A blog covering the health/care ecosystem and people.

“Shouldn’t we, as a society, demand a nutrition label on our algorithms?” asked Dr. John Halamka. Dr. Halamka, President of the Mayo Clinic Platform, was speaking at the HIMSS 2021 annual conference on the meeting’s digital channel. Artificial intelligence and health equity were two key themes discussed during #HIMSS21, and Dr. Halamka’s concerns echoed through the week-long event. To illustrate the need for a healthier approach to AI, he offered this scenario: “If I use a data set of one million Scandinavian Lutherans to create the most amazing EKG algorithm ever and then we decide to use it in Spain,

Financial Experience (let’s call it FX) is the next big thing in the world of patient experience and health care. Patients, as health consumers, have taken on more of the financial risk for health care payments. The growth of high-deductible health plans as well as people paying more out-of-pocket exposes patients’ wallets in ways that implore the health care industry to serve up a better retail experience for patients. But that just isn’t happening. One of the challenges has been price transparency, which is the central premise of this weekend’s New York Times research-rich article by reporters Sarah Kliff and

The rise of digital health investment and growing role of technology in health care services only accelerated during the COVID-19 pandemic. At the same time, people took on their own versions of digital transformation at home, for work, for school, for cooking, shopping, and indeed, for health care. But with digital health adoption gains has come some ambivalence and mixed signals, Accenture has discovered in its 2021 Health and life Sciences Experiences Survey released this week during the HIMSS Annual Conference. As the report concludes, “people’s sentiments and behaviors” with respect to technology in health care “provide no clear answer.”

“What if…healthcare happened where we live, work, play, pray and shop, delivering the highest levels of retail experience?” I asked and answered in my book HealthConsuming: From Health Consumer to Health Citizen. The chapter called “The new retail health” began with that “what if,” and much of the book responded with the explanation of patients evolving toward health consumers and, ultimately, health citizens empowered and owning their health and care. This week, Dollar General announced the hiring of its first Chief Medical Officer, Dr. Albert Wu. With that announcement, America’s largest dollar-store chain makes clear its ambitions to join a

Post-pandemic, the consumer’s priority purchases are grocery, nesting, and health, according to David Shah, a leading thinker about social and design trends. David presented the latest Pantone forecast on color and society in NewTopia – A Balance of Color Opposites – Color for a Post-COVID World this week. I had the opportunity to attend the session, and want to share the health and wellness-related insights David shared in his fast-paced view on the role of color in bolstering wellbeing and community looking out to 2022/23. For context, Pantone plays a role in your life you might not realize. In health

Trust in the technology industry has crashed to an all-time low based on the 2021 Edelman Trust Barometer. As Richard Edelman, CEO, concisely asserted, “Tech loses its halo.” The first chart shows the one-year trend on trust across industries through U.S. consumers’ eyes. Most industries lost citizens’ trust between 2020 and 2021, most notably, Technology, dropping the greatest margin at 9 points Retail, falling 7 points, Entertainment. falling 5 points, and, Fashion and automotive declining by 4 points. Several sectors’ trust equity rose in the year, especially healthcare growing by 8 points and food and beverage rose slightly by 2

A major side-effect of the coronavirus pandemic in 2020 was its impact on the national U.S. economy, jobs, and peoples’ household finances — in particular, medical spending. In 2021, patients-as-health-consumers seek lower health care and prescription drug costs coupled with higher quality care, discovered by the patient advocacy coalition, Consumers for Quality Care. This broad-spanning patient coalition includes the AIMED Alliance, Autism Speaks, the Black AIDS Institute, Black Women’s Health Initiative, Center Forward, Consumer Action. Fair Foundation, First Focus, Global Liver Institute, Hydrocephalus Association, LULAC, MANA (a Latina advocacy organization), Myositis Association, National Consumers League, National Health IT Collaborative, National Hispanic

