A blog covering the health/care ecosystem and people.

In our fast-texting, quick-thinking, Blink-ing society, Jason Riis talks about slowing down our relationship with food. At the Edelman Wellness Ignited meet-up on March 26, 2012, Jason riffed on food  intervention and economics for healthy eating. Jason is a professor at Harvard Business School and among his many research interests is how to change culture to morph away from obesity and Type 2 diabetes toward health. The U.S. is a shopping nation: retail is destination, fun, entertaining, life, for millions of Americans. Jason’s asking what retailers can do about fast and food. This isn’t only about ‘fast food,’ which, of course,

About 50% of women and men in the U.S. are projected to be obese by 2030. The majority of people in America concur that the nation has an obesity problem. What’s been unknown and underestimated is just how much the epidemic is costing the nation in both health and financial terms. On a life-cycle basis, the cost is much greater than previously estimated. Assessing the Economics of Obesity and Obesity Interventions from the Campaign to End Obesity looks at the evidence on the size of the obesity challenge, spending, and interventions available to combat this public health behemoth. “Obesity is not just

There’s a shift in power in health care moving away from providers and suppliers like pharma and medical device companies, toward patients and payers. This is the new health world according to Ernst & Young‘s latest Progressions report called, The third place: health care everywhere. What’s underneath this tectonic shift is the need to bend that stubborn cost curve and address public health outcomes through behavior change. E&Y says look for new entrants, like retailers, IT companies, and telecomms, to be part of the solution beyond traditional health care stakeholders. These participants will be part of both delivery of care

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

While the vast majority of people find value in electronic health records (EHRs) — both those whose doctors currently use them and those patients whose personal health information still resides in paper-based systems — most remain concerned about their patient rights, privacy and security of that data.  Making IT Meaningful: How Consumers Value and Trust Health IT, a report based on a survey from the National Partnership for Women & Families (NPWF) published in February 2012, weaves the story of an American public, keen to have their PHI digitized, but deeply concerned about their rights to access and protect that

35% of consumers who have been altering their food intake to lose weight are eating fewer processed foods, according to a recent Nielsen Global Survey. This percentage has grown from 29% in 2008. Health and wellness is one of three driving forces shaping food in 2012, according to JWT‘s What’s Cooking: Trends in Food. The other two forces, technology and foodie culture, combine with health/wellness and yield some interesting consumer trends in the milieu of food. JWT’s top food issues to watch are: – Fooducate – Nutrition scores – Fat taxes – Health and fresh vending machines – Gluten-free –

A health system that’s built to last: this is the latest sound-bite echoing through health policy circles. The theme of sustainability is permeating all matters of policy, from education and business to health care. Enter IBM, with a rigorous approach to Redefining Value and Success in Healthcare: Charting the path to the future, from the group’s Healthcare and Life Sciences thinkers. What’s inspiring about this report is the team’s integrative thinking, bridging the relationship between operational effectiveness built on a robust information infrastructure that enables team-based care (the “collaboration” aspect in the middle of the pyramid), which then drive personalized healthcare

At the ConvUrgent Care Symposium in Orlando, attendees from the worlds of clinics, ambulatory care, hospital beds, pharmacies, medical devices, life sciences, health information, health IT, health plans, academic medical centers and professional medical societies came together to share and learn about the morphing landscape of retail health. The topline message: primary care is everywhere, and based on the response to my keynote talk this morning, every stakeholder segment gets it. My mantra, courtesy of the U.S. Surgeon General Regina Benjamin: don’t look at health in isolation, that is, where the doctor and hospital are. Health happens wherever the person

Less is more when it comes to health care utilization and outcomes. The U.S. allocates too many resources to a huge line item of waste in the health system – administrative (in terms of too many paper processes and staff to deal with them) and clinically (especially involving duplicated tests and ineffective treatments that aren’t based on evidence based medicine). “Take less” is the tagline of the company called help which is found at the URL http://www.helpineedhelp.com/.  This is a consumer-facing over-the-counter drug supplier. Their product line counts 7 mature products each packaged with the health complaint they target: “Help,” I have

