A blog covering the health/care ecosystem and people.

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

Health care costs cause anxiety for U.S. adults, regardless of their affluence, we learn in Uncertainty About Healthcare, the latest Stress in America poll from the American Psychological Association. The big stat is that 2 in 3 Americans say the cost of health insurance is a stressor for them or their loved ones, whether the person earns more or less than $50,000 a year. Underneath that top-line are some demographic differences. Millennials are most concerned about access to mental health care compared with Boomers and older adults. Reproductive care access is of most interest to Millennials and Gen Xers. Two-thirds

On this day appreciating the legacy of Martin Luther King, Jr., I post a photo of him in my hometown of Detroit in 1963, giving a preliminary version of the “I Have a Dream” speech he would deliver two months later in Washington, DC. Wisdom from the speech: “But now more than ever before, America is forced to grapple with this problem, for the shape of the world today does not afford us the luxury of an anemic democracy. The price that this nation must pay for the continued oppression and exploitation of the Negro or any other minority group

Patients’ health consumer muscles continue to get a work out as more people enroll in high-deductible health plans and face sticker shock for health insurance premiums, prescription drug costs, and that thousand-dollar threshold. The 2017 Alegeus Healthcare Consumerism Index finds growth in patients’, now consumers’, interest and competence in becoming disciplined about planning, saving, and spending for healthcare. Overall, the healthcare spending index hit 60.1 in 2017, up from 54.4 in 2016. This is a macro benchmark that represents most consumers exhibiting greater healthcare spending engagement with eyes on cost as well as adopting purchasing behaviors for healthcare. Underneath that

While more U.S. patients are use digital health tools and take on more clinical and financial decision making for their health care, people also have gaps in health engagement and health literacy. Three studies published in early October 2017 provide insights into the state of healthcare consumerism in America. The 2017 UnitedHealthcare Consumer Sentiment Survey found that a plurality of Americans (45%) turn first to primary care providers (doctors or nurses) as their source for the first source of information about specific health symptoms, conditions or diseases. 28% of people also use the internet or mobile health apps as their

2 in 3 Americans get news via social media, according to News Use Across Social Media Platforms 2017 from the Pew Research Center. One in 5 people get news “often” from social media, shown in the first chart. The growth of people accessing news via social media, overall, hasn’t dramatically grown in the year since 2016. But underneath that fairly flat trend is some important movement to note by demographic cohort, which has implications for health/healthcare marketing: 55% of people 50 and over are social media news consumers (8 in 10 people under 50 are) Nonwhites are more likely than whites

Three-quarters of patients’ decisions on whether to seek services from healthcare providers are impacted by high deductible health plans. This impacts the finances of both patients and providers: 56% of patients’ payments to healthcare providers are delayed some of the time, noted in Optimizing Revenue: Solving Healthcare’s Revenue Cycle Challenges Using Technology Enabled Communications, published today by West. Underneath that 56% of patients delaying payments, 12% say they “always delay” payment, and 16% say they “frequently delay” payment. West engaged Kelton Global to survey 1,010 U.S. adults 18 and over along with 236 healthcare providers to gauge their experiences with

        Between 2012 and 2017, the number of US consumers who shopped online for health insurance grew by three times, from 14% to 42%, according to a survey from Connecture. Cost first, then “keeping my doctor,” are the two top considerations when shopping for health insurance. 71% of consumers would consider switching their doctor(s) to save on plan costs. Beyond clinician cost, health plans shoppers are also concerned with prescription drug costs in supporting their decisions. 80% of consumers would be willing to talk with their doctors about prescription drug alternatives, looking for a balance between convenience

I quote directly from the Twitter feed of Anthony Scaramucci, @scaramucci: “@dhank2525 agree. We already have Univ Health Care, we made decision long ago to treat everyone that enters an emergency room.” Mr. Scaramucci is President Trump’s Communications Chief, replacing Sean Spicer. Mr. Scaramucci is neither veteran journalist nor healthcare policy wonk. He’s a successful businessman, which I respect for his savvy and ability to build a fund, attract investors, and create a media persona which he has telegenically broadcast on CNBC and elsewhere over the past decade. He’s got a engaging public personality, and goes by the moniker, “Mooch.” But

