A blog covering the health/care ecosystem and people.

Most physicians feel some level of burnout, hassled by electronic health records and lost autonomy. No wonder, then, that a majority of doctors favor some type single payer health system — one-quarter fully single payer, a la Britain’s National Health Service; and another one-third a single payer combined with a private insurance option, discovered in the 2018 Survey of America’s Physicians report on practice patterns & perspectives, published by The Physicians Foundation. Eight in ten physicians are working at full-capacity or are over-extended, the survey found. Furthermore, 62% of doctors are pessimistic about the future of medicine. Physician burnout is a

Consumers who have long purchased over-the-counter medicines, anti-dandruff shampoo, whitening toothpaste, and cosmetics-with-benefits at food, drug and mass merchant retailers are switching to other places to shop for health, new data from AT Kearney and GMDC have found. The two organizations have collaborated to launch a new  benchmarking study into health-beauty-wellness (HBW) sales, launched this weekend at the GMDC HBW Conference in Orlando. Overall, 2017 to 2018 year-on-year, HBW sales were flat-to-no growth, notwithstanding the consumer and influencer buzz around the categories.       This study uncovered some very important trends underneath the macro numbers that tell a story

Patients are the new healthcare payors, and as such, taking on the role of health consumers. In fact, health and wellness consumers have existed since a person purchased the first toothpaste, aspirin, heating pad, and moisturizing cream at retail. Or consulted with their neighborhood herbalista, homeopathic practitioner, therapeutic masseuse, or skin aesthetician. Today, the health and wellness consumer can DIY all of these things at home through a huge array of products available in pharmacies, supermarkets, Big Box stores, cosmetic superstores, convenience and dollar stores, and other retail channels – increasingly, online (THINK, of course, of Amazon — more on

Using digital health tech is a new normal for U.S. consumers, including Seniors, found in the 2018 digital health consumer survey from Deloitte. The title of the report, “Consumers are on board with virtual health options,” summarizes the bullish outlook for telehealth. That’s the consumer-demand side of the equation. But the tagline begs the supply side question: “Can the health care system deliver?” For a decade or longer, we’ve noted the slow uptake of telehealth and digital health tools among healthcare providers. But the consumer pressures, along with evidence-based self-service options for health – both for “care” and for wellness,

Looking for health information online is just part of being a normal, mainstream health consumer, according to the third Rock Health Digital Health Consumer Adoption Survey published this week. By 2017, 8 in 10 U.S. adults were online health information hunters. Six in 10 Americans looked for reviews of healthcare providers online, another new-normal consumer digital health activity. But only one in four people had used wearable technology for health, and one in five had participated in a live video telemedicine encounter. The Rock Health team observes that “the needle has not moved equally across every type of digital health solution.” Thus the

All sectors who are stakeholders in the healthcare ecosystem aren’t created equal, Accenture explains in their report, Healthcare’s future winners and losers. Observing the influx of new flavors of entrants like Amazon and Google, start-ups like Iora Health, Oscar and FetchMD, begs the question: how will legacy healthcare system players fare? Who will survive, and what will be the success factors that bolster long-term viability? To answer that question, Accenture points to three market trends that set “new rules” in healthcare: Blurred lines, which are the grey areas and adjacencies between technology, service, finance, and retail The middle of nowhere,

There’s a load of anecdotal data about teens and young adults (TYAs) and their always-on relationship with mobile phones and social networks. There are also hundreds of stories written in both mass media outlets and professional journals on the topic of TYAs and mental health: especially relative to depression and suicidality. In a breakthrough study, Hopelab and the Well Being Trust have sponsored the first deep-dive into the many dimensions of young people, their relationship with social media, and depression in Digital Health Practices, Social Media Use, and Mental Well-Being Among Teens and Young Adults in the U.S., The report was

In this moment post-Cambridge Analytica/Facebook, the launch of the GDPR, and the everyday-ness of data breaches, consumers most trust doctors for sharing personal information. I’ve mined, through my health economic lens, the U.S. data published in the insightful report, Data Privacy: What the Consumer Really Thinks, a global research study from Axciom and the Data & Marketing Association (recently acquired by the Association of National Advertisers) working with Foresight Factory. The report compares consumers’ personal views on privacy and trust in ten countries: Argentina, Australia, Canada, France, Germany, the Netherlands, Singapore, Spain, the UK, and the US. We learn that Americans

Lady Liberty beckons to welcome the tired, the weary, and the ambitious to America in this Shinola video, made in my hometown Detroit. May this bring you joy and positive vibes on Independence Day 2018.  

