A blog covering the health/care ecosystem and people.

As people take on self-service across all aspects of daily living, self-care in health is growing beyond the use of vitamins/minerals/supplements, over-the-counter meds, and trying out the blood-pressure cuff in the pharmacy waiting for a prescription to be filled. Today, health consumers the world over have begun to engage in self-care using digital technologies. And this isn’t just a phenomenon among people in the Millennial generation. Most seniors who regularly use technology (e.g., using computers and mobile phones) are also active in digitally tracking their weight, for example, learned in a survey by Accenture. Older people who use technology in daily

The Field of Dreams works in nostalgic plotlines about baseball, but as I’ve pointed out since the advent of consumer-facing health technologies, there’s no Field of Dreams effect in health care when it comes to consumer health engagement. U.S. health consumers aren’t using the patient portals that health care providers have built as part of their efforts to bolster health engagement via EHRs and health IT, Xerox found in the company’s 5th annual survey on electronic health records. I spoke with Tamara St. Claire to discuss the implications of the consumer poll, which was conducted among 2,017 U.S. adults in

Oliver Wyman’s Health & Life Sciences group names its latest treatise on the new-new health care The Patient-to-Consumer Revolution, subtitled: “how high tech, transparent marketplaces, and consumer power are transforming U.S. healthcare.” The report kicks off with the technology supply side of “Health Market 2.0,” noting that “the user experience of health care is falling behind” other industry segments — pointing to Uber for transport, Amazon for shopping, and Open Table for reserving a table. The authors estimate that investments in digital health and healthcare rose “easily ten times faster” than the industry has seen in the past. Companies like

Moore’s Law is coming to medicine. And it will look and feel a lot like Uber: with rich technology underpinning,  consumer-service oriented and friendly, and shaking up the professionals at the front line of the business (from taxi drivers to physicians). Eric Topol, physician and editor-in-chief at Medscape, told a standing-room-only audience at the kickoff of the 8th annual Health 2.0 Conference that the democratization of health care is coming based on consumers’ use of eight drivers: sensors, labs, imaging, physical exams, access to medical records, transparency of costs, and digital pills. Dr. Topol referred to the cover ot TIME

A new conversation has begun between doctors and patients: talking about money and health care, and what treatments cost — specifically, what a particular treatment will cost a patient, out-of-pocket. Over a dozen physician professional societies are proponents of these discussions, and are providing support to doctors in their networks. Doctors already engaging in the topic of the cost of care with patients aren’t being altruistic about spending this precious time in the already-time-constrained patient encounter: these discussions are increasingly relevant to physicians’ financial outcomes. I’ll be addressing this new feature in the doctor’s office at the upcoming Point-of-Care conference,

Patients are concerned about private risks of personal health data, resulting in some patients not disclosing certain information to health providers to protect their perceived EHR privacy and security risks. Peoples’ mixed feelings about sharing personal health information with their providers and EHRs is explored in The double-edged sword of electronic health records: implications for patient disclosure, published in the July 2014 issue of JAMIA, the Journal of the American Medical Informatics Association (AMIA). “The perception of the [EHR] technology may elicit non-disclosure as a privacy-protecting behavior,” the authors warn. Celeste Campos-Castillo and Denise Anthony, the paper’s researchers who work in

Opportunities abound for sharing data “for good” – to turbocharge clinical trials, inform medical research, anticipate and better manage epidemics, and focus on individual health goals benchmarking oneself vs. peers. At the same time, third party data brokers and marketing interests with which consumers have no direct connection of knowledge are scraping together bits of personal information from internet clouds, social networks, and retail data from which profits are made. And that value does not accrue to the very individuals whose data are being sold. Here’s Looking At You: How Personal Health Information Gets Tracked And Used, published by California HealthCare