“Constipation is hard. Talking about it is even harder,” reads a card I received from the senior director of marketing at Synergy Pharmaceuticals. Emojis-meet-direct-to-consumer pharmaceutical promotion in a new campaign from the drug company, which is embarking on a disease education campaign to bring greater awareness to the condition of chronic idiopathic constipation (CIC). This condition impacts 14% of the global population. The messengers for this effort are a cast of emojis who populate a continuum from constipation-to-diarrhea and every poop step in-between. Meet The Poop Troop: Stressed-Out Stooly Clogged Chris Left-Out Lumpy Plugged-Up Paulie Miss La Poop Mr. Smooth Sausage Sally

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

Former Surgeon General Dr. Regina Benjamin was the first person who quoted to me, “Health isn’t in the doctor’s office. It’s where people live, work, play and pray,” imparting that transformational mantra to me in her 2011 interview with the Los Angeles Times. I wrote about that lightbulb moment here in Health Populi. Dr. Benjamin was the 18th Surgeon General, appointed by President Obama in 2009. As “America’s Doctor,” she served a four-year term, her mission focused on health disparities, prevention, rual health, and children’s health. Today, Dr. Benjamin wears many hats: she’s the Times Picayune/NOLA.com professor of medicine at

Just as consumers use TripAdvisor, Zagat, OpenTable, and their Facebook pages to review restaurants, hotels, automobiles, and financial services companies, many patients – now health consumers in earnest – have taken to reviewing healthcare services in social networks. Finding reliable, understandable information about healthcare quality and prices is very challenging for most consumers. Are healthcare reviews on social networks statistically valid? An analysis of consumer ratings for New York State hospitals on Yelp, the social network, were positively correlated to objective scores of hospital quality, according to the research published in Yelp for Health: Using the Wisdom of Crowds to

The future of wellness combines: Connected (you) Social IRL (in-real-life) Banishing bad (de-tabooing what’s traditionally seen as “bad”) Humanizing data, and The end of experts. These insights come from adidas, whose team developed a forecast of the future of fit, announced at the 2017 South-by-Southwest Festival in Austin this weekend. I had the honor of participating in this forecast and shepherding the SXSW panel on The End of Experts: Crowdsourcing Your Wellness at the adidas meet-up held over the weekend. The future of fit and wellness is Connected, because we are growing to understand that balancing many elements in our daily

Among many health disparities which mar healthcare quality in the United States, there’s another one to add to the list: health and healthcare information access. Access to health care is underpinned in large part on a health consumer’s access to information about available health care services, their location, price, and if the patient is very fortunate to glean, quality. As people take on more responsibility for managing their health care utilization and financing in America, their access to information that is easy-to-find, clear, comprehensive and current is critical to personal and public health outcomes. But consumers are dissatisfied with the

Nine in 10 U.S. consumers think pharma and biotech put profits above patient interests, according to the latest Harris Poll studying reputation equity across organizations serving health care. Notice the relatively low position of the green bars in the first chart (with the exception of the impression for “strong financial performance); these are the pharma/biotech consumer impressions. The health industry stakeholders consumers believe would more likely place them above making money are health care providers, like doctors and nurses, hospitals, and pharmacists. Health insurance companies fare somewhat better than pharma and biotech in this Poll, although rank low on social

Digital health innovations were fast-proliferating at CES 2017. The bad news is there are so many of them, it’s dizzying and fragmented. The good news is that there are emerging health data ecosystems that will streamline consumers’ user experience so that people can derive knowledge, actionable advice and value out of using these tools. Walking miles of aisles in the Sands Convention Center in the first week of January 2017 can be a dizzying prospect, with hype and best-faces-forward in every single exhibitor at the show. In the health segment at CES, there’s a long list of digital tools to

For the first time since 1993, expanding life expectancy in the United States has reversed, based on the latest report from the Centers for Disease Control, Mortality in the United States, 2015. “The last time U.S. life expectancy at birth declined was in 1993, when it dropped from 75.6 to 75.4, according to World Bank data,” as quoted in the Washington Post. Life expectancy at birth in 2015 was 78.8 years, a slight fall from 2014 at 78.9 years. The larger decline fell among men, from 76.5 to 76.3 years. For women, life expectancy at birth in 2015 was 81.2,

“Thanksgiving.” Merriam-Webster’s dictionary defines the word, first, as “the act of giving thanks.” Second, it’s “a prayer of expressing gratitude.” And, third, the word means a public acknowledgment or celebration of divine goodness. We each have our stories about how a loved one’s life has ended. If we’re lucky, that beloved person had a good death: in sleep, perhaps, or simply of old age with no hospital events or trauma. Then there are the Rest-of-Us who have the stories of long and painful endings, in institutional settings and costly, futile care. When you’re already in the situation of making tough health