Cue up the song “Hey Big Spender” from the Broadway hit, Sweet Charity, when you read the January 2012 AHRQ report with the long-winded title, The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009.” The report’s headline is that 1% of the U.S. population consumed 20% of all health costs spent in the U.S. in 2008 and 2009, illustrated by the chart. These Big Health Spenders tend to be in poor or fair health, older, female, non-Hispanic whites and people with only publicly-provided health insurance. Their mean expenditure was $90,061. The top 10%

‘Tis the season of weight loss plans, particularly among women, as this NPR story discusses. For the weight loss industry, this first quarter of the new year is akin to Black Friday for retailers the day-after-Thanksgiving. Special K called January 2, 2012, as National Weigh-In Day. To commemorate the event, Kelloggs commissioned a survey among women to find out what “inspires and tires” them when it comes to losing weight. Two-thirds of women in the U.S. started or re-started a weight management plan on January 1st, 2012. Other times of the year when women initiate weight-loss plans are to prep

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

People enrolled in consumer-directed health plans (CDHPs) are more likely than enrollees in traditional health insurance products to be cost-conscious. In particular, CDHP members check prices before they receive health care services, ask for generic drugs versus branded Rx’s, talk to doctors about treatment options and their costs, and use online cost-tracking tools. Furthermore, CDHP members are also more likely to use wellness programs offered by their employers, and are offered “carrots” to participate in them in the forms of financial rewards and other incentives, as well as reduced health care insurance premiums. The 7th annual Employee Benefits Research Institute

The Great American Recession of 2008 will reawaken in 2012, Goldman Sachs expects. In the current economic climate of a jobless recovery and dropping home values, the definition of The American Dream has changed. It’s more about personal fulfillment than financial gain, according to the 2011 MetLife Study of The American Dream: The Do-It-Yourself Dream. This is the rise of the “do-it-yourself” American Dream, MetLife found in its survey of 2,420 online adults conducted in September-October 2011. Across the generations — from Silent (born between 1920 and 1945) to Gen Y (born between 1978 and 1993), this redefining concept is relatively consistent.

The Internet, broadband, mobile health platforms, and consumers’ demand for more convenient health care services are fueling the development and adoption of health technologies in peoples’ homes. However, designing products that people will delight in using is based on incorporating human factors in design. Human factors are part of engineering science and account for the people using the device, the equipment being used, and the tasks the people are undertaking. The model illustrates these three interactive factors, along with the outer rings of environments: health policy, community, social, and physical. Getting these aspects right in the design of health technologies meant for

Per capita calorie intake has grown by 9 to 30 calories a day since the 1980s. Portion sizes have grown; as a result, so has the level of overweight and obesity in America. By 2020, 83% of men will be overweight or obese in the U.S.; so will 72% of U.S. women, according to Mark Huffman in a paper presented to the American Heart Association meeting in November 2011. “An individual’s decision to eat is not a result of personal weakness, but rather is determined, to a great extent, by the many environmental cues that have emerged since the early

The health status of the American workforce is declining. Every year, unhealthy behaviors of the U.S. workforce cost employers $623 per employee annually, according to the Thomson Reuters Workforce Wellness Index. People point to smoking, obesity and stress as the 3 most important factors impacting health costs. Thomson Reuters and NPR polled over 3,000 Americans on their health behaviors, utilization and costs of health care, publishing their results in a summary, Paying for Unhealthy Behaviors in October 2011. 4 in 5 overall — and 9 in 10 of those with over $50,000 annual income — believe that people with healthy behaviors should receive a

The signs of the primary care crisis in America are visible: A growing number of visits to the emergency room for treating commonplace ailments Waiting lists for signing up with and queuing lines to see primary care doctors Fewer med students entering primary care disciplines Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban. The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of