Open data is a growing trend in health care. Analyzing data sets across lots and lots of people can help researchers identify medical cures, anticipate epidemics, and solve knotty problems where social and behavioral issues complicate clinical questions and solutions. Joining the open health data community is the health IT company Practice Fusion, which is sharing with the public aggregated data on some 81 million patients collected through over 100,000 active users every month recording patient data in the company’s cloud-based electronic health records system. Insight, the searchable database, is freely available to people, researchers, policymakers, and anyone who wants to look at top line

People managing chronic diseases are more likely to have accessed information in their electronic medical records — and are also less likely to worry about the privacy risks of their personal electronic health information compared with people who are healthy. Over 2,000 people, both those who say they’re healthy and those with chronic conditions, were surveyed by Accenture in February-March 2014, and their responses are summarized in the report, Consumers with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion. Slight more consumers are concerned about privacy risks related to online banking, online shopping,

The CEO of a family-owned grocery store chain wrote a letter to New York State lawmakers to support $65 million worth of spending on a computer system for health information in the state. That grocer is Danny Wegman, and that project is the Statewide Health Information Network, aka SHIN-NY. In his letter beginning, “Dear New York Legislator,” Wegman identifies several benefits he expects would flow out of the health IT project: 1. Improve health care for all New Yorkers 2. Lower health care costs, through reducing hospital readmission rates and reducing duplicate testing. 3. Lead to health data “liquidity” (my

Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are: Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the

Thinking about personal health information technology – the wearable devices, remote health monitors, digital weight scales, and Bluetooth-enabled medical equipment scaled for the home – there are two glasses. One is half-full and the other, half-empty. The half-full glass is the proliferation of consumer-facing devices like Fitbit, Jawbone and Nike, which comprise the lion’s market share in the health wearables segment; the mass adoption of mobile phones and tablets; consumers’ multi-screen media behavior (as tracked by Nielsen); and consumers’ growing share of medical spending, now about 40% of annual spending (or something north of $8,000 for a family of four

This is my second post for the #HIMSS14 Blog Carnival, written to coincide with the annual 2014 HIMSS Conference convening health IT leaders in Orlando, FL, 23-28 February 2014. I am gratified to be one of a dozen+ Social Media Ambassadors to the Conference. The first post, on why health IT ‘should’ matter to consumers, can be found here.  Investments in the digital health space reached nearly $2 billion in 2013, based on Rock Health’s look back at venture funding in the market. These financings covered $245 mm that went toward electronic health records and clinical workflow; $161 toward analytics

The convergence of technology developments – such as the internet, mobile phone adoption, cloud computing, sensors, electronic health records – with societal evolution including consumerism, demand for transparency, and “flatter” organizations – enable the phenomenon of Connected Health. Connected Health by definition includes mobile health (mHealth), telehealth and telemedicine, as presented in the February 2014 issue of Health Affairs which is dedicated to this theme. Why Connected Health’s time is Now relates to those factors cited above, and the underlying challenge of managing health care costs. While all nations in the developed world are facing difficult health economies, the U.S. spends so

  More than twice as many people value the opinions of friends and family for health care provider choices than turn to online ratings for doctors’ bedside manner, waiting times, or clinical quality, according to the Altarum Institute Survey of Consumer Health Care Opinions, Fall 2013, released on January 8, 2014. 1 in 3 consumers also looks into the cost and quality of services recommended by nurses, doctors, labs and hospitals before choosing a provider. However, most people (4 in 5) say they are comfortable asking their doctor about how much treatment will cost: 43% are “very comfortable,” and 38% somewhat comfortable,

The 2013 Mobile Health Summit was hosted by HIMSS at The Gaylord Resort in suburban Washington DC, taking place over 4 days during the mid-atlantic region’s iciest conditions in years. But inside the cocoon of this convention space, 5,000 conveners took in demonstrations of innovations using mobile platforms and standards that extend health services, knowledge and self-help tools to people and providers. Several themes emerged out of the meeting… Lots of apps, too few business models.  There are too many apps and not enough companies, Esther Dyson noted in a keynote session during which she dialogued with two Steve’s: Steven

