A blog covering the health/care ecosystem and people.

“Banks and insurance companies that cannot keep pace will find their customers, busy pursuing flawless service models and smart solutions, have moved on without them and they are stranded on the wrong side of the digital divide — from which there will be no return,” according to a report on The Future of Retail Financial Services from Cognizant, Marketforce, and Pegasystems. You could substitute “healthcare providers” for “banks and insurance companies,” because traditional health industry stakeholders are equally behind the consumer demand for digital convenience. This report has important insights relevant to health providers, health plans and suppliers (especially for

9 in 10 people in the U.S. use some form of digital technology or electronic tools for health management, Accenture found in the company’s 2016 Consumer Survey on Patient Engagement. Younger people (18-34) tend to favor wearable technology, apps and social media for health. More older people (age 65-74) mine electronic health records (EHRs) for personal health data and more likely use tech for remote consultations with care providers. Overall, the percent of U.S. consumers accessing their EHR data grew by over 50% between 2014 and 2016, from 27% to 45% of people doing so, with older people indexing higher

When I say “Fitbit,” you may think, “digital health.” When I mention “Gatorade,” “Nestle,” and “Dannon,” you might think, “drink,” “chocolate,” and “yogurt.” But soon, the phrase “digital health” will come to mind. That’s because a growing list of food manufacturers is looking to digital technologies to bake (or cook, blend, or mix) health into their value propositions. “Gatorade Taps Into Tech-Thirsty Consumers” is an article published in today’s Wall Street Journal, page B1 in the Business & Tech section of the newspaper. Mike Estrel writes that Gatorade is going high tech, working on a “smart cap” bottle with a microchip

One in three people suffer from some form of insomnia in the U.S. With sleep a major contributor to health and wellness, we recognize it’s National Sleep Awareness Week. As a health economist, I’m well aware of sleep’s role in employee productivity, absenteeism and presenteeism. U.S. companies lose 11.3 days of lost work performance per person who suffers from insomnia, according to research from a Harvard-based team published in the journal Sleep. The cost of this to U.S. business is about $63 billion annually. Science writers at the BBC developed a long list of modern-life issues that deter us from

One in 3 consumers is using mobile apps for health, doubling from 16% in 2014 to 33% in 2016, according to a survey from Accenture released during HIMSS 2016 conference. The proportion of people donning a wearable device for health more than doubled, from 9% to 21% between 2014-15. Part of this response is due to more physicians asking their patients — consumers — to adopt a wearable to track a health or fitness metric. One in 5 consumers said their doctor “prescribed” the use of a wearable, and 76% of these people followed the doctor’s recommendation. Most consumers and

Patients are from Mars and Doctors from Venus when it comes to their views on whether consumers should have full access to their electronic health records (EHRs), according to a survey from Accenture released this week at the 2016 meeting of the HIMSS conference in Las Vegas. The vast majority of consumers are keen to access their full EHR, compared to a majority of doctors who advocate for limited access, as the circle diagram dramatically illustrates. The “old days” of patient information asymmetry — with a paper-based folder that got locked up in a health records cabinet — are gone.

As HIMSS 2016, the annual conference of health information technology community, convenes in Vegas, an underlying market driver is fast-reshaping consumers’ needs that go beyond personal health records: that’s personal health-financial information and tools to help people manage their growing burden of healthcare financial management. There’s a financial risk-shift happening in American health care, from payers and health insurance plan sponsors (namely, employers and government agencies) to patients – pushing them further into their role as health care consumers. The burden of health care costs weighs heavier on younger U.S. health citizens, based on a survey from the Xerox Healthcare

As consumers’ growing financial skin in the health care game compels them to seek care in lower-cost settings, the pharmacy business recognizes the opportunity to provide healthcare services beyond the core business of filling prescriptions. This month, Drug Store News (DSN) published a special section called which profiles several pharmacy companies’ expanding reach into retail health – in particular, re-defining the concept of the “health fair.” A health fair is “an educational and interactive event designed for outreach to provide basic prevention and medical screening to people in the community,” according to the latest Wikipedia definition. But the health fairs described