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

Seven in 10 U.S. adults are willing to be vaccinated, and they’re not happy about the process in getting their jab, according to Gallup’s poll taken in the last week of January 2021. The proportion of Americans willing to receive a COVID-19 vaccine has steadily grown since October 2020, which fell to a mere 50% of folks keen to get the shot. That percentage has risen to 71% as of February 1 2021, as the first line chart shows the reversal in public embrace for vaccination against the coronavirus. Now that most people in the U.S. welcome the opportunity to

Citizens around the world unite around the concept that Trust is Dead. This is no truer than in the U.S., where trust in every type of organization and expert has plummeted in the wake of the COVID-19 pandemic, political and social strife, and an economic downturn. Welcome to the sobering 2021 Edelman Trust Barometer, released this week as the world’s technology innovators and analysts are convening at CES 2021, and the annual JP Morgan Healthcare meetup virtually convened. As the World Economic Forum succinctly put the situation, “2020 was the year of two equally destructive viruses: the pandemic and the

The first year of the coronavirus pandemic in America was a kind of stress test on the U.S. health care system, revealing weak links and opportunities for bad behavior. “These are not just about individual instances or bad apples,” Dr. Vikas Saini, President of The Lown Institute, explained, referring to them as “cautionary tales” of the current state of U.S. health care. Dr. Saini and his colleague Shannon Brownlee released the annual Lown Institute 2020 Shkreli Awards this week, highlighting their ten most egregious examples of the worst events in U.S. health care that happened in the past year —

From appointment scheduling to checking in, payment and clinical encounter follow-up, patients now expect digital experiences across the health care continuum….and really great ones, like they get from Amazon and other platforms that earn high net promoter scores. That is the big message from the 2020 Healthcare Consumer Experience Study published by Cedar, based on the input of 1,502 U.S. adults who paid a medical bill between October 2019 and October 2020. The timing of this study coincided with the start of the COVID-19 pandemic in the U.S. through at least seven months of American patients’ experiences in 2020. Two-thirds

In the wake of the coronavirus pandemic, women have experienced more than the direct physical, clinical impact of COVID-19: beyond “lives,” women’s livelihoods, financial health and emotional well-being have been hard-hit. This is true on both a global basis as well as in the United States. In that context, last week I engaged in a fascinating conversation with Varsha Rao, CEO of Nurx, to discuss the current state of women and health/care in America, and some thoughts about the future. If you’ve had the TV on sometime since March 2020, one of many millions of people in the U.S. spending

As the COVID-19 pandemic emerged in the U.S., Americans were already Primed for ecommerce — even in health care. The coronavirus accelerated the digital transformation on people as consumers — and consumers as health consumers. Today, Amazon announced the company’s launch of Amazon Pharmacy. Watch for earth-shaking (negative) impacts on the incumbent pharmacies like CVS, Rite-Aid, Walgreens, as well as discount and ecommerce players such as GoodRx. [Sidebar: as of 10 am this morning, the announcement “sunk” the retail pharmacy stocks, according to TheStreet.com]. Some context: this announcement builds on Amazon’s previous major move into pharmacy with its acquisition of

Over one-half of Americans would likely use virtual care for their healthcare services, and one in four people would actually prefer a virtual relationship with a primary care physician, according to the fifth annual 2020 Consumer Sentiment Survey from UnitedHealthcare. What a difference a pandemic can make in accelerating patients’ adoption of digital health tools. This survey was conducted in mid-September 2020, and so the results demonstrate U.S. health consumers’ growing digital health “muscles” in the form of demand and confidence in using virtual care. One in four people would consider online options as their first-line to evaluating personal health

In the first six months of the COVID-19 pandemic, telehealth was a “bright spot in the ‘new normal,’” according to a report from J.D. Power, Telehealth Patient Satisfaction Surges During Pandemic but Barriers to Access Persist. But as the report’s title asserts, most telehealth users experienced obstacles to accessing and using virtual care platforms that drove less positive consumer experiences. Overall, the telehealth segment achieved a higher consumer satisfaction score (860 points out of 1,000) than other sectors J.D. Power has studied including health insurance, insurance and financial services. J.D. Power assessed two categories of telehealth vendors: direct-to-consumer (DTC) and