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

If Californians represent their American peers, then most people in the U.S. want to access their health information online, based on findings in Health Information Technology in California: Milestones and Miles to Go, a report from California HealthCare Foundation published on 6 November 2013. Interviews among 319 California residents conducted in February 2013 found that: 3 in 4 people believe an electronic health record (EHR) is a valuable tracking tool 85% of people say doctors should have access to a patient’s personal health information – but 49% say “my health records are for my own use and should not be

Where can you shop the health and beauty aisles, pick up some groceries and a prescription, get a flu vaccine, and weigh in on Obamacare and what digital health tools you like? Why, at one of several thousand retail stores where you can find a SoloHealth kiosk. As of yesterday afternoon, over 32 million encounters were recorded on SoloHealth kiosks, based on an app I saw on the company CEO Bart Foster’s smartphone. Kiosks are locatted around the United States in retailers including Walmart and Sam’s Clubs, along with major grocery chains like Schnuck’s and Publix, and the CVS pharmacy

A cadre of pioneering Americans has been meaningfully using personal health information technology (PHIT), largely outside of the U.S. health care system. These applications include self-tracking and wearable health technologies, mobile health apps, and digital medical tracking devices like glucometers that streamline tracking and recording blood glucose levels. In the meantime, only 21% of doctors surveyed by Accenture currently allow patients to have online access to their medical summary or patient chart – very basic components of the electronic health record. We know what’s primarily driving health providers’ adoption of health IT: namely, the HITECH Act’s provisions for incentives. But

In game-scoring unit terms, 52 is the number of hours an average American spends seeking health information online each year. The 1 (hour) is roughly equivalent to the approximate total time a patient spends with a physician (an average of 3 visits, with an average time per vision of 20 minutes). Thus, 52:1. This means that the average U.S. health consumer spends much more time DIYing her health using digital information resources than speaking face-to-face with their physician in the doctor’s office. Still, the physician continues to be a go-to source for health information, according to Makovsky, a health communications

Imagine walking into a storefront where you can shop for an arthroscopy procedure, mammogram, or appointment with a primary care doctor based on price, availability, quality, and other consumers’ opinions? Welcome to the “health care automat,” the online healthcare marketplace. This is a separate concept from the new Health Insurance Marketplace, or Exchange. This emerging way to shop for and access health care services is explored in my latest paper for the California HealthCare Foundation (CHCF), Help Yourself: The Rise of Online Healthcare Marketplaces. What’s driving this new wrinkle in retail health care are: U.S. health citizens morphing into consumers,

In the long-run, health information technology (HIT) will improve the quality of health care, according to 73% of U.S. physicians. However, about the same number (7 in 10 physicians) believe that the ROI on health IT is inflated and that implementing EHRs will cost more, not less. Still, market forces from health insurance plans, payers and consumers are driving health IT adoption, according to Deloitte’s survey report, Physician adoption of health information technology: implications for medical practice leaders and business partners. Electronic health records (EHR) adoption and meeting meaningful use (MU) Stage 1 criteria appears strongly related to the size

Strange political bedfellows have come together to draft a formula for dealing with spiraling health care costs in the U.S. iin A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment from the Bipartisan Policy Center (BPC). The BPC was founded by Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. This report also involved Bill Frist, Pete Domenici, and former White House and Congressional Budget Office Director Dr. Alice Rivlin who together work with the Health Care Cost Containment Initiative at the BPC. The essence of the 132-page report is that the U.S. health system is

Only one-third of U.S. physicians believe that patients should have “full access” to their electronic health records, according to Patient Access to Electronic Health Records What Does the Doctor Order?, a survey conducted by Accenture, released at HIMSS13 in March 2013. Two-thirds of doctors in the U.S. are open to patients having “limited access” to their EHRs. However, the extent to which doctors believe in full EHR access for patients depends on the type of health information contained in the record. Accenture surveyed 3,700 physicians in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States, and found the doctors’