Design-thinking has come to health/care, finally, and Amy Cueva has been beating this drum for a very long time. I’m delighted to be in her collegial circle, speaking at the conference about the evolving healthcare consumer who’s financially strapped, stressed-out, and Amazon Primed for customer service. I’m blogging live while attending HXD 2018 in Cambridge, MA, the health/care design conference convened by Mad*Pow, 26th and 27th June 2018. Today was Day 1 and I want to recap my learnings and share with you. Amy, Founder and Chief Experience Office of Mad*Pow, kicked off the conference with context-setting and inspiration. Design

As I walked by windows with Marvel-inspired superhero characters, I stopped to read their talk-bubbles: “strengthen your savings, power your financial quest, be the hero of your money, be one with your budget.” The top-line message here is that you can be your own fiscal superhero. The sign read, Capital One Cafe with Peet’s Coffee. But was it a bank branch or a cafe? I asked myself, passing by this sign yesterday morning at the corner of Walnut and 18th Streets in center city Philadelphia. It’s both, as it turned out, and when I entered I found a welcoming, beautifully

Doctors have a complicated relationship with electronic health records (EHRs): two-thirds of primary care providers (PCPs) see value in digital records (EHRs), but at the same time believe the technology has weakened relationships with patients, detracted from clinical effectiveness, and lack streamlined user experience. That deficiency is, in three words, lack of interoperability; that challenge has required one-half of physician-users to use work-around’s to make their EHR investments more useful. These insights come out of a survey conducted among primary care providers by The Harris Poll for Stanford Medicine, published to coincide with the medical school’s convening of the EHR

“Do no harm” has been the professional and ethical mantra of physicians since the Hippocratic Oath was first uttered by medical students. The origins of that three-word objective probably came out of Hippocrates’ Corpus, which included a few additional words: “to do good or to do no harm.” The proliferation and evolution of digital technologies in health care have the potential to do good or harm, depending on their application. Doing good and abstaining from doing harm can engender trust between patients, providers, and other stakeholders in health. Trust has become a key currency in provider/patient/supplier relationships: 94% of health executives

What if you went to visit a Vermeer still life with fruit, vegetables, and flowers, and the only image you saw in the famous painting was the flower and an urn? What if you heard the sounds of a juicing machine whirring as you reflected on a Rembrandt? That’s exactly what happened to museum-goers visiting Amsterdam’s Rijksmuseum. These art patrons witnessed a museum guard literally pulling an apple out of a painting, to leave a barren portrait of an urn and little else. Roll over, Anthony Oberman, the artist of “Still Life with Fruit in a Terracotta Dish,” one of

This is the second post of three written to summarize what I learned participating in Medecision’s annual meeting with the company’s partners, held March 27-29, 2018 at the Ritz-Carlton in Dallas, TX.  I concluded the first of this three-part series with Dr. Don Rucker’s belief that, “Patients are the massive use-case for interoperability.” This second post focuses on the key role of designing for healthcare – for patients, caregivers, providers, all industry sector workers indeed. And designing information to make it beautiful, useable, meaningful. You’ll read about Renaissance Man/Doctor Andrew Chacko MD, a board-certified physician, French and Physics student at the Naval

Chronic diseases are what kill most people in the world. In the U.S., the chronic disease burden takes a massive toll on both public health and mortality, accounting for 7 in 10 deaths in America each year. That personal health toll comes at a high price and proportion of national health expenditures. A new alliance between Livongo and Cambia Health seeks to address that challenge, beginning with diabetes and scaling to other chronic conditions. Livongo has proven out the Livongo for Diabetes program, which has demonstrated positive outcomes in terms of patient satisfaction and cost-savings. The plan with Cambia is