This morning during my still-dark-at-5:15 am walk, my iPod was motivating me to “get up offa that thing,” as James Brown was motivating me to “release the pressure.” Two minutes into the song, he urges, “Get into the sunshine, church is out.” This brought to mind a publication I’ve taken time to review from the General Accounting Office (GAO) report to the U.S. Congress, Health Care Price Transparency – Meaningful Price Information Is Difficult for Consumers to Obtain Prior to Receiving Care, published in September 2011. While employers and health plans want consumers to become more engaged in their health, a key barrier facing

More people with higher levels of concern about their health feel they are in good health, see their doctors regularly for check-ups, take prescription meds “exactly” as instructed, feel they eat right, and prefer lifestyle changes over using medicines. And 40% of these highly-health-concerned people have also used a health technology in the past year. At the other end of the spectrum are people with low levels of health concern: few see the doctor regularly for check-ups, less than one-half take their meds as prescribed by their doctors, only 31% feel they eat right, and only 36% feel they’re in

Kids lead their parents in the adoption of  digital technologies; that’s why the youngers are called Digital Natives. An intriguing survey of adults’ use of technologies finds that those who do so like “childlike play,” and at the same time, for kids, make them feel more grown up. The trend, Ogilvy says, is blurring generational lines: market to adults as kids, and kids as adults. This convergence is leading families to become more “units” — parents and kids increasingly on the same page in purchase decisions. In Tech Fast Forward: Plug in to see the brighter side of life, from

“56 million U.S. Consumers Access Medical Information from Electronic Health Records,” asserted Manhattan Research’s press release of October 12, 2011. This statistic, fresh out of the firm’s 2011 Cybercitizen Health survey, is among several stunning numbers that demonstrate a growing trend: U.S. health citizens’ embrace of their personal health information in digital formats, via electronic channels. To kick the tires on the survey a bit, I spent time on the phone with the “3 M’s” of Manhattan Research — Meredith Ressi, President; Monique Levy, VP of Research; and, Maureen Malloy, Senior Healthcare Analyst who can recite the survey data backwards and forwards. Together,

Lifestyle, nutrition, the environment and the health system are four key factors that people globally say have the most impact on their health. Underlying these influences, its friends and family who most shape our health, followed by government and business. Welcome to the 2011 Edelman Health Barometer, the third year the communications firm has polled health citizens around the world on their views on health, behavior change, and the use of information and digital tools. Edelman conducted 15,165 interviews 12 countries in North America, Asia and Europe to gather health citizens’ perspectives. The top-line, globally, is that there is a knowledge-action

3 in 4 of the Fortune 50 companies are part of the U.S. health economy in some way. Only 1 in 3 of these is in traditional health industries like pharmaceutical and life science companies, insurance, and businesses in the Old School Health Care value chain. 2 in 3 of the Fortune 50 companies involved in health are in new-new segments. In their report, The New Gold Rush, PricewaterhouseCoopers (PwC) identifies four roles for “prospectors” in the new health economy which will represent 20% of the GDP by 2019: Fixers Connectors Retailers, and Implementers. These are the disruptive roles that will

Globally, in developed economies, the challenges of increasing health care costs, access to quality health care, aging citizens and the supply of clinicians are universal. CSC says telemedicine can address these challenges as part of reforming health care delivery and financing throughout the world. In Telemedicine: An Essential Technology for Reformed Healthcare, CSC sees telemedicine as an enabler for health reforms’ goals the world over. In the U.S., telemedicine is explicitly mentioned in the Affordable Care Act. In April 2011, the Federal Register included language about health financing reform that said, “The ACO shall define processes to promote evidence-based medicine and patient engagement, report

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

Randomized controlled trials (RCTs) have been the rational cornerstone of medical decision making for decades. RCTs demonstrate a drug or therapeutic course’s efficacy – that is, the extent to which a specific intervention, procedure, or regimen produces a beneficial result under ideal conditions. Of course, how a particular therapy works in an individual is highly personalized based not only on a body’s biochemistry, but personal preferences, perceptions, and personality. That’s why Dr. Andrew Weil and his colleagues, Dr. Scott Shannon and Dr. Bonnie Kaplan, say that medical decision making should take into account the patient perspective. In Medical Decision Making in