Wearing his Walking Gallery jacket painted by (im)patient advocate, Regina Holliday, Dr. Eric Topol evangelized the benefits of digital medicine and consumer empowerment in health care, largely summarizing his epic (pun intended – wait for Hot Point, below) book, The Creative Destruction of Medicine. A founder of the West Wireless Health Institute (now known as West Health), Dr. Topol is a physician and researcher at Scripps and was recently named as editor at Medscape. A new piece of Topol Trivia for me is that GQ magazine called him a rock star of science. Dr. Topol is one of the more

Patients are getting comfortable with remote health care – that is, receiving care from a health provider at a distance via, say, telehealth or via a Skype-type of set-up. Furthermore, 70% of people globally saying they would trust an automated device to provide a diagnosis that would help them determine whether or note they needed to see a doctor. Based on the findings from Cisco‘s survey summarized in the Cisco Connected Customer Experience Report – Healthcare, published March 4, 2013, just-in-time for the annual 2013 HIMSS conference, a majority patients the world over are embracing health care delivered via communications

A vast majority – 9 in 10 physicians – like mobile health (mHealth) apps, especially when tied to electronic health records (EHRs). eClinicalWorks surveyed physicians in January 2013, and found physicians bullish on mobile health apps for patient benefit – not just for their own office productivity and workflow. Specifically, – 93% of physicians say mobile health apps can improve patients’ health outcomes – 89% of physicians would recommend an mHealth app to a patient – 58% of doctors note a key mHealth benefit is providing patients with appointment alerts and reminders – 2 in 3 physicians say mHealth apps

Consumers want multiple functions on single devices, smooth transitions from one screen to another, and value-laden experiences in the post-recession economy. I wrote about this phenomenon during the week of the 2013 Consumer Electronics Show, highlighting Accenture’s survey on consumer attitudes toward technology — the connected home as consumer medical home. In the fast-evolving mobile health (mHealth) era, the consumer-facing suppliers are fast-responding to these customer demands. This is fostering consumer-centered interoperability in mHealth. On the health care system and professional side of health IT, getting to interoperability remains elusive and slow-going, with a customer base (hospitals, physicians) that’s not

The use of retail and work-site health clinics is up, and their consumers skew young. Overall, 27% of all U.S. adults have stepped into a walk-in clinic in the past two years. But only 15% of people 65 and over have used such a clinic. This begs the question: are retail and on-site clinics at the workplace filling the role of medical homes for younger adult Americans? The Harris Interactive/HealthDay poll published in January 2013 discovered that use of retail clinics grew from 7% in 2008 to 27% in 2012. The largest age cohort using walk-in clinics is people between

People enrolled in consumer-directed health plans (CDHPs) and high-deductible health plans (HDHPs) are more cost-conscious than those enrolled in more traditional plans, according to Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey from the Employee Benefit Research Institute (EBRI), published in December 2012. The logic behind CDHPs and HDHPs is that if health plan enrollees have more “skin in the game” — that is, personal financial exposure — they’ll behave more like health “consumers.” By 2012, 36% of employers with over 500 employees offered either HRA- or HSA-eligible plans. About 15% of working age adults are enrolled

“The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more helath information online and will take more responsibility for their care. The doctor/patient relationship will be altered. Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but

Mobile technology will change the delivery of health care, according to 2 in 3 health IT execs polled in the 2nd Annual HIMSS Mobile Technology Survey, sponsored by Qualcomm Life. Only 2% of health IT management says mobile won’t impact the delivery of health care in the future. This week finds the mHealth Summit convening in Washington, DC, hosting some 3,000 interested stakeholders looking at the intersection of mobile devices and platforms and health and health care. The 2012 theme is Connecting the Mobile Health Ecosystem, and the exhibitor area of the Summit speaks to the broadening of that ecosystem, including