“A full medical team via your mobile,” leads an article on clickdoctors.se, covering a Spanish mHealth start-up. This, in the February 2015 (Febrero 2015) issue of ling, the Vueling airlines magazine. I am flying from Florence, Italy, to London via Vueling airlines, heading from an art-and-Slow Food-filled holiday to a couple days of work in the UK. So imagine my surprise as I head to work on digital health and food projects in London reading this article enroute, in the lovely skies flying above the Alps. The story begins: “In 2050 Spain will be, along with Japan, one of the countries

All over the world, people define their health and wellness across many dimensions…physical, mental, financial, and appearance. In Florence, Italy, I happened upon a riff on this last component on “look good, feel good” at the Coin Department store located on Via Del Calzaiuoli in central Firenze. Welcome to Coin’s Health&Beauty Store. The two photos tell a story about health, where we live, work, play, and shop, the mantra for public health focused on the social determinants of health beyond healthcare. Here at Coin, adjacent to the holistic brands of Clarins and other luxury labels, is a pharmacy along with

In a growing on-demand society, coupled with a burden of more out-of-pocket health care costs, U.S.health consumers tend to vote with their pocketbooks for healthcare based on cost and convenience, at least when it comes to prescription drug demand, according to the Finn Futures Health Poll conducted by Finn Partners. The survey was conducted in November 2015 among 1,000 U.S. online adults. 51% of consumers have been with their current health plans and primary care physicians for three years or less, which Finn Partners sees as a sign that brand loyalty isn’t a top motivation for health consumers signing on

The so-called legacy healthcare system are the incumbents in American health care — hospitals, physician practices, pharma, health plans, and other organizations that have long-served and been reimbursed by traditional volume-based payment. Patients, now morphing in to health consumers, look to these stakeholders to provide new levels of service, accessibility, convenience, transparency and value — the likes of which people find in their daily life in other market sectors. Those consumer demands are pressuring the health system as we know it in many new ways, which I discussed with Unity Stoakes, Co-Founder of Startup Health, at the Health 2.0 Conference in

People – patients, caregivers, health consumers all – have begun to use the digital tools they use in daily life for booking taxis, managing money, seeking information — for their health. This is the growing adoption of Personal Health IT (PHIT), and it’s a growing aspect of the annual HIMSS Conference that the planet’s health IT folk will attend from 29th February until 4th March in Las Vegas. I talk about the phenomenon of PHIT and #HIMSS16 in The State of Health IT to Engage the New Health Consumer, a summary of the driving forces of the trend and opportunities

Where you live in the U.S. is a risk factor for your health. Hawaii, Alaska, Montana, Colorado and Wyoming rank highest on the State of American Well-Being 2015 State Well-Being Rankings, the Gallup-Healthways Well-Being Index. Well-Being is based on an index of five components that people self-assess: purpose, social, financial, community, and physical. See the map: the darker blue the state, the healthier the population perceives itself to be. Note more light blue to the northeast and south, and dark blue in the mountain states, Alaska and Hawaii. Some states have stayed in the top-tier of wellness since 2012: Hawaii

“Consumers expect to have their data available and shareable.” Two essays in two issues in the past two weeks of The New England Journal of Medicine point to the importance of patients – people, caregivers, consumers, all — in the morphing “health information economy,” a phrase used in the title of one of the published pieces. In Time for a Patient-Driven Health Information Economy, Dr. Ken Mandl and Dr. Isaac Kohane, who are both affiliated with the Department of Biomedical Informatics at Harvard, discuss peoples’ growing interest in engaging with their personal health information, noting frustrating barriers to doing so:

“It depends” is the hedge-phrase that characterizes how Americans see disclosing personal information versus keeping private information private, according to the consumer survey report, Privacy and Information Sharing, published by the Pew Research Center (PRC) in January 2016. U.S. adults see a privacy trade-off, living in the convenience-context of 21st century digital economy in exchange for some form of value. The “it depends” is a factor of what kind of data is geing collected, especially by third parties, how long that data area retained, for what use — vis-à-vis what a person is trading in return which could be a hard dollar

About one-half of consumers want to partner with doctors instead of allowing their physicians to make treatment decisions for them, according to a report from the Deloitte Center for Health Solutions, Health care consumer engagement: No “one-size-fits-all” approach. 1 in 4 people (25%) want to make treatment decisions themselves. Call that clinical health engagement. But even more people, 6 in 10, want to be financially-health engaged: 58% believe doctors should explain treatment costs before decisions are made, shown in the first chart. Most consumers would be comfortable talking about health care costs with doctors, and believe doctors should provide and explain the