While American workers appreciate the benefits they receive at work, people are concerned about health care costs. And consumers’ collective response to rising health care costs is changing the way they use health care services and products, like prescription drugs. Furthermore, 6 in 10 U.S. health citizens rank healthcare as poor (27%) or fair (33%). This sober profile on healthcare consumers emerges out of survey research conducted by EBRI (the Employee Benefit Research Institute), analyzed in the report Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and

Here’s a new definition of “wearable” that’s Old School stuff: a baby onesie. But this onesie doesn’t just look cute and keep baby’s bum warm. The onesie helps teach caregivers baby CPR. This health education project was sponsored by Tesco in collaboration with St. John Ambulance, one of the largest health charities in the United Kingdom. Tesco ranks among the biggest retailers in the world (after Walmart, Costco, Kroger, and Lidl), operating in the UK, Ireland, Asia and Europe. Watch this video and get charmed by adorable, telegenic Baby Lucy – your CPR model. Tesco held live CPR classes at over

“In the developed world, patient disengagement has become the new killer disease — not the lack of diagnostic devices, trained physicians or efficacious treatment options,” argues Andrea LaFountain, PhD, in her book, How Patients Think. Disbanding prescription drugs in advance of doctors’ instructions, postponing lab and diagnostic tests, and avoiding daily blood glucose testing when managing diabetes are just some examples of “how patients think” about health care and the many tasks involved in caring for oneself and the health of loved ones. But better understanding how patients think — technically speaking, the cognitive neuropsychology underneath the thinking — can

As consumers gain more financial skin in the game of paying for health care, we look for more retail-like experiences that reflect the Burger King approach to consuming: having it our way. For health are, that means access, convenience, transparency and fair costs, respect for our time, and a clear value proposition for services rendered. That doesn’t happen so much in the legacy health care system — in hospitals and doctors’ offices. It has already begun to happen in retail health settings and, especially, in the changing nature of pharmacies. Retail Health 2027, a special supplement to Drug Store News

The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016. The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable

“Work is the second most common source of stress, just behind financial worries,” introduces The Business of Healthy Employees report from Virgin Pulse, the company’s 2016 survey of workplace health priorities published this week. Virgin Pulse collaborated with Workforce magazine, polling 908 employers and 1,818 employees about employer-sponsored health care, workers’ health habits, and wellness benefit trends. Workplace wellness programs are becoming more holistic, integrating a traditional physical wellness focus with mental, social, emotional and financial dimensions for 3 in 4 employers. Wearable technology is playing a growing role in the benefit package and companies’ cultures of health, as well

Technology alone won’t improve health care in America, especially in people with chronic health problems don’t want to use it. Furthermore, too many clinicians who have invested in digital health technologies (namely, electronic health records systems), aren’t fully taking advantage of what they have. This and other health care realities are explored in Better Together: Patient Expectations and the Accountability Gap, based on a consumer survey conducted by Nielsen Strategic Health Perspectives for the Council of Accountable Physician Practices, an affiliate of the American Medical Group Foundation. The survey polled 30,007 consumers in March 2016, and combined physician data culled from Nielsen’s

The top award at the annual Cannes Lions International Festival of Creativity for best pharmaceutical advertising campaign went to Philips, the company that’s placing a big corporate bet on digital health.  The campaign was called Breathless Choir, and it left me, well, breathless (in a good way). Watch it now. This is how health/care advertising should be done. This inspires health and patient engagement, social connections, and sound self-care principles. Evidence shows that singing in the right way can bolster lung capacity — just what these patients, all dealing with some sort of respiratory condition, must do to enhance their quality

“Health comes to your local store,” explains the recently-launched portal, GoHealthEvents. This site is a one-stop shop for health consumers who are seeking health screenings and consults in local retail channels like big box stores, club stores, drug stores, and grocery stores. Events covered include cholesterol, diabetes, heart health, nutrition, osteoporosis, senior health, vaccinations and immunizations. By simply submitting a zip code, a health consumer seeking these kinds of services can identify where and when a local retailer will provide it. I searched on my own zip code in suburban Philadelphia, and found the following opportunities taking place in the

The top reason people in America over 50 don’t fill a prescription is the cost of the drug, according to the AARP 2015 Survey on Prescription Drugs. Eight in 10 people 50+ think the cost of prescription drugs is too high, and 4 in 10 are concerned about their ability to afford their medications. Thus, nearly all people over 50 think it’s important for politicians (especially presidential candidates) to control Rx drug costs. Older consumers are connecting dots between the cost of their medications and direct-to-consumer prescription drug advertising: 88% of the 50+ population who have seen or heard drug

