Late last week, iHealthBeat, a service of the California Healthcare Foundation (CHCF) posted an interview with RevolutionHealth’s senior medical director, Dr.Val Jones, While the overall interview had predictable questions and responses, I did like the concluding question and answer, which is provided below:

iHealthBeat: What are your predictions for the online health care market in 2008 and beyond?

Jones: With decreasing access and increasing patient loads, I think we’re going to see the consumer-driven health care movement take center stage. Patients are going to need to “do it themselves” a lot of the time (meaning manage their own health information, teach themselves about disease management and make financial plans to take care of their own needs if the government cannot afford to do so).

Another trend I have my eye on is the retainer medicine movement. As primary care physicians continue to be squeezed out of existence by decreasing Medicare reimbursements, they are beginning to join an “off-the-grid” group of providers who simply do not accept insurance.

As more PCPs create retainer practices, I think IT solutions will really take off. Online tools that simplify their practices and speed up their patient communication will be welcomed and encouraged.

On her first point regarding consumers having to take more control, I fully agree with her but I am challenged to understand exactly how that will happen. Today, the vast majority of consumers, despite all the medical-specific Internet search they are doing, are little prepared to take on this role. It is increasingly being dropped in the consumers lap, most often by employers looking to reign in healthcare costs, with little attention paid as to how a consumer will actually do this. I see lots of talk about consumer empowerment, but we really need some pro-active consumer education first. Sites like RevolutionHealth, WebMD, and even the relaunched initiative by AHIMA on PHRs can help, but even these efforts are based on the assumption that everyone is using the Web. As a society we need to step back and begin rethinking how we educate consumer on their role in managing their healthcare. Ideally, such education would begin in high school for the next generation. And for those adults today, a more aggressive and comprehensive combination of employer and provider drivn educational efforts is needed.

Her second point about physicians going off the grid is also quite interesting and something I myself have not paid much attention to. This will, however, be important to track closely as it could become another important driver for accelerating the growth in adoption and use of Personal Health Records (PHRs). While PHR vendors are telling me that they are inundated with RFPs from employers and health plans, the true long-term success of these PHR systems will be consumer (employee) adoption and use.  As physicians “go off the grid” and consumers choose such physicians for any number of reasons including possibly costs (a key issue for those with high-deductible plans?), PHR solutions that are truly portable and allow the consumer to securely share their records with the physician(s) of their choosing will have an advantage over those that do not.