U.S. consumers rank supermarkets, fast food chains, retailers, and banks as their top performing industries for experience according to the 2018 Temkin Experience Ratings. Peoples’ experience with health plans rank at the bottom of the roster, on par with rental cars and TV/Internet service providers. If there is any good news for health plans in this year’s Temkin Experience Ratings compared to the 2017 results, it’s at the margin of “very poor” performance: last year, health plans has the worst performance of any industry (with the bar to the furthest point on the left as “low scoring”). This year, it

Girls Rule the World, Beyoncé has told us. But not when it comes to digital health…at least until 2018, as Fitbit has announced a woman-focused smartwatch called the Versa which is expected to hit the market in April 2018. The waterproof Versa will measure heart rate, do the usual fitness tracking metrics, and enable women to track their menstrual cycle. Fitbit has been quite clear that the device isn’t for conception or contraception. The watch will be priced at $199 at retail, a much lower price-point than the Apple Watch at $329. So here Fitbit also has an argument for

“It’s not about shiny new technologies but about designing relationships to truly impact the patient at the center of the disconnected ecosystem,” asserted Amy Cueva, Founder and CXO of the design consultancy Mad*Pow. That patient is a consumer, a caregiver; it’s you and me, Cueva explained. To reconnect the fragmented pieces of healthcare delivery, Cueva said, mantra-style, “collaboration is the new innovation.” And collaboration with patients, caregivers — the people for whom that healthcare is aimed — is the optimal workflow for effectively, enchantingly designing healthcare. In a talk she delivered at the Innovation Summit in a preconference meet-up at the annual

On July 18, 2017, Neil Gomes, Chief Digital Officer at Thomas Jefferson University and Jefferson Health in Philadelphia, tweeted this: When I saw this tweet, I was especially struck by Gomes’s phrase, “Designed & developed with heart/love by my @DICEGRP.” That’s Jefferson’s health solutions group that focuses on digital innovation and consumer experience. Here’s a health system that’s focused on that customer experience, which has become a critical success factor for healthcare to thrive. That’s because, as Steve Laughlin, VP and General Manager of IBM’s Global Consumer Group recently explained to me, a consumer’s last great customer experience becomes the

We are only just past the dawn of the second machine age, where digitization is enabling artificial intelligence. “Our new tools are destroying both trust and truth, creating a hunger for community and authenticity. We crave actual physical connection to neighbours, colleagues, and fellow townspeople, even if digitally facilitated.”  Anne-Marie Slaughter wrote this in a column I read this morning in the Financial Times titled, “Our struggle with technology to protect trust and truth.” Trust and truth underpin health engagement, we learned in the first Edelman Health Engagement Barometer launched ten years ago. Those were the early days of the formation

This blog appears today as part of a #HIMSS18 primer series for attendees, and the industry at large, to discuss major health IT issues that will help move health and healthcare delivery forward in 2018 – and beyond. I’m grateful to HIMSS to be one of 20 Social Media Ambassadors appointed for this year’s conference, which convenes in Las Vegas at the Sands Expo Center from March 5 to 9th, 2018.  Prioritizing the patient-as-consumer through my health economic lens, the biggest priorities will be: Engaging patients in self-care and driving health and health plan literacy to better manage constrained access

New research points out that real people live real lives, and our assumptions about social determinants of health (SDOH) may need to be better informed by those real lives. I read three reports in the past week sobering up my bullish #SDOH ethos dealing with food deserts, transportation, and health service access — three key social determinants of health. To remind you about the social determinants, here’s a graphic from Kaiser Family Foundation that summarizes the key pillars of SDOH. Assumption 1: Food deserts in and of themselves diminish peoples’ healthy nutrition lifestyles. Low-income households who are exposed to the same food-buying

When patients feel disrespected in a medical exam room, they will be less likely to follow instructions they receive from a doctor. Research from the Altarum Institute revealed this fundamental finding. The chart shows that feeling respected reduces  a patient’s diabetes medication adherence by a factor of nearly 2x, and is a risk factor for poorly managed diabetes. Furthermore, consumers who feel disrespected by providers are three times more likely to not believe doctors are accurate sources of information than consumers who do feel respected. And, patients with diabetes who do not feel respected are one-third more likely to have poorly