Health care professionals (HCPs) have adopted smartphones and tablets faster than the man-and-woman-on-the-street. As a result, mobile devices have become an all-important channel for communicating information to all clinicians: doctors, nurses and pharmacists. Today, medical practice is “done” via computers: the chart, from MedPage Today’s survey of physicians conducted in July 2012, shows that 100% of doctors get their learning via desktop and laptop computers (THINK: continuing medical education, for example). 88% of doctors go social online, including using point-of-care tools based on MedPage’s definition of “social interactions.” 9 in 10 doctors have increased the use of the internet in

The godfather of evidence-based medicine, Dr. David Sackett, said that the practice of evidence-based medicine integrates: Individual clinical expertise A patient’s values and expectations The best available external clinical evidence. If a physician’s got the first issue covered, and a patient is very engaged in their health in full collaboration with their physician, there’s still the third issue to deal with: the proliferation of medical information and keeping up with the literature. It’s impossible to be an expert, claimed two Welsh med school professors in the British Medical Journal in an honest appraisal of the “avalanche of information.” Today, med

The first day of the Health 2.0 Conference in San Francisco kicked off with a video illustrating the global reach of the Health 2.0 concept, from NY and Boston to Mumbai, Madrid, London, Tokyo and other points abroad. Technology is making the health world flatter and smarter…and sometimes, increasing problematic fragmentation, which is a theme that kept pinching me through the first day’s discussions and demonstrations. Joe Flowers, health futurist, offered a cogent, crisp forecast in the morning, noting that health care is changing, undergoing fundamental economic changes that change everything about it. These are driving us to what may

  Consumers’ online access to electronic health records is growing in and outside of the U.S. — particularly evident in the U.K., where the National Health Service (NHS) patients are being given online access to their health records held by primary care providers (GPs). This program is termed “Record Access” and could morph into the larger concept of personal health records which, today, aren’t prevalent in the U.K. A new report analyzes U.K. consumers’ perceptions about online health record access called, Personal Health Records: Putting Patients in Control? The report was published in the UK by 2020health.org with support from Microsoft. The report is written

Americans find health insurance decisions the second most difficult major life decision only behind saving for retirement (36%) and slightly more difficult than purchasing a car (23%), via Aetna’s Empowered Health Index Survey. Why are health insurance choices so tough? Consumers told Aetna that the available information is confusing and complicated (88% percent), there is conflicting information (84%) and it’s difficult to know which plan is right for them (83%). Based on this survey’s findings, millions of Americans indeed feel dis-empowered by health care decision making. Who is empowered? Aetna says the empowered are likely to be more affluent, insured, married, take

While 87% of U.S. adults are familiar with health providers converting paper medical records into digital records, only 26% — 1 in 4 — say they want their own medical records to go digital. This sobering statistic comes as hundreds of thousands of doctors and hospitals are migrating to electronic health records (EHRs), motivated by the U.S. government’s HITECH act which provides incentives for the adoption and so-called meaningful use of EHRs. To gauge U.S. consumers’ views on digital medical records, Xerox polled 2,147 U.S. adults ages 18 and via an online survey in May 2012. The chart illustrates several key

One-half of the members of Kaiser Permanente use the plans’ personal health record system, MyHealthManager. The most-used function of MyHealthManager is accessing lab results, according to KP. Now that Quest, the lab and health information company, has launched the mobile phone app, Gazelle, more health citizens will have access to lab test results. This could be a health-activating opportunity inspiring patient engagement. While Gazelle is a fully functional personal health record (PHR), it’s the connection to lab test results that’s the lightbulb moment. PHRs have been available to health consumers for over a decade. There are millions of users of

The supply-side of healthcare DIY is growing, with the advancement of Castlight Health through its $100mm VC influx and Cakehealth’s new version for managing health spending online. Consumer demand is growing, too, for these services. But don’t get over-hyped by the healthcare, everywhere, scenario. Health citizens also demand face-to-face time with their physicians and clinicians, evidenced by a survey from Accenture titled, Is healthcare self-service online enough to satisfy patients? The answer is a clear, “no.” 90% of U.S. adults like the idea of digital health self-service, 83% want online access to personal health information, 72% want to book appointments

