A blog covering the health/care ecosystem and people.

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

Health and wellness motivations among women cross all generations, driving them to purchase products that bolster health as they define it…not how media and stereotyping advertising have typically portrayed it, according to a survey report from Anthem Worldwide, What Women Really Want From Health and Wellness. Over all generations, 3 in 4 women say they make choices to benefit their health and wellness. Anthem asked women about the “external voices” of health/wellness messaging versus their “internal voice.” The external represent societal expectations: over 80% of women expect to take responsibility for their family’s health, and about 70% of women say the

Costco and Aetna announced that the Big Box retailer would expand its marketing of Aetna health insurance policies to card-carrying members in California. Costco has already been selling health insurance through stores in Arizona, Connecticut, Georgia, Illinois, Michigan, Nevada, Pennsylvania, Texas and Virginia. Later in 2013, Aetna plans will be available in Costco stores in other state markets. BTW, Costco operates stores in 42 U.S. states (as well as Canada, the UK, Taiwan, Korea, Japan, Australia, and Mexico). All together, the company serves 37 million households. The Costco Personal Health Insurance Program offers five plans, a network of health providers, and

PwC has seen the future of health care for the next year, and the crystal ball expects to see the following: Affordable Care Act implementation, with states playing lead roles The role of dual eligibles Employer’s role in health care benefits Consumers’ role in coverage Consumers’ ratings impact on health care Transforming health delivery Population health management Bring your own device Pharma’s changing value proposition The medical device industry & tax impact. In their report, Top health industry issues of 2013: picking up the pace on health reform, PwC summarizes these expectations as a “future [that] includes full implementation of

Consumers are looking for electronic devices that do many things, don’t care much about what platforms they use, like the convenience that cloud computing enables, and are bringing their own devices to the workplace for productivity, conference calls, and communication. Accenture has studied the wired consumer and developed this infographic, which illustrates these four key findings. Accenture says it’s “an open playing field” when it comes to consumer technology: there are many suppliers who can develop products and sell into this market, where consumers seem pretty agnostic relative to operating systems and even brands — as long as the devices

1 in 3 U.S. adults have enough trust in online health resources that they’ve gone online to diagnose a condition for themselves or a friend. “For one-third of U.S. adults, the Internet is a diagnostic tool,” according to Health Online, the latest survey on online health from the Pew Internet & American Life Project. Nearly one-half of these people eventually sought medical attention. One-third did not. Women are more likely to do online medical diagnoses than men do, as do more affluent, college-educated people. When people perceive they’re ‘really’ sick, 70% get information and care from a health professional and

One of the fastest-growing segments at the 2013 Consumer Electronics Show in Las Vegas this week is digital health. And within that segment, there’s a battle brewing for what technology companies seem to think is the most valuable part of real estate on the human body: the wrist. I counted at least fifty products as I cruised aisles 26000-27000 in the South Hall at the Las Vegas Convention Center that had wristbands, usually black, plastic or rubbery, and often able to click in and out of the band for use in-hand, in pocket, or in a few cases, on a

Over one-third of U.S. consumers plan to buy a new fitness technology in the next year, especially women. They’ll buy these at mass merchants (females in particular, shopping at Target and Walmart), sporting goods retailers (more male buyers here), online and at electronics stores like Best Buy. These potential buyers consider themselves in good or excellent physical health. They’ll see the latest applications on retail store shelves in pedometers, calorie trackers, fitness video games, digital weight scales, and heart rate monitors that will be launched this week at the 2013 Consumer Electronics Show in Las Vegas. In advance of the

1 in 2 people wants to improve their financial situation in 2013; 1 in 5 wants to improve their health, and another 1 in 5 seeks more time with friends and family. Ipsos Open Thinking Exchange has polled 18,000 global citizens from 24 countries under the age of 64 in December 2012 to learn that it’s money that people want, first and foremost, in the new year. Health and time for friends and family roughly tie for second place, overall. Not surprisingly, as the data chart for the U.S. shows, more people at the lowest third of household income (HHI) polled

“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

Two surveys of American consumers point to their growing concern over (1) rising costs and (2) wanting control over their care. More than 1 in 3 U.S. adults put off health care due to costs in the past year, a Gallup poll found. As shown in the graph, this is the highest proportion of people forgoing care due to cost since Gallup began asking the question in 2012. This survey was conducted in November 2012. There are differences between people without insurance and those with commercial or public sector plans such as Medicare and Medicaid. Over one-half of uninsured people