Connecting Life’s Dots, the organization Living in Digital Times partners with CES to deliver conference content during the show. At CES 2018, LIDT is connecting a lot of dots to help make health streamline into daily living. Robin Raskin, founder, kicked off LIDT’s press conference setting the context for how technology is changing lifestyles. Her Holy Grail is to help make tech fun for everybody, inclusive for everybody, and loved by everybody, she enthused. LIDT has been a presence at CES for many years, conceiving the contest the Last Gadget Standing, hosting  tech-fashion shows with robots, and supporting a young innovators

While a phrase containing the words “health” and “Las Vegas” may seem a dichotomy, there will be a lot of health-tangent goods and services I’ll be seeking next week at the annual CES. This year, health will be ubiquitous at this huge conference, whose three-letter acronym for “consumer electronics show” typically conjures up images of shiny new things in the guise of automobiles, video games, big TV screens, and drones. At CES 2018, health will go beyond wearable tech and the first phase of fitness that’s been growing at the meeting over the past five years since I began attending

This month, two hospital mega-mergers were announced between Ascension and Providence, two of the nation’s largest hospital groups; and, between CHI and Dignity Health. In terms of size, the CHI and Dignity combination would create a larger company than McDonald’s or Macy’s in terms of projected $28 bn of revenue. (Use the chart of America’s top systems to do the math). For context, other hospital stories this week discuss in southern New Jersey. And this week, the New Jersey Hospital Association annual report called the hospital industry the “$23.4 billion economic bedrock” of the state. Add a third important item

More consumers are seeking health-making opportunities everywhere, both within and outside of traditional healthcare touch-points. That includes peoples’ consumption of beer. We learned from the Edelman Health Engagement Barometer that consumers seek to engage for health beyond healthcare organizations – namely, hospitals, providers, over-the-counter medicines, pharma and insurance. What was perhaps the most surprising industry segment consumers called on for personal health engagement was brewing and alcohol. Fully 8 in 10 consumers expect brewing and spirits companies to engage in health. The bar chart shows this finding, arraying beer and liquor producers on par with retail and consumer technology, along

Talk about the last mile in healthcare. CVS Pharmacy will deliver prescription drugs to patients’ homes, the company announced this week. “Same-day prescription delivery gives customers the easy option of having the pharmacy they trust deliver right to their front door at no cost,” Helen Foulkes, President of CVS Pharmacy, said in the press release. Rx home delivery may not be “the” last mile to conquer all healthcare access challenges, but it’s nonetheless a signal that healthcare industry suppliers are focusing on helping patients streamline their health-consumer lives. In this case, it’s also CVS morphing towards Amazon’s Prime delivery model. Amazon

The math is straightforward. Assume “A” equals $59.039, the median household income in 2016. Assume “B” is $18,142, the mean employer-sponsored family insurance premium last year. B divided by A equals 30.7%, which is the percent of the average U.S. family’s income represented by the premium cost of health insurance. Compare that to what American households spent on food: just over $7,000, including groceries and eating out (which is garnering a larger share of U.S. eating opportunities, a topic for another post). Thus, health care represents, via the home’s health insurance premium, represents 2.5 times more than food for the

“With Mad Men still in charge, ad campaigns miss the mark,” an editorial published this week in the Financial Times asserts. Leave it to a fiscally conservative British publication to be spot-on about a particularly, but not uniquely, American challenge, in this post-Weinstein (Miramax), -Price (Amazon), and today, -Halperin (MSNBC) moment of sexual harassment revelations. In health/care, women are key consumers, buyers and influencers, yet under-represented in the Mad Men demographic of senior advertising executives, as the data-driven FT essay points out. So it’s especially heartening to find this month a few examples of empowering, inspiring ad campaigns getting health/care marketing

THINK: money and love. To find health, working-aged people seek financial stability and good relationships, according to the Consumer Health POV Report from Welltok, meQuilibrium, and Zipongo, featured in their webinar broadcast today. The online consumer survey was conducted among 2,000 full-time working U.S. adults in August 2017, segmented roughly into thirds by Boomers (37%), Gen Xers (32%), and Millennials (31%). Much lower down the priority list for healthy living are managing food, sleep, and stress based on the poll. Feeling stress is universal across most consumers in each of the three generational cohorts, especially related to work and finance.

