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Consumerizing Healthcare: Talk is Cheap, Work is Hard

by ndrao | October 13, 2015

I had the privilege of moderating a webinar last week on the hot topic of the consumer movement in healthcare. I was joined by three panel speakers: Dr. Jordan Shlain, a practicing physician and tech entrepreneur, Dave deBronkart, a well-known e-Patient (or Patient Engagement Advocate as he prefers to be known), and Brad Hoyt, an executive and thought leader at Wellmark BCBS in Iowa. The sponsor of the session was HealthSparq, a Portland-based startup offering a growing toolkit of consumer-geared decision support tools.

This has been a busy stretch for the banner of healthcare consumerism, which was waved around loudly and proudly onstage at last week’s annual Health 2.0 conference. Our discussion on the webinar touched on many industry cornerstones, including technology, policy issues, medicine, payment, and more. A short tweetstream is available here, and the complete webinar is available on demand. In summary, while there are encouraging signs for the healthcare consumer on numerous fronts – policy, technology, payment, and more – there is still a lot of work left to do by all sides on this front. While I did not get a chance to take detailed notes while moderating, I did jot down a handful of takeaways and a few soundbytes:

  • It’s important to distinguish between “lifestyle” and “life.” (Shlain). Managing a severe disease versus counting calories are two separate issues and should be treated and discussed as such.
  • Organizations today have developed a tendency to “think they’re already doing it.” (deBronkart). Couldn’t agree more – talk is cheap, but more importantly, pretending something has already been accomplished prevents real change from happening.
  • The data liberation movement will turn into a set of “data spigots” that enable an innovation ecosystem in a few years’ time (deBronkart). I see the long-term goal as helping healthcare get out of its own way, and letting patient-entrepreneurs and others figure out how to build new tools based on the data they’ve never had good access to.
  • Algorithms will become a bigger and bigger part of how organizations get involved with engagement. We should think of them as “filters” to help systems and organizations sort out which patients could benefit from what sort of outreach (Hoyt). This is an ongoing item of interest at Chilmark and we have been briefed by a number of companies in the emerging “CRM for healthcare” space.
  • Consumerism in healthcare will always suffer from “The Principle Agent Problem,” which is an intrinsic part of the payer/provider/consumer dynamic we have in the US healthcare system. (Hoyt, Shlain) Could not agree more here – more thoughts below.
  • Medicare’s recent Comprehensive Care for Joint Replacement initiative can serve as a thought exercise to see how the healthcare providers’ world is changing (Shlain). Under such a model, what is the opportunity for consumer decision support tools and better price transparency?
  • “We don’t have a healthcare ecosystem. We have a healthcare Freakosystem.” (Shlain). Someone needs to create a Halloween meme for this.
  • What it will take for healthcare organizations (HCOs) to start making improvements for the consumer? DeBronkart opined that bringing patients on board as partners to develop strategy from the beginning is important (and I agree.) Another panelist was more blunt, suggesting that HCOs “have to be shamed” into taking action (I would tend to agree with that, too.)
  • Somewhat surprisingly, all of the panelists had a pessimistic long-term outlook on the role of gamification. I do agree it’s become somewhat of a gimmick, and it might be better suited to short-term lifestyle goals than long-term health goals.

 Talk is Cheap – Work is Hard

A topic we touched on briefly but which deserves more attention is the chasm between health plans and health care providers when it comes to interacting with patients. DeBronkart shared an anecdote in which he was hot-potatoed back and forth between the two sides when asking for the price of a procedure. Ultimately, every different layer of the system can add new features, but if no one is ensuring they work with each other, talk to each other, and provide a seamless experience to the consumer, then we’ll be doing it wrong. Imagine ordering something off of Amazon and then having to deal with another company for billing and maybe a third for shipment. That’s where we are today.

It’s certainly something we all suffer through whenever we actually have to use the healthcare system. It’s also set to get worse with the ongoing shift to “consumer-driven” coverage that will leave consumers footing more of the bill, but without the adequate tools, guidance, or support to navigate the complex, dysfunctional health care Freakosystem. It’s going to take concerted effort from all sides – and that includes the consumer, too.

What do you think about the “consumerization” movement in healthcare? Is this more of a technology issue, a behavior issue, or a payment/reimbursement issue? Please share your thoughts below.



One response to “Consumerizing Healthcare: Talk is Cheap, Work is Hard”

  1. Greg Eoyang says:

    It’s more of a cultural issue. Doctors are viewed like Oz and patients don’t see themselves as players. We think that healthcare is practiced by doctors while it really should be practiced by consumers with Doctor assistance.

    It is our lives and we need to take charge of it. There are certain conditions that are out of the patients hands but patients can mitigate the effect.

    We still have a magic pill mentality which hurts both doctors and patients.

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