Retailers in the U.S. are morphing into health destinations in 2016. Members of Target’s management team attended the 2016 Consumer Electronics Show (CES) and shared their perspectives in the company blog. Among the Target teams observations came from the Chief Marketing Officer, Jeff Jones, who observed, “A tidal wave of newness is coming to fitness technology and many companies are on the cusp of changing the game. From nutrition and sleep to how you exercise, it’s all going to be measured, linked and tracked. Wearables are here to stay and getting smarter every year.” The Senior Vice President for Hardlines,

As he walked across the stage, back-and-forth, the CEO of the Connected Technology Association talked about pacing not to think, but to compete in a Fitbit Challenge at the 2016 CES this morning, live in Las Vegas. Shapiro leads the Consumer Technology Assoociation (CTA), formerly known as the Consumer Electronics Association. The Association was re-amed with “Technology” as its middle name, morphing away from Electronics, to recognize the growth of the market away from Radio Shack (metaphorically speaking) toward the Uber-ization of Everything and the Internet of Everyday Things like cars, refrigerators, washing machines, and thermometers. “Intelligence and data are

The Internet of Healthy and Medical Things will proliferate at CES 2016 in Las Vegas next week – the annual Consumer Electronics Show. This is the yearly mega-convention organized by the Consumer Technology Association, and digital health has been among the fastest-growing marketplaces at the CES for several years in a row. The two-day Digital Health Summit will complement the vendors ont he convention floor with content, education, and networking for the industry. Here’s a link to my latest Huffington Post column on Health at the 2016 Consumer Electronics Show – What to Expect. Health Populi’s Hot Points: The Consumer

There’s an overall feeling of angst about healthcare in America among both health care consumers and the people who provide care — physicians and administrators. On one thing most healthcare consumers and providers (can agree: that the U.S. health care system is on the wrong track.  Another area of commonality between consumers and providers regards privacy and security of health information: while healthcare providers will continue to increase investments in digital health tools and electronic health records systems, both providers and consumers are concerned about the security of personal health information. In How We View Healthcare in America: Consumer and Provider Perspectives,

Health is where we live, work, play, pray and have fun. And if you’re Penn Jillette, the magician who collaborates with Teller, it took more than sleight of hand or a magic trick to lose 100 pounds — one-third of his body weight. He did it, according to this video, with the help of hard work, and using activity tracking tools from Withings. [youtube https://www.youtube.com/watch?v=EQWCVLvuBzI?rel=0] Unlike many people who quantify themselves for wellness and fitness, Penn did so to avoid having a medical procedure (i.e., the implantation of a stomach sleeve for weight loss) and also to reduce the six

Prescription drug costs have become a front-and-center health benefits cost issue for U.S. employers in 2015, and in 2016 the challenge will be directly addressed through more aggressive utilization management (such as step therapy and prior authorization), tools to enable prescription intentions like DUR, and targeting fraud, waste and abuse. Consumers, too, will be more financially responsible for cost-sharing prescription drugs, in terms of deductibles and annual out-of-pocket limits, as described in the PBMI 2015-206 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda. The Pharmacy Benefit Management Institute has published this report for 15 years, which provides neutral, detailed survey

A start-up company called Factual was profiled in the Wall Street Journal on December 11, 2015. Factual profiles consumers using mobile devices based on the digital dust users’ apps create — “streams of location data supplied by apps,” as Elizabeth Dwoskin (@lizzadwoskin), author of the article, put it. The primary goal? To help publishers finely target ads to specific audiences. “If we know you go to the gym five times a week,” Lindy Jones of the Goodway Group is quoted, “it’s likely you’ll be interested in workout gear.” Factual garnered $35 mm of additional funding last week, “to make data

Food + Drink, Beauty, Tech + Innovation, Retail, Lifestyle…JWT pulls out their crystal ball for 2016, and I see health, everywhere. The Future 100 – Trends and Change to Watch in 2016 is J. Walter Thompson Intelligence Innovation Group’s annual trend forecast, which I highly value and mine each year to help THINK-Health continue to hone our own environmental analyses for health and healthcare. [Here’s what I wrote one year ago about JWT’s 2015 forecast]. Health is baked into JWT’s 2016 trendscape, well beyond their “Health” chapter. Even the report’s introduction is health-flavored: “As forecasters, we’re watching the rapid metabolism