People engage with social media as a matter of do-it-yourself (DIY) life. Increasingly, patients are engaging with social media for HealthcareDIY. As a member of the HIMSS eConnecting with Consumers Committee, we’re committed to seeing that people-patients engage more with their health and the health of their loved ones. At the same time, we advocate for health providers to engage in shared decision making, collaborative and participatory medicine and health. This is not only a key component for Meaningful Use under the HITECH Act, but greater patient engagement breeds greater health, better outcomes, and can bend the cost curve for

  Nurses, pharmacists and doctors rank tops with Americans when it comes to honesty and ethics. Most people also rate engineers, dentists, police officers, clergy and college teachers as high on honesty metrics. Lawmakers (THINK: Congress) and car salesman fall to the bottom of the honesty-and-trust roster, who only 1 in 10 Americans believe act with honesty and integrity. Other low-ranking professions on this list are HMO managers, stockbrokers, and folks in the advertising business. Welcome to this year’s Gallup Poll on consumers’ perceptions of honesty and ethics in 22 professions in the U.S. Gallup measures six health care professions

Consumer price inflation grew 2% between September 2011 and September 2011. The price of branded drugs increased over 13% in the same period according to the Express Scripts 2012 Q3 Drug Trend Quarterly report, issued in November 2012. But the overall trend, including generics, was flat — 0.1%. This, due to the use of generics, now comprising 80% of prescription drug utilization. Since 2008, the brand prescription price index grew from a base of 100 to 163; the generic index fell from 100 to 61. The CPI index grew from the 100 base to 110. Generics have proven to be a

Notwithstanding the fact that most phones on U.S. streets are “smart” ones, most adults surf the net for health information, and most people try to change a health habit each year, Americans haven’t adopted healthier long-term relationships with food. The International Food Information Council has conducted the Food & Health Survey: Consumer Attitudes Toward Food, Safety, Nutrition & Health poll since 2006, thus enabling us to track peoples’ attitudes and behaviors over the past several years. The latest polling results appear in Is it Time to Rethink Nutrition Communications? A 5-Year Retrospective of Americans’ Attitude toward Food, Nutrition, and Health online in

Health benefit costs grew a relatively low 4.1% in 2012 (5.4% for large employers), largely due to companies moving workers into lower-cost consumer-directed health plans. Last year, benefit costs grew at an annual rate of 6.1%, representing about a 30% fall in year-on-year cost growth for companies. And, coverage is up to 59% of employees having ticked down to 55% for the past couple of years. Employers expect about a 5% increase for 2013. Mercer’s National Survey of Employer-Sponsored Health Plans analysis finds that U.S. employers are looking toward 2014, when they’ll be covering more uninsured workers, and using this advance

The ubiquity of mobile phones, increasingly smart ones (one-half of all mobile phones in the U.S. ), means people are walking around, working, playing and driving with self-tracking devices and ultra-mini computers in their pockets and totebags. 52% of smartphone owners seek health information on their phones, and overall 1 in 3 people seek health information on all mobile phones — nearly doubling the percent of those seeking health info via mobile in 2010 (17%). People who are sicker, caregivers, and those who have had a big change in health are also more prone to using phones for health, as

When the phrase “health care innovation” is considered, most people think about technologies like digital imaging, breakthroughs in cancer treatment, and robotic surgery. But before clinicians order or prescribe the use of any of those choices, there’s a cognitive process that gets them to that decision. It’s a cerebral mash-up of information, learned knowledge, and that special art of medicine embodied in the provider’s experience with patients, well-honed over time. How can innovation improve this process? “Healthcare innovation can be defined as the introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention and

Nearly 50% of business start-ups view health and wellness as crucial to employee recruitment and retention. 31% of start-ups under 10 years of age have adopted wellness programs. Furthermore, 3 in 4 small companies that offer wellness programs say they positively impact the businesses’ bottom-lines. Nonetheless, more than one-half of small business — companies with fewer than 100 employees — say that there isn’t enough information available that focuses squarely on wellness in small business. These findings come from Workplace Wellness Programs in Small Business: Impacting the Bottom Line, a report from the National Small Business Association (NSBA) and Humana, details findings

Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital

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

Transparency in health care can bring greater empowerment and enable more rational decision making for health consumers. Physicians acknowledge this: “We believe that increasing transparency in the health care system can be beneficial to both patients and physicians,” said J. Fred Raslton, Jr., MD, FACP, president of the American College of Physicians. There’s an indication that patients will embrace transparency in the form of accessing their physicians’ notes about them, based on the OpenNotes project research published in the Annals of Internal Medicine this week. The objective of the study was to measure the impact on doctors and patients of extending