Older workers and retirees in the U.S. are most pleased with their healthcare experiences and have the fewest problems accessing  services and benefits. But, “younger workers [are] least comfortable navigating U.S. healthcare system,” which is the title of a press release summarizing results of a survey conducted among 1,536 U.S. adults by the Harris Poll for Accolade in September 2015. Results of this Accolade Consumer Healthcare Experience Index poll were published on April 12, 2016. Accolade, a healthcare concierge company serving employers, insurers and health systems, studied the experiences of people covered by health insurance to learn about the differences across age

April 7 is World Health Day, and the World Health Organization (WHO) has named #diabetes the big public health challenge for 2016. What’s striking about this year’s World Health Day is the “Stay Super” public health ad campaign that WHO has developed featuring figures of super-people. THINK: Superman and Wonderwoman meet Doctors Welby, Kildare, and McDreamy. I’ve included several of the posters in the blog today to show how engaging health messaging works well when it works. The materials can be downloaded at this link. This week also saw the publication of America’s Health Rankings, spotlighting the impact of unhealthy behaviors.

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

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

By 2020, according to the World Economic Forum, more than 5 billion people and 30 billion “things” will be connected to the Internet — cars, refrigerators, TVs, washing machines and coffeemakers, among those 5 bn folks’ electronic stuff. But so will medical devices, activity trackers, and a host of sensor-enabled “things” to help people and clinicians optimize health and manage illness. The Internet of Things (IoT) phenomenon, which is already penetrating households with energy management and security applications, is reaching health care. One of the pioneers in this connected health market is Dr. Joseph Kvedar, who leads the Center for

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

A growing desire for shared decision making with doctors. Increasing trust and consumption of health care information online, in social media, and report cards. Reliance on technology for monitoring health adn wellness, and medical conditions. Together, these three signals converge, illustrating a growing sense of consumer engagement among U.S. patients, found in the 2015 Deloitte Center for Health Solutions Survey of US Health Care Consumers. In Deloitte’s research summary, the title states that “No ‘one-size-fits-all’ approach” will work, given diversity among American health consumers. The sickest health consumers, Deloitte notes, have higher levels of health engagement and index higher on

When most patients in the U.S. visit their doctors, they find their medical history missing or incomplete. 1 in 2 American patients say their doctors do not have a complete list of their medications. But the new health consumer expects a connected health experience the likes of which, as consumers, they expect and generally find in their everyday lives. One-half of consumers would prefer to get lab test results, access their medical records, and fill out paperwork from a doctor’s office ahead of a visit online versus via phone or in person. Surescripts conducted a survey with Kelton Global in

‘Tis the summer of big, smart reports covering the Internet of Things (IoT) impact on health and fitness. Just this month, three of these missives have come to my inbox, and they all contribute sound thinking about the topic. Today, tomorrow and Friday, I’ll cover each of these here in Health Populi. We begin with McKinsey Global Institute’s The Internet of Things: Mapping the Value Beyond the Hype. [In full disclosure, I was an outside adviser to the MGI team members who focused on the human/health and fitness aspects of this report, and thank MGI for the opportunity to provide

May 31st is World No Tobacco Day, heralded by the World Health Organization, and celebrated by the advocacy group Action on Smoking and Health (with the very appropriate acronym ASH). Smoking is one of the most addictive (anti-)health behaviors around, so persuading people to quit the habit continues to challenge public health advocates. Enter ASH’s engaging campaign called “The Wrinkler,” with the introductory question, “Ever notice how some people who are 25 look 45?” The video continues to explain how we can “expedite the aging process….Ladies, wish you were half your age? Don’t wait for him to look younger; make yourself

Health care consumers face a fragmented and complicated payment landscape after receiving services from hospitals and doctors, and paying for insurance coverage. People want to “view their bills, make a few clicks, pay…and be done,” according to Jamie Kresberg, product manager at Citi Retail Services, a unit of Citibank. He’s quoted in Money Matters: Billing and payment for a New Health Economy from PwC’s Health Research Institute. The healthcare service segment most consumers are satisfied with when it comes to billing and payment is pharmacies, who score well on convenience, affordability, reliability, and seamless transactions – with only transparency being