The COVID-19 pandemic hastened digital transformation for both the health care industry and for individuals — as health consumers, patients, caregivers, and health citizens. Two new reports from Accenture update our understanding of the changed health consumer in the context of both “home: and the health care ecosystem. These reports are Accenture’s annual Digital Health Technology Vision 2020, and an analysis of the firm’s Wave 7 of consumer research, answering the question, How will COVID-19 change the consumer? The 2020 tech vision for health is summarized here, tying to Accenture’s previous two years of forecasts. This year, the five pillars

Nine in ten Americans is concerned about the price of prescription drugs in the wake of the coronavirus pandemic, Gallup and West Health found in their survey on the cost of healthcare, published today. A majority of people across political party share this concern: overall, 88% of U.S. adults are concerned about rising drug prices in response to COVID19, split across party ID with: 94% of Democrats, 86% of Independents, and 84% of Republicans. By demographics, more women than men are concerned about rising costs for the three health care spending categories the survey studied: drug prices, insurance premiums, and

Millions of dollars and developers’ time have been invested in conceiving and making digital health tools. Yet with that bullish supply side of digital health,  there was a marked decline in peoples’ use of them in the past two years, found by Accenture in their latest health consumer survey, Digital is Transforming Health, So Why is Consumer Adoption Stalling? Use of mobile apps to track personal health activity fell from nearly 1 in 2 consumers to 1 in 3. Use of wearable tech nearly halved, from 33% to 18%, between 2018 and 2020. Some, but not necessarily a majority, of

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

The topline of this year’s annual Gallup Poll into honesty and ethics of professions finds nurses sustaining their reign as the top trusted profession in America. But it’s also important to point out that four of the top five most ethical professions are people working on the front lines of health care: doctors (#3), pharmacists (#4) and dentists (#5). Engineers rank second this year after nurses, edging ahead of doctors and pharmacists who typically have ranked 2nd and 3rd each year in the past decade. One of these years, pharmacists’ reputation fell as the profession was associated with being a

Today is Day 1 of two Media Days at #CES2020 in Las Vegas, kicking off this manic week of the Consumer Electronics Show at the Mandalay Bay convention center. For several years, I’ve convened with journalists and industry analysts from around the world for these two days before the “official” opening of CES to hear the latest news from some of the largest tech-focused companies on Earth. Announcements come from across industry sector — from automotive and transportation, telecoms, consumer goods, entertainment, social media, travel, and retail…with platform technologies playing a role including but not limited to AI, AR/VR/XR (the

While customer satisfaction with health insurance plans slightly increased between 2018 and 2019, patient satisfaction with hospitals fell in all three settings where care is delivered — inpatient, outpatient, and the emergency room, according to the 2018-2019 ACSI Finance, Insurance and Health Care Report. ACSI polls about 300,000 U.S. consumers each year to gauge satisfaction with over 400 companies in 46 industries. For historic trends, you can check out my coverage of the 2014 version of this study here in Health Populi. The 2019 ACSI report bundles finance/banks, insurance (property/casualty, life and health) and hospitals together in one document. Health

“Google’s ‘Project Nightingale’ Gathers Personal Health Data on Millions of Americans,” the Wall Street Journal reported in today’s paper and on the WSJ.com website. The story started with the scenario that, “Search giant is amassing health records from Ascension facilities in 21 states; patients not yet informed.” Here’s Ascension’s press release on the collaboration, described in the title as “healthcare transformation.” Note: this release was written after the Wall Street Journal published this story. And, according to the WSJ reporting, “Neither patients nor doctors have been notified. At least 150 Google employees already have access to much of the data

Health and our health information are deeply personal. Changing health care and inspiring positive health behaviors is hard to do. But we must and we will, a group of inspiring and inspired people who work across the health/care ecosystem affirmed this week in Dallas at the conference of Medecision Liberation 2019. I was engaged at this conference to wear several hats — as a keynote speaker, a sort of “emcee,” and, finally, to trend-weave the many talks and discussions happening throughout the meeting. This post is my synthesis of the summary I delivered live at the end of the conference,