Health professionals are go-to sources for medical diagnoses, information about prescription drugs and alternative treatments, and recommendations for doctors and hospitals. On the other hand, health information seekers turn to fellow patients, friends and family for emotional support in dealing with health issues, and quick remedies for everyday issues. And increasingly, those health information searches are going mobile, with 17% of U.S. adults having ever used their cell phone to look up health or medical information. This proportion nearly doubles for 18-29 year olds, and is also higher for wealthier people, Latino’s, college graduates, and urbanites. 1 in 10 people with a

Apple has supplanted Google as the world’s #1 most valuable brand, worth more brand-wise than Microsoft and Coca-Cola combined (#5 and #6). the other most valuable global brands are IBM, McDonalds, AT&T, Marlboro, China Mobile, and GE. Technology brands have significantly grown in value with consumers allocating more personal disposable income to products like tablet computers and smartphones, even in the face of recessionary economics the world over. Technology companies are now 1/3 of the top 100 brands. Millward Brown, the brand consultancy that is part of WPP, the global communications firm, has conducted the BrandZ top 100 most valuable

With non-communicable diseases (NCDs) killing two-third’s of the Earth’s residents — not malaria, HIV or other infectious diseases — the World Health Organization calls lifestyle-borne chronic conditions a “slow-motion catastrophe.” The solution for addressing this global challenge isn’t just about deploying more doctors and medical technology in hospitals and bricks-and-mortar institutions. The real health reform is about infrastructure-independent care and feeding that bolsters peoples’ health where they live, work, play and pray, as characterized by the U.S. Surgeon General Dr. Regina Benjamin in the Los Angeles Times on March 13, 2011. Today I’ll be participating on the eHealth track at the J.

Representatives from eight U.S. Federal government agencies, including the FDA and Veterans Administration, among others; health financiers (VCs, angels); health tech start-ups; providers, life science companies, and analysts, attended the Health Care Innovation Day DC sponsored by West Wireless Health Institute on April 28, 2011. The meeting had the tagline, A Discussion with the FDA, setting the stage for a day-long consideration of the role of regulation vis-a-vis health innovation. The $2.5+ trillion question (annual spending on health care in the U.S.) is: can innovation drive making health care “cheaper?” This was the underlying theme of the panel on which I sat

Today’s kickoff of the National eHealth Collaborative‘s Consumer Consortium on eHealth convened the most diverse workgroup of over 70 stakeholders with various lenses on consumers and health, rarely seen at similar meetings, as Lygeia Ricciardi (@lygeia) of the Office of the National Coordiantor for Health IT (ONC) in the Department of Health and Human Services, observed. However, although representing every conceivable segment of health consumer stakeholders, from seniors (AARP)  and physicians (MGMA) to people with disabilities (AAPD), women (National Partnership for Women and Families) and people who fall through the health safety net (the National Health IT Collaborative for the Underserved), there was concurrence

Anyone attending a Health 2.0 or health IT meeting in the past 18 months has (hopefully) been exposed to the force known as  Todd Park, Chief Technology Officer of the Department of Health and Human Services, and his mantra of “Data Liberación.” Data Liberación is the act of freeing data — in this instance, health data — locked within data silos, to be ‘liberated” allowing it to move about so that analysts can learn from it and develop strategies to better manage health for individuals and populations. Now there’s a force advocating for “Social Media Liberación” in Health: health activists, the most engaged patients

In the “House & Home” section of last weekend’s Financial Times, an article titled ‘Domestic Science’ talked about internet-operated vacuum cleaners that feed pets, refrigerators that track emptying cartons of milk, and the $10 Savant TruControl iPad app that helps control home systems’ remotely (tied to a $6,000 home-based system). The article also touched on the Withings WiFi body scale. The Withings scale communicates wirelessly to a computer or mobile phone, transferring and automatically recording the user’s weight, BMI, body fat percentage and other parameters to a secure, password-protected online system. The user can choose to tweet their weight via Twitter if they choose