Bruce Broussard, CEO of Humana, forgot the charger for his smartwatch on a business trip. Stopping into a consumer electronics store, he was struck by the options he faced of various wearable technologies. He ended up buying a new watch, which he uses for exercise tracking. “Technology is such an important part of the direction of health care,” Broussard told the HIMSS 2015 audience in his keynote address on 14 April 2015. But Broussard was quick to point out to the thousands of technology geeks that comprise HIMSS’s membership that improving the health/care system isn’t just about technology: “we have

This was not a theoretical question Dr. Farzad Mostashari, former head of the Office of the National Coordinator of Health IT in the Department of Health and Human Services, asked yesterday at the closing keynote of Day 1 of the Patient Engagement Forum. Dr. Mostashari issued a challenged to the community of mischief-makers in health/tech patient advocacy: tell everyone you know to contact their doctors — by phone, email, patient portal, or in-person, on one designated day which he called a “Day of Action.” Health IT journalist Neil Versel (disclosure: also a long-time friend in the field) covered this news

There’s a trifecta of books written by three brilliant doctors that, together, provide a roadmap for the 21st century continuum of health care: The Patient Will See You Now by Eric Topol, MD; The Digital Doctor from Robert Wachter, MD; and, Being Mortal, by Atul Gawande. Each book’s take provides a lens, through the eyes of a hands-on healthcare provider, on healthcare delivery today (the good, the warts and all) and solutions based on their unique points-of-view. This triple-review will move, purposefully, from the digitally, technology optimistic “Gutenberg moment” for democratizing medicine per Dr. Topol, to the end-game importance of

While shopping is a life sport, and even therapeutic for some, there’s one product that’s not universally attracting shoppers: health insurance. McKinsey’s Center for U.S. Health System Reform studied people who were qualified to go health insurance shopping for plans in 2015, covered by the Affordable Care Act. McKinsey’s consumer research identified six segments of health insurance plan shoppers — and non-shoppers — including 4 cohorts of insured and 2 of uninsured people. The insureds include: Newly-insured people, who didn’t enroll in health plans in 2014 but did so in 2015 Renewers, who purchased health insurance in both 2014 and

2 in 3 people in the U.S. would use a mobile app to manage their health, especially for diet and nutrition, medication reminders, tracking symptoms, and recording physical activity. The fifth annual Pulse of Online Health survey from Makovsky finds that digital health is blurring into peoples’ everyday lives. We’ve covered previous Makovsky digital health surveys here on Health Populi; last year, we focused on consumers managing risk in digital health platforms, and in 2013, the state of seeking health information online. That most consumers would go beyond health information search to the more engaging pursuit of managing health over

Offering wellness programs is universal among U.S. employers, who roughly divide in half regarding their rationale for doing so: about one-half offer wellness initiatives to invest in and increase worker health engagement, and one-half to control or reduce health care costs. Two-thirds of companies offering wellness will increase their budgets, according to the International Foundation of Employee Benefit Plans (IFEBP)  report, Workplace Wellness Trends, 2015 survey results. The IFEBP polled 479 employers in October 2014, covering corporate, public, and multi-employer funds in the U.S. and Canada. The statistics discussed in this post refer solely to U.S. organizations included in the study

Long an advocate for consumer-directed health in his company, John Mackey, co-CEO and co-Founder of Whole Foods Market, is talking about expanding the food chain’s footprint in retail health. “Americans are sick of being sick,” Mackey is quoted in “Whole Foods, Half Off,” a story published in Bloomberg on January 29, 2015. Mackey talks about being inspired by Harris Rosen, a CEO in Florida, who has developed a workplace clinic for employees’ health care that drives high quality, good outcomes, and lower costs. Mackey imagines how Whole Foods could do the same, beginning in its hometown in Austin, TX. He

“Health care spending grows at lowest-ever rate,” USA Today celebrated in their December 3, 2014 headline. The announcement was drawn from national health spending data gleaned from an annual report from the Centers for Medicare and Medicare Services (CMS), which tallied U.S. health spending at $2.9 trillion. From the bird’s-eye view, slowing healthcare cost growth is indeed good news. But from the point-of-view of consumers’ own pockets, health care costs are rising. And, a survey published today by Gallup points to this reality: that people in American say the most important financial problem they face is healthcare costs, tied for first place

People with more financial skin in the health care game are more likely to act more cost-consciously, according to the latest Employee Benefits Research Institute (EBRI) poll on health engagement, Findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey published in December 2014. Health benefit consultants introduced consumer-directed health plans, assuming that health plan members would instantly morph in to health care consumers, seeking out information about health services and self-advocating for right-priced and right-sized health services. However, this wasn’t the case in the early era of CDHPs. Information about the cost and quality of health care services was scant,