEO of Consult-a-Doctor).
Consult-a-Doctor: Pricing, $100/yr/member(consumer) for direct access to a doctor for second opinions. Go to market is primarily through payers and employers. Forecast they will reach 1M covered lives within the year.
J&J representative on the stage is very pragmatic. It’s all about making the consumer’s life easier. Believes all the big talk about changing healthcare is mis-directed. Need to look at the individual and what we can do to help them. Right on!
Question on regulatory environment, does it hinder expansion. Wolf Shalgman from Consult-a-Doctor sees a big problem with the disparate regulatory structure, at the state level. Other panelists did not bother to respond, though I know from talking directly to Dovetail, that it is a significant issue that hinders their growth.
3:50pm Panel Session on Getting Past 3% (basically how do we drive broader adoption of PHR-type services): Carol Diamond from Markle is moderating and we have Bosworth from Keas, Jamie Heywood, co-founder of PatientsLikeMe (PLM) and Craig Froude from WebMD.
Ask Craig what makes employer health platforms work. Craig stated that if you build it, they may or may not come, but if you offer incentives, they will show-up. Need to communicate very clearly to employees why you are doing it, what’s in it for the employee and most importantly, what will the employer do with your data. Transparency s absolutely critical to establish trust. Some mployers do it well, others less so. Employees typically like the reduce co-pays, versus straight cash-card like reimbursements.
Bosworth stating that technology is not the problem with regards to adoption. We have plenty of technology currently available to address privacy, security and interoperability. Went on to state that Dept of HHS, Kolodner’s statement last week at Health 2.0 comparing the software interoperability issue to VHS vs. Betamax as a poor analogy (actually said it was simply wrong) as software is not a “hardened” product, but quite malleable to the need(s) of the end user/application.
PLM design requirement, all information that a consumer and a physician would need to collaborate wth regards to care must be able to be delivered in 2 web pages. Another design concpet: assume that te consumers that use PLM are altruistic, that they do wat to contribute to the broader community and make the world a better place. Jamie believe that in healthcare today, far too many companies ignore this very important factor, too myopically focused.
Craig just announced that beginning in Q1’09 any employee that leaves an employer who has been sponsoring their WebMD PHR will have the ability to port their employer-based PHR data to the direct to consumer WebMD portal, thus supporting full portability of the record, albeit within WebMD properties. Craig considers this a big move for them.
Now the question is: Will they let me port that data out of WebMD in some come standard (CCD or CCR) to a Google Health or HealthVault. Don’t hold your breath as yesterday during the panel I moderated, Craig stated that such would not occur until there was a business case and right now, they don’t see one.
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