Transparency, data-based pharmacy decisions, incentivizing patient behavior, and outcomes-based payments will reshape the environment for marketing pharmaceutical drugs in and beyond 2012. Two reports published this week, from Express Scripts–Medco and PwC, explain these forces, which will severely challenge Pharma’s mood of market ennui. Express-Scripts Medco’s report on 9 Leading Trends in Rx Plan Management presents findings from a survey of 318 pharmacy benefit decision makers in public and private sector organizations. About one-half of the respondents represented smaller organizations with fewer than 5,000 employees; about 20% represented jumbo companies with over 25,000 workers. The survey was conducted in the

Employers expect total health costs to reach $11,664 per active employee this year, over $700 more than in 2011. Employees’ share of that will be nearly $3,000, the highest contribution by workers in history. In 2012, workers are contributing 34% more to health costs than they did 5 years ago. The metric is that for every $1,000 employers will spend on health care in 2012, workers will pay $344 for premium and out-of-pocket costs. Still, health care cost increases are expected to level off to about 6% in 2012, that’s still twice as great as general consumer price inflation. with

comScore has issued its annual report on the state of the American digital consumer in U.S. Digital Future in Focus 2012 and the topline is that mobile and Facebook are redefining communication in both the digital and physical worlds. This disruptive phenomenon has transformational implications for health and health care. comScore’s macro observations are that: – Social networking, and especially Facebook, is capturing a growing proportion of online users’ time, thus redefining how brands and organizations must interact with customers offline and on-. – Google remains the search leader but Bing has grown, surpassing Yahoo! as #2 in 2011. –

Doctors are using iPads in huge numbers for personal life project management. 80% of doctors are excited about using them in clinical practice. But when it comes to clinical applications, don’t confuse physicians’ desire for mobility with their current use of iPads in everyday practice. What’s surprising is the “why” behind that phenomenon. It’s not a lack of desire; to a large extent, it’s a hospital-based system that’s not listening to physician demand for seamless mobility that fits with real-life workflow. This was the light-bulb-over-the-head finding of Gregg Malkary of Spyglass Consulting. Gregg recently complete 100 in-depth interviews with switched-on doctors to

Transparency and authenticity, constant and clear communication, and a drive toward value underpin the future health system — for those health leaders who can commit to these pillars of transformational change. Leading Through Transformation: Top Healthcare CEOs’ Perspectives on the Future of Healthcare summarizes the interaction among 17 health execs who convened at the second CEO Forum held by Huron Healthcare Group. The report was released in January 2012. Health leaders concur that regardless of the politics of the Affordable Care Act and its prospects for whole or partial survival beyond November 2012, market pressures in the health sector are driving

Congrats to the 2012 Top 15 Health Systems as crowned by Thomson Reuters today, shown in the chart. They are segmented by size, with large systems (>$1.5 bn), medium ($750mm – $1.5 bn), and small (<$750 mm). No matter their size, though, across the segments, these best hospitals share several traits: They demonstrate better patient outcomes in terms of better survival rates and fewer complications Better long-term outcomes They adopt evidence-based medicine They have better patient safety track records Their patients leave hospital sooner, which could result in the fact that Patients are more satisfied than consumers at other hospitals (with higher HCAHPS scores). To

When I would meet up with clients and friends during the latter half of 2011, people whom I hadn’t seen for months would do a double-take when they saw me. “What have you done?” they have asked. In this first post of 2012, I will share with Health Populi readers my story of 2011 — a year of living health-fully for me. One of the blessings of my work-life is that I have access to some of the great minds in health and health care. But not until I began to personally harness their wisdom, intentionally incorporating what they’ve learned into my own life-flow and

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value. While these 3 segments – physicians, people-patient-consumers, and hospital execs, agree on this topline assessment, what they see about the future of health delivery in America varies, according to a new survey from the new Optum Institute for Sustainable Health, Sustainable health communities: A manifesto for improvement. This is the kick-off of the Optum Institute, a member of the