National health spending in American grew by 5.3% in 2014, hitting the $3 trillion mark. This represented an up-tick nearly twice the growth rate of 2.9% in 2013, the slowest rate of growth in 55 years, according to the latest analysis of the U.S. health economy published by Health Affairs. The first chart illustrates the factors that contribute to that 5.3% growth in health spending. The two largest factors were medical prices and so-called “residual use and intensity.” The medical price increase portion was 1.8% in 2014, up from 1.3% in 2013. The use and intensity component was attributable to

U.S. spending on medicines will approach $590 billion in 2020, increasing 34% over 2015, IMS Institute for Healthcare Informatics projects in its forecast, Global Medicines Use in 2020. Growth in spending will be attributable to innovation (new products), price increases and some patent losses of exclusivity (e.g., branded drugs going generic). The U.S. will cover the bulk of drugs spending in 2020 at 41% of the world medicines market, shown in the first pie in the first chart. U.S. medicines spending dwarfs any other country or region in the world, including China which is expected to account for 11% of

For the first time since 2008, a majority of Americans say government is responsible for ensuring that people have health insurance. The first chart shows the crossing lines between those who see government-assured health insurance in the rising dark green line in 2015, and people who see it as a private sector responsibility. The demographics and sentiments underneath the 51% are important to parse out: people who approve of the Affordable Care Act are over 3x more likely to believe in government sponsoring health insurance versus those who disapprove, 80% compared with 26%. The demographic differences are also striking, detailed

Most Americans support price controls on drug and medical device manufacturers, hospitals, and payments to doctors, along with allowing Medicare to negotiate drug prices. U.S. health citizens, now consumers, have been experiencing sticker-shock when it comes to prices on medical bills upon hospital discharge, leaving the doctor’s office, filling a prescription at a pharmacy or receiving a specialty drug recommended for a serious medical condition. The HealthDay/Harris Poll of 5 November 2015 quantifies their observation that Americans Want Bold Steps to Keep Health Care Costs in Check. The topline of the Poll shows that: 73 percent support price controls on

My National Health Care Consumer Week, I’ll coin this, looking back on flying some 12,000 airmiles over six days, criss-crossing America from the City of Brotherly Love to Sacramento, back to Philly and then to Los Angeles. Finally, today, heading home to Philadelphia and my beloved, most necessary Tempur-Pedic bed, a loving husband and some therapeutic TV binge-watching. It’s Friday and I’m at LAX, reflecting on a week of meeting with three groups of healthcare executives and stakeholders who all wanted to hear my take on the evolution of patients, people, caregivers, all, morphing into health care consumers. The lens

Consumers may demand connected experiences in daily living, but there have been many barriers to health care industry stakeholders delivering on that expectation: among them, privacy and security concerns, and provider resistance. This demand-and-supply chasm is noted in Deloitte’s Center for Health Solutions’ latest look into the healthcare landscape, Accelerating the adoption of connected health. The objectives of connected health, or cHealth, are: To improve digital connectivity among consumers, providers, health plans and life sciences companies To facilitate self-managed care in a secure environment that protects privacy To deliver care outside of traditional institutional settings To enable chronic care management

The phone continues to be the platform technology used in this digital age of health care, according to Better Together: High Tech and High Touch, a survey report sponsored by the Bipartisan Policy Center and the Council of Accountable Physician Practices. Nielsen’s Strategy Health Perspectives project polled 5,014 U.S. adults in June and July 2015 for this study. According to the study sponsors, this is the largest consumer population studied conducted to-date on the topic of digital health use and demand. The first chart illustrates the reality of digital health in the U.S. 2015: that notwithstanding the availability of telehealth,

Shocking statistics were published in this week’s Proceedings of the National Academy of Sciences showing rising death rates for middle-age men. The major causes: suicide, drug and alcohol poisoning, and liver diseases. The line chart illustrates the death rates per 100,000 population of U.S. whites (“USW”), the top line on the graph, compared with 45-54 year old men in France, Germany, the United Kingdom, Canada, Australia, and Sweden — along with U.S. Hispanic males (“USH”) — for whom death rates have fallen since 1990. The authors note that the increase in midlife mortality is only partly understood. Increased availability of