As the Web Goes Mobile, Healthcare Stands Still, sums up a survey from Makovsky Health and Kelton. Their research finds that, while consumers have beloved relationships with their mobile devices (phones and tablets) and use them regularly for aspects of daily living, healthcare information search is still largely managed via desktop and laptop computers. The infographic organizes some of Makovsky-Kelton’s findings. Of note is that parents are more likely to seek health answers online, Wikipedia has gained in health use since 2011, women are more likely than men to research before filling a prescription, and recommendations from friends and family are

Just as people go online for travel planning. photo development. and financial transactions. they’re looking for health engagement with their doctors and health records online, too. Harris Interactive heralds this as The Age of the Healthcare Consumer. Harris Interactive polled U.S. adults and found that people are interested in a range of technologies for engaging in their health, arrayed in the chart: when asked which would be important for health providers to implement, consumers said (NET = very important + important): – Online medical record access to visits, Rx, test results, and history, 65%. 17% of consumers said their doctor

U.S. health consumers continue their self-rationing behavior, forgoing prescription drug fills and doctor’s appointments due to cost. Consumer Reports annual prescription drug poll echoes the news, consistent with other surveys finding Americans skipping necessary care from Kaiser Family Foundation and the American Osteopathic Association. I’ve discussed the trend of health self-rationing identified in these polls in past Health Populi posts, here and here. Since 2011, nearly 1 in 2 health citizens younger than 65 — that is, those people without Medicare which carries the Part D prescription drug benefit — did not fill a prescription due to cost. This proportion

Among factors that contribute to patients’ positive experiences with health care providers, the doctor’s ability to access ‘my’ overall medical history is nearly as important to consumers as the doctor’s overall knowledge, training and expertise. This enlightening data point comes to us from a Harris Interactive poll conducted in July 2012 and published this week. This news is important because it’s National Health IT Week. I attended the kickoff meeting for #NHITWeek yesterday in Washington, DC, held in the Department of Health and Human Services headquarters building named for Hubert Humphrey – an early public health proponent (and trained pharmacist,

With “Zero” large employers expecting to drop health insurance, as reported in the Washington Post, companies are getting creative and innovative about how to manage workers’ health and wellness, while addressing ever-growing costs. One strategy that’s getting more traction is the re-invention of the onsite health center. Towers Watson‘s 2012 Onsite Health Center survey report, finds that one-half of employers view establishing an onsite health center as a linchpin to enhancing productivity and health in the workplace. Following close behind productivity is the onsite health center’s promise of reducing medical costs, improving access to care, and the traditional reason for providing onsite

Employee benefits make up one-third of employers’ investments in workers, and companies are looking for positive ROI on that spend. Health benefits are the largest component of that spending, and are a major cost-management focus. In 2012 and beyond, wellness is taking center stage as part of employers’ total benefits strategies. In the 2012 Wellness & Benefits Administration Benchmarking study, a new report from bswift, a benefits administration company, the vast majority of large employers (defined as those with over 500 workers) are sponsoring wellness programs, extending them to dependents as well as active workers. Increasingly, sticks accompany carrots for

Most seniors look forward to aging in place, and are confident in their ability to do so. Such is the top-line feel-good finding from the National Council on Aging‘s (NCOA) survey, The United States of Aging, sponsored by USA Today and United Healthcare. A majority of seniors have a sense of purpose and plans for their future. Three-fourths of older Americans say staying physically fit through exercise and proactively managing their health is important. However, only 36% of seniors say they exercise or engage in physical activity every day. 11% never do. The most common chronic conditions noted by seniors

Target, the beloved retail channel for many design-minded value-conscious consumers, has opted in to mobile health through its purchase of SMARTCOACH mobile health coaching devices. SMARTCOACH is part of a growing category of wearable devices that monitor health behaviors like walking and calories consumed. What differentiates SMARTCOACH is the “coach” element, which provides real-time feedback throughout the day. Most other devices in the market simply track and record data. And it’s feedback loops that more experts say are key to sustaining health behavior change. Target will bring the device into stores for purchase in the fall. Like some other wearable

Two in 3 employees (62%) can’t estimate how much their employers spend on health benefits. Of those who could estimate the number (which is, on average, about $12,000 according to the 2012 Milliman Medical Index), most weren’t very confident in their guess. Some 23% calculated the monthly spend by employers was less than $500 a month — less than 50% the actual contribution. Thus, most U.S. health consumers don’t fully value the amount of cash their employers spend on their health care, according to a poll from the National Business Group on Health, Perceptions of Health Benefits in a Recovering