Patients’ experiences with the health care industry fall short of their interactions with other industries — namely online retail, online banking and online travel, a new survey from Cedar, a payments company, learned. Survata conducted the study for Cedar among 1,607 online U.S. consumers age 18 and over in August and September 2019. These study respondents had also visited a doctor or hospital and paid a medical bill in the past year. One-third of these patients had a health care bill go to collections in the past year, according to Cedar’s 2019 U.S. Healthcare Consumer Experience Study. Among those people

As patients have taken on more financial responsibility for first-dollar costs in high-deductible health plans and medical bills, hospitals and health care providers face growing fiscal pressures for late payments and bad debt. Those financial pressures are on both sides of the health care payment transaction, stressing patients-as-payors and health care financial managers alike. I’m speaking to health industry stakeholders on patients-as-payors at Cerner’s Now/Next conference today about the patient-as-payor, a person primed for engagement. That’s as in “Amazon-Primed,” which patients in their consumer lives now use as their retail experience benchmark. But consumers-as-patients don’t feel like health care today

“We knew millions of people weren’t getting the care they needed — they were either too embarrassed to seek help or felt stuck in a system that was confusing and intimidating. Digital health has the potential to radically change the way people approach their wellness and, since launching in 2017, we’ve outpaced even our own expectations, delivering more than 1 million Hims & Hers products to our customers. In collaboration with highly-qualified doctors and healthcare providers, we’ve built a digital health platform that is changing the way people talk about and receive the care they need.” That’s  a verbatim paragraph

Four in ten U.S. patients said the state of the economy changes how often they seek health care, according to a new study from TransUnion, the credit agency that operates in the health care finance space. Nearly two-thirds of patients said that knowing their out-of-pocket expenses in advance of receiving health care services influenced the likelihood of their seeking care. Given reports from mass media, business press and regional Federal Reserve press releases, the short-to-midterm economic outlook may be softening, which is the signal that TransUnion is receiving in this health consumer poll. The other side of this personal health

As patients continue to morph into health care payers, they’re increasingly expecting value-for-money, transparency, and customer experiences that show respect, bolster trust, and deliver quality services. Is that so much to ask from health care providers? Sure is, as it turns out, based on this year’s annual report from Kaufman Hall, the 2019 State of Consumerism in Healthcare: The Bar is Rising. For several years, Kaufman Hall have developed an Index of healthcare consumerism based on several pillars that, together, gauge health care providers’ performance on consumer health engagement. Providers fall into one of four tiers, ranging from Tier 1

Patients in the U.S. are confused, cost-challenged and lacking control, according to The Consumer Healthcare Paradox from Maestro Health, an employee health and benefits company. Data illustrating that “paradox” is shown in the second chart: while 78% percent of patients told Maestro Health their health care experience is positive, 69% feel they lack control over their patient journey. Quality health care in America is too expensive, 79% of consumers said. Furthermore, one in two U.S. patients had received a medical bill that was higher than they anticipated it would be. Finally, one in two U.S. patients said the quality of

There are about 55 million patient records held by the United Kingdom’s National Health Service (NHS). Their monetary value to private sector companies would be £5 billion and nearly that much in patient benefits. Add in value for patient outcomes, and the total approaches £10 billion. In today’s UK:US currency exchange rate, 10 billion British pound sterling is worth roughly $12 billion. Realising the Value of Healthcare Data from EY explores how patient data can, in the words of the report, “unlock significant operational savings, enhanced patient outcomes, and wider economic benefits” for the NHS and patients through using artificial