Reluctantly accepting the Affordable Care Act, health executives and their architects now see opportunities for re-imagining the hospital and health care services, according to Healthcare Industry Trends, a publication that’s part of the 2015 Building & Development Leadership Series provided by Mortenson, a construction services firm that’s active with healthcare organizations. Mortenson conducted a survey at the 2015 ASHE Planning, Design, and Construction Summit, the results of which were published in this report. The over 300 respondents included healthcare executives, facilities managers, and healthcare architects. Thus the lens on the data in this survey is through the eyes of physical

I lost a best friend last week. His memorial service, held this past weekend, was a celebration of his life. And part of that well-lived life was a very conscious planning of his last days. The Economist published its 2015 Quality of Death Index, a data-driven treatise on palliative care, the very week my dear friend Rick died. This gives me the opportunity to discuss palliative care issues with Health Populi readers through The Economist’s lens, and then in the Hot Points below through my personal context of this remarkable man’s end-of-life choices. The Economist ranks 80 countries on several

Two-thirds of all internet users, and 65% of all adults over 18 years of age, use social networking sites. Social Media Usage: 2005-2015, the latest report from the Pew Research Center, finds social networking is the new normal for people up to 65 years of age. One-third of people over 65 use social networking sites. Peoples’ use of social media impacts every aspect of daily living beyond sharing social updates, from home keeping and political discussions to work, parenting, and managing stress, the Pew research found. Key findings in the report are that: Seniors’ use of social networks rose from

By 2018, 90% of health care delivered to people enrolled in Medicare will be paid-for on the basis of quality, not on the amount of services delivered (that is, volume). But as providers must up their game in that new value-oriented health payment world, they are bound up in work flows and organizational structures built for fee-for-service reimbursement. This changing future is discussed in Healthcare’s alternative payment landscape, PwC’s Healthcare Research Institute report on the volume-to-value shift. PwC notes that health care providers’ ability to adapt to changing payment regimes vary and fall into four categories: traditional, lagging, vanguard and

8 in 10 people in the U.S. say that Medicare as well as private health insurance plans should pay for discussions held between patients and doctors about hatlhcare at the end-of-life. The September 2015 Kaiser Family Foundation Health Tracking Poll asks people their opinions about talking end-of-life with their doctors. The vast majority of people support the concept and physicians being paid for holding such conversations in doctor-patient relationship. The question is germane because the Obama Administration has announced plans to pay doctors for office visits to discuss end-of-life (EOL) issues with Medicare patients. There isn’t a huge variation across

Health is where we live, work, play, pray, learn, and increasingly, shop. The new Retail Health goes well beyond the pure-play pharmacy. Part of Target’s re-imagined market positioning is in this expanding sweet-spot as healthcare morphs from institutional providers like hospitals and doctors’ offices to the community. Don’t think pharmacy’s not important: it will remain a core business and revenue center in retail health. But that business is fast-changing, as the role of pharmacy benefits management companies change, more (expensive) specialty drug benefits come out of pipeline and into the market, and health insurance continues to shift financial risk to

American workers are working to pay for health care costs, having traded off wage increases for health premiums, out-of-pocket costs and growing high deductibles. Welcome to the 2015 Employer Health Benefits survey conducted annually by the Kaiser Family Foundation (KFF) and Health Research & Educational Trust (HRET). Premiums are growing seven times faster than wages.  The report calculates that high-deductibles for health insurance have grown 67% from 2010 to 2015. In the same period, wages grew a paltry 10%, while the Consumer Price Index rose 9%. The first chart illustrates that growing gap between relatively flat wages and spirally health

Fitbit, the company that makes and markets the most popular activity tracker, is getting serious about its users’ personal data. The company  announced that it will enter into HIPAA business associate agreements with employers, health plans, and companies that offer workers the devices and the apps that organize and analyze consumers’ personal data. The Health Insurance Portability and Accountability Act (HIPAA) protects patients’ personal health information generated in a doctor’s office, a hospital, lab, and other healthcare entities covered under the law (as such, “covered entities”). However, data generated through activity tracking devices such as Fitbit’s many wearable technologies have