Amidst uncertainties and wild cards about health care’s future in the U.S., there’s one certainty forecasters and marketers should incorporate into their scenarios: consumers will bear more costs and more responsibility for decision making. The 2012 Deloitte Survey of U.S. Employers finds them, mostly, planning to subsidize health benefits for workers over the next few years, while placing greater financial and clinical burdens on the insured and moving more quickly toward high-deductible health plans and consumer-directed plans. In addition, wellness, prevention and targeted population health programs will be adopted by most employers staying in the health care game, shown in

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

In some surveys, U.S. consumers seem primed for health engagement, liking the ability to schedule appointments with doctors online, emailing providers, and having technology at home that monitors their health status. The chart illustrates some of these stats from a 2011 survey by Intuit. However, organizations that develop quality report cards on providers and plans, and developers of mHealth apps, will point out that consumers aren’t rushing to use the quality reports or sustain use of apps: in fact, most downloaded health apps aren’t used after one try, according to PwC’s research. How do we make sense of these different

With the stunning Supreme Court 5-4 majority decision to uphold the Patient Protection and Affordable Care Act (ACA), there’s a Roberts’ Rules of (Health Reform) Order that calls for liberating primary care beyond the doctors’ office. That’s because a strategic underpinning of the ACA is akin to President Herbert Hoover’s proverbial “chicken in every pot:” for President Obama, the pronouncement is something like, “a medical home for every American.” But insurance for all doesn’t equate to access: because 32-some million U.S. health citizens buy into health insurance plans doesn’t guarantee every one of them access to a doctor. There’s a

More than 2 in 3 U.S. households with debt point to medical spending as a key contributor to their indebtedness. Among the out-of-pocket (OOP) costs that drive household debt are the cost emergency room visits, dental expenses, prescription medications, inpatient hospital stays, and visits to the doctor, shown in the chart. Welcome to The Plastic Safety Net, the use of credit cards to fund living expenses in America, a phenomenon explained in a report from Demos, published in May 2012. Demos surveyed nearly 1,000 low- and middle-income households in February and March 2012 to gauge the rate of use of credit cards

Since the advent of the Great Recession of 2008, more Americans have been splitting pills, postponing needed visits to doctors, skipping dental care, and avoiding recommended medical tests due to the cost of those health care services. Call it health care self-rationing: the Kaiser Family Foundation (KFF) has been tracking this trend for the past several years, and the proportion of American adults rationing health demand is up to 58%. This KFF Health Tracking Poll interviewed 1,218 U.S. adults age 18 and older via landline and cell phone in May 2012. As the chart illustrates, 38% of people are “DIYing” health care

Skype and videoconferencing have surpassed the tipping point of consumer adoption. Grandparents Skype with grandchildren living far, far away. Soldiers converse daily with families from Afghanistan and Iraq war theatres. Workers streamline telecommuting by videoconferencing with colleagues in geographically distributed offices. In the era of DIY’ing all aspects of life, more health citizens are taking to DIY’ing health — and, increasingly, looking beyond physical health for convenient access to mental and behavioral health services. The Online Couch: Mental Health Care on the Web is my latest paper for the California HealthCare Foundation. Among a range of emerging tech-enabled mental health

Half of patients globally expect that mobile health will improve health care. These health citizens expect that mobile health will help them manage their overall health, chronic conditions, how they manage their medications and measure and share their vital health information. Welcome to the new mobile health world, a picture captured in PwC’s report, Emerging mHealth: Paths for growth, published in June 2012 and written by the Economist Intelligence Unit. Patients’ views on mHealth are bullish, and while most doctors and payors share that vision, they also expect mHealth to come into focus more slowly, recognizing the institutional, cultural and

To get to be 100 years or older requires exercise, social connectedness, and good sleep, according to a majority of centennarians polled in UnitedHealthcare’s 100@100 Survey, 2012 Report of Findings. The key findings of this fascinating survey are that: Centenarians have better eating and sleeping habits than Boomers. One-half of centenarians regularly exercise. The most common forms of exercise are walking or hiking, muscle strengthening, gardening, indoor cardio exercise, exercise classes, and yoga/Tai Chi or other mind/body/spirit forms. Social networks bolster health, with most old-old people communicating with family or friends nearly every day And, laughter is a vitamin, with most