One in two U.S. consumers told Aflac that enrolling in health insurance should feel like an experience on Amazon. But health consumers still lack that high benchmark retail experience with health plans, based on new research published in HealthMine’s 2017 Health Intelligence Report focusing on communication and digital healthcare tools. “Most members believe health plan communications are impersonal and centered around bills rather than healthcare guidance,” HealthMine asserts in the introduction to the report. That’s about as un-Amazon as we can imagine.   Top findings from HealthMine’s research are that: 3 in 4 consumers don’t think their health insurance plan

It’s National Health IT Week (#NHIT Week), and I’m revisiting research published earlier this year to connect the dots between EHR implementation (good news: it’s nearly universal in doctors’ offices and hospitals) and patients embracing their health information (not-so-much). What’s missing: UX design and respect for peoples’ life-flows.  Most physician practices and hospitals in the U.S. have installed electronic health records (EHRs). But in a classic Field of Dreams scenario, we have made patients’ medical records digital, but people aren’t asking for them or accessing them en masse. “How do we make it easier for patients to request and manage their

The future of effective and efficient healthcare will be underpinned by artful combinations of both digital technologies and “analog humans,” if the first day of the Health 2.0 Conference is a good predictor. Big thoughts about a decentralized future in healthcare kicked off Day 1 of the 11th annual Health 2.0 Conference in Santa Clara, CA. The co-founders of Health 2.0 (H20), Matthew Holt and Indu Subaiya, explained the five drivers of the tech-enabled health future. 1. The new interoperability, underpinned by FHIR standards and blockchain. “FHIR” stands for fast healthcare interoperability resources, which are informatics standards that enable data

“Wellness is a way to cope with the demands and rigors of new modern lifestyles,” according to Ogilvy in their latest report, The Wellness Movement Pioneers: New Global Research Findings. The report makes the case that the mass public are project-managing life adopting mental health, nutrition, physical activity and sleep to boost personal wellness. There is a big business model underneath this, which has inspired Ogilvy to start up the company’s Health & Wellness Practice. Think of this report as the group’s own business case to address the $3.7 trillion global wellness economy, illustrated by the first image. The report

Most U.S. patients want healthcare providers to offer cost information before a procedure, and whether doctors offer financial options to help them extend payments over time. This is an automotive or home appliance procedure we’re talking about. It’s healthcare services, and American patients are now the third largest payors to providers in the nation. Thus, the title of a new report summarizing a consumer survey from HealthFirst notes, “It’s Never Too Soon to Communicate Pricing and Payment Options. The study found that two-thirds of U.S. consumers would like healthcare providers to discuss financing options; however, only 18 percent of providers have

9 in 10 hospitals and health systems prioritize improving the consumer/patient experience, but only 30% of providers are building these capabilities. This consumer experience gap was found by Kaufman Hall in their survey research published in the report, 2017 State of Consumerism in Healthcare: Slow Progress in Fast Times. Digital health innovations will play big roles in supporting that consumer health experience for most health providers: 58% prioritize offering digital tool and information for consumer engagement, and 56% of providers look to develop a range of virtual/telehealth access points. But it appears that while healthcare providers’ spirits are willing, their flesh

Most U.S. consumers support the idea of price-shopping for healthcare, but don’t practice it. While patients “should” shop for health care and perceive differences in costs across providers, few seek information about their personal out-of-pocket costs before getting treatment. Few Americans shop around for health care, even when insured under a high-deductible health plan, conclude Ateev Mehrotra and colleagues in their research paper, Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information. The article is published in Health Affairs‘ August 2017 issue. The bar chart shows some of the survey results, with the top-line finding

On July 23, 1967, I was a little girl wearing a pretty dress, attending my cousin’s wedding at a swanky hotel in mid-town Detroit. Driving home with my parents and sisters after the wedding, the radio news channel warned us of the blazing fires that were burning in a part of the city not far from where we were on a highway leading out to the suburbs. Fifty years and five days later, I am addressing the subject of health equity at a speech over breakfast at the American Hospital Association 25th Annual Health Leadership Summit today. In my talk,

There’s more evidence of shopping behavior among patients: there’s new data showing that patients-as-consumers switch healthcare providers not due to quality of care or costs, but because of lack of service. I discovered one key verb and feature patient-consumers expect from doctors: it’s the ability to text, for appointment reminders, alerts, treatments, and communicating with the practice. SolutionReach, in the business of patient engagement, conducted a survey among 500 consumers asking about primary care providers, communication experience and satisfaction levels. The company presented the research results in a webinar on 29 June 2017. The research was also written up in