Adoption of mobile health (mHealth) apps will increase by 23% as a compound annual growth rate. according to a forecast from Arthur D. Little (ADL), featured in their report published in April 2011, Capturing Value in the mHealth Oasis. What is this mHealth Oasis? ADL notes that mobile network operators (MNOs — mobile phone companies) see gold in them thar’ health hills given unsustainable health economies the world over. However, ADL rightly points out that mobile health is just about as easy to conquer as any other aspect of health technology, full of minefields. ADL lays out the success factors for MNOs who want to engage

In December 2010, an article describing a telehealth remote monitoring program for heart failure patients concluded that telemonitoring did not improve patient outcomes. The paper, Telemonitoring in Patients with Heart Failure, written by Sarwat I. Chaudhry, M.D, and nine other authors, analyzed 1,653 CHF patients, 826 of whom participated in a remote health intervention: a telephone-based interactive voice-response system that patients dialed into on a daily basis to report symptoms and weight; this was designed to occur every day over six months.  These data were then reviewed by patients’ clinicians who could contact patients when data pointed to the clinical need to adjust patients’ medications and other parameters.

Health consumers are at least as keen to access their medical history online as they are to manage other aspects of their personal lives. Intuit, the people who brought Quicken to the market to help consumers manage their personal financial lives, are keen to do the same for health care. And they’ve got the survey data in The Intuit Health Second Annual Health Care Check Up to make their case for the online personal health information management market. It is no surprise that the survey found that 70% of U.S. adults are concerned (very or somewhat) about managing their health

  About 1 in 10 people in the U.S. suffer from migraine headaches. The direct cost to business for medical care and wage replacement is over $1 bn, but this underestimates the total economic impact of lost productivity to the economy and personal lives (for more on  whole-health costs, read yesterday’s Health Populi, Lost Costs: Lost Productivity Represents One-Half of Health Costs for U.S. Employers). There are actually 14 kinds of headaches, as classified by the International Headache Society (IHS). Among these, there are four primary headache types: migraine, tension-type headaches, cluster headaches and trigeminal autonomic cephalagias, and a fourth

Most health consumers in the U.S. use the internet to seek health information, socialization and empowerment. Dig deeper, and you’ll find a growing cadre of people who go online to find people with the same conditions they have; 1 in 4 people (23%) among those living with chronic conditions have gone online to ID others like them, including people with high blood pressure, diabetes, heart disease, lung conditions, cancer, and other chronic health issues. The percentage of people looking for “people like me” drops to 15% of internet users with no chronic conditions seeking health-peers online. However, peers-in-health aren’t always seen as the ideal source

What doctors are most likely to use patients’ personal electronic health records? Fewer than 1 in 2 are willing to. Those who most likely would include Hispanic physicians, doctors who practice in rural areas, those employed in hospitals, and surgeons. As part of the HITECH Act included in the American Recovery and Reinvestment Act (ARRA) 0f 2009, U.S. physicians have the opportunity to receive a portion of the $20.8 billion carved out as incentive payments to those who adopt and “meaningfully use” electronic health records (EHRs). Many EHRs include portals which allow patients to access a slice of their personal health information.

February is American Heart Month. The month also features Eating Disorders Awareness Week, Duchenne Muscular Dystrophy Awareness, and National Condom Week. It also feels like mobile health month. I’ll be speaking three times this month at meetings featuring mobile health themes, in very different venues. On February 8, the Health|Tech|Food event will be held at the Paley Center for Media in New York City as part of Social Media Week. I’ll set the stage at the meeting for mobile health, sharing my perspective on the role of social media and mobile health, and how together these can combine to address health