“It’s the prices stupid,” Uwe Reinhardt and Gerard Anderson and colleagues asserted in the title their seminal Health Affairs manifesto on U.S. healthcare spending. Sixteen years later, yesterday on 8th July 2019, a Federal U.S. judge blocked, in the literal last-minute, a DHHS order mandating prescription drug companies to publish “retail prices” of medicines in direct-to-consumer TV ads. I was getting this post on transparency together just before that announcement hit the press, so this post would have had a different nuance yesterday compared with today. And that’s how health care politics and economics in America roll these days. Welcome to

By Susannah Fox, Jane Sarasohn-Kahn and Lisa Suennen I’ve lived long enough to have learned The closer you get to the fire the more you get burned But that won’t happen to us Cause it’s always been a matter of trust           A Matter of Trust, by Billy Joel If you’re in health care and don’t live under a rock, you have probably heard that United Health Group (UHG) has acquired PatientsLikeMe (PLM).  After the announcement, there was a lot of sound and fury, some of which signified nothing, as the saying goes, and some which signified a lot.

Americans consumed 17.6 prescriptions per person in 2018, two in three of which treated chronic conditions. Welcome to Medicine Use and Spending in the U.S. , the annual review of prescription drug supply, demand and Rx pricing dynamics from the IQVIA Institute for Human Data Science. In a call with analysts this week in which I participated, the Institute’s Executive Director Murray Aitken discussed the report which looks back at 2018 and forward to 2023 with scenarios about what the U.S. prescription drug market might look like five years from now. The report is organized into four sections: medical use

As patients now assume the role of health consumer, they rationally expect retail-level experiences with greater first-dollar payment for health insurance, health care services and medical products like prescription drugs. Consumers know what good retail looks and feels like, and are focusing that experiential lens on health care, Aflac found when their Workforces Survey polled Americans on their desirable health insurance shopping experience. One in two people said it should feel, “like Amazon,” and another 20% of folks said, “like retail.” Chapter 3 of HealthConsuming is titled, “How Amazon Has Primed Health Consumers,” and explains this re-shaping of patient expectations.

“ATA” is the new three-letter acronym for the American Telemedicine Association, meeting today through Tuesday at the Convention Center in New Orleans.  Ann Mond Johnson assumed the helm of CEO of ATA in 2018, and she’s issued a call-to-action across the health/care ecosystem for a delivery system upgrade. Her interview here in HealthLeaders speaks to her vision, recognizing, “It’s just stunning that there’s such a lag between what is possible in telehealth and what is actually happening.” I’m so keen on telehealth, I’m personally participating in three sessions at #ATA19. On Monday 15th April (US Tax Day, which is relevant

Pharmaceutical company executives are testifying in the U.S. Congress this week on the topic of prescription drug costs. One of those medicines, insulin, cost a patient $5,705 for a year’s supply in 2016, double what it cost in 2012, according to the Health Care Cost Institute. Know that one of these insulin products, Lilly’s Humalog,  came onto the market in 1996. In typical markets, as products mature and get mass adoption, prices fall. Not so insulin, one of the many cost components in caring for diabetes. But then prescription drug pricing doesn’t conform with how typical markets work in theory.

As more mobile app users — consumers, patients, and caregivers — use these handy digital health tools, much of the data we share can be re-identified and monetized by third parties well beyond those we believe we’re sharing with. This compromised health data privacy scenario comes out of research published this month in the BMJ, Data sharing practices of medicines related apps and the mobile ecosystem: traffic, content, and network analysis. The researchers, faculty from the University of Toronto (Canada) and the University of Sydney (Australia), come from nursing, pharmacy, and computer science expertise — a sound combination of disciplines

Self-care in health goes back thousands of years. Reading from Hippocrates’ Corpus about food and clean air’s role in health sounds contemporary today. And even in our most cynical moments, we can all hearken back to our grandmothers’ kitchen table wisdom for dealing with skin issues, the flu, and broken hearts. The annual conference of the Consumer Healthcare Products Association (CHPA) convened this week, and I was grateful to attend and speak on the evolving retail health landscape yesterday. Gary Downing, CEO of Clarion Brands and Chairman of the CHPA Board, kicked off the first day with a nostalgic look