Taking literally the maxim that health is where we live, work, play and pray, Cox Communications acquired Trapollo, a remote health monitoring company, extending the core business of cable TV into the world of health services to the home. “We believe that the home will be an increasingly important node within the healthcare delivery architecture,” Asheesh Saksena, executive vice president and chief strategy officer, Cox Communications, said in the company’s press release. In the past year, Cox Communications entered in a joint venture with the Cleveland Clinic, to form Vivre Health for developing digital health care services. Cox also invested in

“What is the meaning of health to our businesses?” asked Dr. Thomas Parry of the Integrated Benefits Institute (IBI) at a dinner last night, convened by the Pittsburgh Business Group on Health on the eve of the organization’s annual meeting being held today in Steel City. I was fortunate to attend the dinner and hear Dr. Parry speak; I will be addressing the meeting today on the topic, “Building a Better Health Consumer.” The IBI is researching the direct link between the top line of a healthy employee base and healthy workers’ impacts on the bottom line. A report will be

This is the dawning of the Age of Consumer-Driven Health, the tipping point of which has been passed. The data point for this assertion comes from the National Business Group on Health‘s annual 2016 Large Employers’ Health Plan Design Survey. The tagline, “reducing costs while looking to the future,” suggests some of the underlying tactics employers will use to manage their financial burden of providing health insurance to workers. That burden will continue to shift to employees and their dependents in the form of greater cost-sharing: for premiums, co-pays and co-insurance, and the hallmark of consumer-driven health plans (CDHPs): high(er) deductibles.

Will fitness tracking take off in middle and rural America? The larger question is whether people really, truly want to engage in health and, if so, how? My colleague and friend Dr. Carol Torgan, who curates the most extensive wearable tech Pinterest board and writes extensively about the subject in her blog Kinetics: From Lab Bench to Park Bench, was struck by my recent blog post, Health, Wearables and the IoT in the Windy City. That weekend I was in Chicago, Carol was visiting a rural region in the state of Virginia and spent time at a county fair. The quintessential

I switched from being a devoted coffee drinker to green tea several years ago, but once in a while I still love an excellent cup of coffee (especially when I’m in Italy – stay tuned for late October posts from the 2015 Milan Expo where I’ll be all-food-and-health, all-the-time). One of my long-time favorite coffee brands is Lavazza, based in Italy. The company hadn’t allocated much resource to advertising in the U.S. But they are launching a new multimedia campaign in America; here’s a look at their initial video promotion… [youtube http://www.youtube.com/watch?v=Jfx2yL6guhk?rel=0] This ad covers many features that are relevant

Think of the word “pharmacy,” and what names come to your mind? CVS Health, Walgreens, Rite-Aid, perhaps. But it’s Wegmans who’s #1 across all pharmacy brands and types, according to the 2015 J.D. Power Pharmacy Study. The big improvement in pharmacy satisfaction in 2015 has been among supermarket drug stores, up to an index score of 851 (of 1,000), the highest consumer score. The satisfaction score for chain pharmacies increased a small 2 points, whereas satisfaction for two other channels for pharmacies — mass merchandisers and mail order — both fell from 2014. It may come as no surprise to Health

Most consumers think favorably when they picture doctors, food manufacturers, banks, and airlines. But the pharma industry continues to be lumped with Big Oil and health insurance in the minds of U.S. consumers, industries for which more than 50% of people in America share unfavorable impressions. The August 2015 Kaiser Family Foundation Health Tracking Poll focuses a lot on the pharmaceutical industry. The link to the poll is here: http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-august-2015/ Key findings from the survey tell a story about a health citizenry highly suspicious of pharma: 72% of Americans think that drug costs are unreasonable 74% of people think patients in

The top 25 life science companies grew a paltry 1% in 2014, and 70% of recent brand launches underperformed analysts’ expectations. The introductory page of a new report from KPMG describes, in a single sentence, the very challenging market environment for bio/life sciences: “The pharmaceutical industry is caught between a blockbuster-driven past and a future comprising precision medicine, curative therapies, and payment for outcomes. The years of consistent double-digit growth and unconstrained pricing power are fading into memory.” The assertively titled, “Change in pharma? Not optional,” offers 10 “integrated imperatives” for the pharma industry to follow to best respond to