Women’s #1 priority is health and wellness. Wellness means taking care of herself, based on a survey of women by Saatchi Wellness.  Women are coming out of the recession with the modus operandi of a “me-covery,” according to Saatchi Wellness’s read on women’s attitudes about the economy’s impact on their wellbeing and health priorities among 800 women polled online in August 2010. The 5 elements of the “me-covery” for women are: To eat right. This doesn’t mean “diet;” it’s striking a balance and buying healthier, and more organic, food. People most negatively impacted by the economy are buying less fast food. To

While 8 in 10 U.S. adults want a physician to have primary responsibility for the diagnosis and management of their health care, many people are not sure who’s a medical doctor. Surprisingly numbers of health consumers don’t think that orthopaedic surgeons, family practitioners, dermatologists, psychiatrists, and ophthalmologists are MDs. The American Medical Association‘s survey, Truth in Advertising, published in January 2011, follows up the AMA’s 2008 survey which had similar results.  Data based on consumers answering the question, “Is this person a medical doctor,” are organized in the chart. 90% of people say that a physician’s additional years of medical education

An Explanation of Benefits (EOB) came in the U.S. mail yesterday. A plain piece of white 8.5″ x 11″ printed in tiny font with black ink, the logo of my health insurance company in the upper left of the form, and several lines of words and numbers showing me names of providers and facilities, dollar amounts billed, dollar amounts discounted, dollar amounts paid to the providers, and dollar amounts that were the patient’s responsibility — that would be me. The procedure was for a colonoscopy, for preventive screening and base lining for future reference. The good news: my colon looks just fine, and I’ll be reminded

If you don’t speak French and/or have aging eyesight, you might not understand the label on the medicine in the photo. When someone doesn’t understand the label placed on their prescription drug, they’re in a compromising position: this lowers health literacy and potentially endangers peoples’ health. As I monitor the tweets from today’s meeting of the Business Development Institute’s (BDI) Mobile Healthcare Communications conference, covering statistics and case studies about who’s using smartphones for accessing health information and how pharmaceutical companies can bolster adherence by developing mobile health apps, I’m struck by an important story in the health news that won’t get much coverage because it’s not about

Caregivers identify the most helpful technologies that benefit them in providing care to family and friends as personal health record tracking, medication support, caregiving coordination, and monitoring and transmitting symptoms. These technologies are seen to help caregivers save time, make caregiving logistically easier, make the care recipient feel safer, reduce stress and enhance feelings of being effective. The most formidable obstacle preventing caregivers from adopting beneficial technologies is cost, followed by the technology not addressing the caregiver’s most pressing challenges, care recipient resistance to using the device, privacy issues, diminishing the care recipient’s sense of independence and pride. The National Alliance

1 in 2 people who use the internet to seek health information do so to self-diagnose; this is highest in China, US, UK, Russia, and Australia. Furthermore, health citizens in emerging economies including India, Russia, China, Brazil, and Mexico, may rely more on online health searches than people in developed countries. In these regions, health seekers face high costs of face-to-face visits with medical professionals. These global findings come out of the report, Online Health: Untangling the Web, from Bupa. Bupa is a health company based in the UK that serves 10 million members in 190 countries, and another 20 million

Target, fondly known as “Tar-zhay“ in my home, won the Design of the Decade award from the Industrial Designers Society of America for the innovation called ClearRx — a pill bottle. While a pill bottle might seem to be a commoditized sort of item, this bottle was designed to prevent medication mistakes committed by patients who take maintenance medications for chronic conditions. The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) defines medication errors as preventable events that can cause or lead to inappropriate medication use or patient harm while the medication is in hands of patients or providers. The Institute of Medicine estimated that

Exactly one year ago, health care companies, online portals (from Google to health advocacy sites), and advertising agencies serving the health industry convened in Washington, DC, to voice their positions to the Food & Drug Administration (FDA) concerning pharmaceutical promotion and social media. It was such a monumental meeting that a tweetstream was initiated at the event that has been ongoing for the past year at #FDASM on Twitter. Why would hundreds of individuals collectively spend thousands of hours airing their arguments, pro and con, on the issue of how pharmaceutical companies promote their products and services online? “The drug industry