“Helping people on their path to better health” is the mission-mantra of CVS Health. Re-branded from its previous identity as CVS/pharmacy, the organization convened a Health Innovation Summit with its vendor partners whose products fill the front-of-store shelves to empower, inspire and support consumers to manage health and wellness for themselves and their families. I was grateful for the opportunity to provide the first talk for the day, setting the context for the evolving retail health/care landscape with the consumer at the center. The consumer is, at any point in a 24-hour day: a person wearing many hats (a worker,

U.S. consumers consider Consumer Electronics to be the most innovative industry they know. But people believe that Health & Wellness should be the most innovative sector in the economy. Welcome to the 2017 Klick Health Consumer Survey, which focuses on health innovation in the context of peoples’ hopes for technology to improve health and healthcare. 1 in 2 people say that technology has had a positive impact on their health and wellness, skewing slightly more toward younger people (although 45% of people 55 years of age and older agree that tech positively contributes to health. 41% of consumers say they’ve

In the past few weeks, two announcements from Amazon point to a strategy, whether intended or my dot-connecting, that the ecommerce leader has the health of its customers in its sights. In late May, CNBC first published the news that Amazon was seeking out a candidate to be a general manager for a pharmacy business. Here’s the video telling the story. Getting into the retail pharmacy channel is in itself a huge message to this health industry segment, which is very competitive between chain pharmacies (led by CVS, Walgreens, and Rite-Aid), grocery pharmacies (the largest of which are Kroger and

While trust in major institutions is eroding the world over, peoples’ trust in healthcare is on the rise, according to the 2017 Edelman Trust Barometer. Still, compared to other industry sectors, healthcare is still barely positive — and just one spot ahead of financial services. When it comes to trust, “the healthcare industry is making slow but steady progress,” notes Kym White who leads Edelman’s healthcare practices. Consumers’ trust in the five healthcare segments of pharmaceutical/drug companies, consumer health/over the counter, biotech/life sciences, insurance and hospitals/clinics is improving over 2016. In the U.S., for pharma and biotech, trust is reversing a

The economics of kidney disease in America is a hefty burden: about 26 million people in the U.S. have some aspect of chronic kidney disease and are at-risk of kidney failure. The number of people diagnosed with kidney disease doubled during each of the last two decades, according to the American Society of Nephrology. The annual cost of treating end-stage renal disease (ESRD) is over $32 billion, consuming 28% of Medicare expenditures…and increasing. Now consider the personal costs of dialysis in America: about $500 for a single hemodialysis treatment in a center, roughly $72,000 a year for one patient. There

This week I celebrate two spring holy holidays in one city that embraces spirituality, civility, and culture: Florence, Italy. Today, I had the special opportunity to tour Ospedale degli Innocenti: the Hospital of the Innocents. The hospital is now an institute for studying the culture and economics of children, and a museum telling a unique story of Florentine babies born in the early 15th century, spanning our contemporary era. The founding and root history of this beautiful place has lessons to teach us even today. It is key to realize, first, that Florentine humanism exalted the ideal virtues of the

Consumers love their supermarkets, fast food shops, retailers, delivery services, and banks. These industries rank highest in the 2017 Temkin Experience Ratings, my go-to source for understanding consumer service Nirvana. Health insurance companies and internet service providers (ISPs) are at the bottom of the Temkin Ratings, as shown in the first chart. Note that health plans range from a score approaching 70 to under 50, illustrating the very wide range of consumer experience from okay-to-good, too very poor. The top-ranked health plan was Kaiser Permanente, with a rating of 67%; Health Net was ranked the worst of the health plans

The non-vote for and withdrawal of The American Health Care Act on March 24, 2017, was a win for the retail health market, at least in the short-run. Before the vote, there had been some pronouncements that the passage of the AHCA would have been a boon to retail health. Here’s one story stating that, “A boom in medical tourism to Mexico predicted if Obamacare ends.” Another article asserts, “Why the American Health Care Act Works for Retailers,” a public policy statement from the National Retail Federation (NRF). But NRF, please don’t fret. Retail health is consumer-driven and will persist beyond the