  One-third of employers will increase investments in wellness programs in 2013. Employers look to these programs to reduce health care costs, to create a culture of health, to improve workforce productivity, and to enhance employee engagement. Workers say wellness programs are important in their choice of employer. But while employers and employee chasm agree on that point, there’s a gap between how employers see the programs’ benefits, and how aware (or unaware) employees are. Call this a Wellness Literacy Gap, akin to health literacy and health plan literacy. Over one-half of employers believe employees understand the programs they offer,

Health spending will increase by 7.5% in 2013, with employees’ contributions rising for in-network deductibles, prescription drugs and emergency room visits. 3 in 4 employers, seeking to control rising health expenses, will offer wellness programs, even though a vast majority can’t yet measure an ROI on them. The Health and Well-Being: Touchstone Survey Results from PriceWaterhouseCoopers (PwC). PwC points out that the 7.5% medical cost increase is historically lower than in recent years, as a result of structural changes in the health care market including: A sluggish economy Growing focus on cost containment Lower utilization of health services by patients Employers’ efforts

On May 23, 2012, Pfizer announced its teaming with EatingWell magazine to launch a mobile app for patients on Lipitor. Eight days later, on May 31, 2012, generic versions of Lipitor will hit the market. Lipitor is the best-selling drug in pharmaceutical history, to-date. Sales of the product top $125 billion. While generic atorvastatin has been available in the U.S. since November 2011 from two manufacturers, low prices for the generic will drop to $10 or less for a month’s supply at the end of May. This is Pfizer’s first foray into a prescription drug-affiliated app. The free mHealth app,

Trust is a precursor to health engagement. Trust impacts health outcomes such as a patient’s willingness to follow a doctor’s or health plan’s instructions. Two new studies point out that U.S. consumers don’t trust every touchpoint in the health system. Online medical information has become a trusted channel. Health plans? Not so much. Wolters Kluwer’s Health Q1 Poll on Self-Diagnosis found that consumers trust online health information to inform themselves — even for self-diagnosis. 57% of U.S. adults turn to the Internet to find answers to medical information; 25% “never” do, and 18% rarely do. Two-thirds of people say they trust

Mom is the Chief Health Officer of her family, she’s mobile, and seeking health information and community on-the-go. But underneath the persona of the Mobile Mom, she’s consuming information and sharing perspectives on many other ‘screens,’ too. And that’s the challenge for marketers seeking to grab the attention of this key player in the health ecosystem. There are new survey data from Enspektos‘s report, Digging Beneath the Surface: Understanding the Digital Health Mom, that are must-reading for health industry stakeholders who seek to motivate health behaviors among women, who are at once nurturing wellness, caregiving for sick people, and sharing

Once upon a time, patient satisfaction with visits to doctors’ offices used to be a function of bedside (exam room) manner, demeanor and responsiveness of the reception and insurance staff, and the age of magazines in the waiting room. Today, waiting time is a key factor, and social media is raising expectations around response time in health care. See the first chart, based on data from PwC’s survey, Social Media “Likes” Healthcare, published in late April 2012. The poll found that when U.S. adults use social media in healthcare, at least 4 in 10 people want complaints and information requests responded to

Two reports this week suggest countervailing trends for employer-sponsored health benefits: the erosion of the health benefit among companies, and opportunities for those progressive employers who choose to stay in the health benefit game. In 2010, nearly 50% of workers under 65 years of age worked for firms that did not offer health benefits. The uber-trend, first, is that the percentage of workers covered by employer-sponsored health insurance has declined since 2002. Workers offered the option of buying into a health benefit, as well as the percent covered by a health plan, have both fallen, according to the Employee Benefits Research Institute (EBRI), an organization that

Even though Inside-the-Beltway economists have said The Great Recession of 2007 is officially over, it doesn’t look that way when you ask consumers about health spending in 2012, based on results from a survey conducted on behalf of the American Osteopathic Association (AOA). One in 5 U.S. adults is trying to lower their personal health spending. One in four is seeking free or alternate sources of health care. Overall, 1 in 5 people says their health has been negatively impacted by the economy. The AOA discovered that people in the U.S. whose health has been negatively impacted by the economic downturn were

One in 3 Americans uses social media for health discussions. Health is increasingly social, and PwC has published the latest data on the phenomenon in their report, Social media ‘likes’ healthcare: from marketing to social business, published this week. PwC polled 1,060 U.S. adults in February 2012 to learn their social media habits tied to health. Among all health consumers, the most common use of social media in health is to access health-related consumer reviews of medications or treatments, hospitals, providers, and insurance plans, as shown in the graph. Social media enables people to be better health “consumers” by giving them peers’