On the road to retail health: healthcareDIY and primary care, everywhere

At the ConvUrgent Care Symposium in Orlando, attendees from the worlds of clinics, ambulatory care, hospital beds, pharmacies, medical devices, life sciences, health information, health IT, health plans, academic medical centers and professional medical societies came together to share and learn about the morphing landscape of retail health.

The topline message: primary care is everywhere, and based on the response to my keynote talk this morning, every stakeholder segment gets it.

My mantra, courtesy of the U.S. Surgeon General Regina Benjamin: don’t look at health in isolation, that is, where the doctor and hospital are. Health happens wherever the person ‘is,’ and that is, as Dr. Benjamin says, where people “live, work, play and pray.”

Regular readers of Health Populi may be tiring of my repeating that mantra — but it cannot be overstated.

I created my presentation slide deck two weeks ago to meet the meeting organizer’s deadline. In the interim, several new signposts have popped onto the landscape of retail health, among them:

o The 2012 Consumer Electronics Show, that featured a plethora of connected health devices from body trackers to new-new digital glucometers. Jawbone, which mobile phone users know for its Bluetooth ear device, launched the Up wristband to compete with the likes of BodyMedia’s armband and the FitBit. And, speaking of FitBit, they promoted a new WiFi scale to compete with the Withings, and raised $12mm this week to support that launch. Withings, not to be outdone in innovation, promoted a new blood pressure monitor that plugs into iDevices (iPhones, iPads, iTouch’s) where data can be sent to doctors (a very important feature in the data-siloed U.S. health IT infrastructure).

o Telehealth has begun to get traction beyond being supported by grants from governments and foundations; evidence of this is seen in QuadMed’s announcement on January 16 2012 that the clinic group would partner with MDLiveCare to provide telehealth services to QuadMed’s worksite clinics. QuadMed was a pioneer in the world of worksite clinics, launching an onsite employer-based clinic for its QuadGraphics employees over 20 years ago. This initial site spawned a company called QuadMed which offers onsite health care to other companies (generally Fortune 1000 firms). Some of QuadMed’s customers are MillerCoors, Northwestern Mutual, and STIHL.

o Best Buy announced that it would be selling self-healthcare online programs branded by Aetna for managing smoking cessation, weight loss, stress management and fitness, through the chain’s Chicagoland stores for $19.99 apiece.

o Walgreens introduced a group of future-pharmacy stores around metro Indianapolis where the pharmacist “comes out” from behind the pharmacy wall to commune with patients/consumers, and health ‘navigators’ carry iPads that help customers connect with local health services information and providers. The stores also feature fresh food and offer other consumer-focused amenities, according to the company’s press release calling this new model a “health and living destination.”

Health Populi’s Hot Points: Signs of retail health are all around us, popping up as the primary care shortage/maldistribution drives pent-up demand among consumers for accessible, convenient, well-priced quality services and products.

This is HealthcareDIY. 52% of U.S. adults have done something to self-ration care in the traditional health care system such as skipping prescription fills (both initial and re-fills), cutting pills, postponing visits to doctors and dentists even when feeling unwell, and forgoing recommended medical tests.

At the same time, many health citizens are relying on home remedies, over-the-counter products, self-tracking devices, and other self-health tactics to manage health outside of the doctor’s office and hospital ambulatory clinic.

All well and good–to a point. It will be important to get patient data aggregated so that we can receive real-time feedback and therapeutic advice to improve our self-care efforts. It is early days for this. It is encouraging to see that Withings’ BP device will communicate to doctors’ offices. Most self-tracking devices can’t do this, yet, but we are on the way toward that data-liquid environment based on open standards and opening the kimono of APIs.

Runkeeper enabled self-trackers (like me) put our personal data collected by different devices on one “dashboard” in a Health Graph. This is a start.

Marrying those Observations of Daily Living (a Robert Wood Johnson Foundation-coined phrase) to “hard” medical data (such as our lab test results and digital imaging analyses) will be Nirvana. We’re on the road to getting ‘there.’

In the immediate term, patients will begin to have access to electronic copies of their health information based on meaningful use regs in the HITECH law. As more patients assume the mantle of engaged patient, they will begin to appreciate the power of knowing one’s numbers over time. Patient engagement (or activation, in the paradigm of sage Dr. Judith Hibbard), is a precursor to achieving optimal outcomes.

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