There’s little Americans, by political party, agree upon in 2019. One of the only issues bringing people together in the U.S. is prescription drug prices — that they’re too high, that the Federal government should negotiate to lower costs for Medicare enrollees, and that out-of-pocket costs for drugs should be limited. The Kaiser Family Foundation has been tracking this topic for a few years, and this month, their March 2019 Health Tracking Poll shows vast majorities of Democrats, Independents and Republicans all share these sentiments. It’s not that patients who take prescription drugs don’t appreciate them – most (58%) say medicines

Just as we experienced “e-business” departments blurring into ecommerce and everyday business processes, so is “telehealth” morphing into, simply, health care delivery as one of many channels and platforms. Telehealth and virtual care are key education topics and exhibitor presences at HIMSS19. Several factors underpin the adoption of telehealth in 2019: Consumers’ demand for accessible, lower-cost health care services as people face greater financial responsibility for paying the medical bill (via high-deductible health plans and greater out-of-pocket costs for co-payments) Some consumers’ lacking or losing health insurance as ACA coverage eroded in the past two years, resulting in these patients

On January 10, 2019, Jim Cramer of CNBC’s Mad Money recommended that Apple buy Epic, a market leader in EHRs. At that moment in the Twitterverse, it occurred to me that health IT as a consumer-facing industry was beginning to mainstream in America. Cramer’s pronouncement led to a tweetstorm where hundreds of tweeters in and outside of health/care talked back and with Cramer. A few of my favorite comments were: “Jim Cramer needs a crash course in FHIR standards” from the wonkier section of peanut gallery. “They are not even in the same universe” among people dissing the idea in

To succeed in the business of health information technology (HIT), a company has to be very clear on the problems it’s trying to address. Now that EHRs are well-adopted in physicians’ practices and hospitals, patient data have gone digital, and can be aggregated and mined for better diagnosis, treatment, and intelligent decision making. There’s surely lots of data to mine. And there are also lots of opportunities to design tools that aren’t very useful for the core problems we need to solve, for the clinicians on the front-lines trying to solve them, and for the patients and people  whom we

Organizations that address consumers’ data privacy and access to healthcare create greater social brand equity, inspiring people to say nice things about the companies, recommend them as good employers, and be welcomed as businesses operating in peoples’ community. In The Societal ROI Index: A Measure for The Times We Find Ourselves In, Finn Partners and The Harris Poll measure U.S. companies’ reputations for social good, the project’s press release explains. “Our new data shows that the public has a definite opinion about what issues they feel companies should address and the social impact bar has been set high,” according to Amy Terpeluk,

Eat food, not too much, mostly plants, Michael Pollan advised us on the cover of his breakthrough book on nutrition in America, In Defense of Food.  In Las Vegas, it’s not too easy to live and eat  according to Pollan’s Food Rules. We’re at a fork in the road when it comes to food, retail grocery shopping, and health, which is an intersection I’m increasingly working in these days. The Groceryshop conference is further informing my understanding of the landscape of the technology that’s enabling the consumer’s ability to curate, purchase, and receive the food they want to satisfy hunger and

    CVS Health’s acquisition of Aetna was approved this week by U.S. Federal regulators after months of scrutinizing the antitrust-size-market control implications of the deal. I wrote this post on the deal as an inflection point in American healthcare on 3rd December 2017 when CVS and Aetna announced their marriage intentions. This post updates my initial thoughts on the deal, given the morphing US healthcare market on both the traditional health services front and fast-evolving retail health environment. The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal

The prices of medicines prescribed in outpatient settings rose, on average, 10.3% in 2018. Wages increased about 2.6%, and consumer prices, 1.3%, based on the 2019 Segal Health Plan Cost Trend Survey. Segal forecasts that medical cost trends will moderate for 2019, lower than 2018 rates. But to the patient, now feeling like a consumer dealing with high-deductibles and the growing sticker shock of specialty drug prices, a so-called “moderate” trend still feels like a big bite in the household budget. Specifically, specialty drug trend is expected to be 14.3% in 2019, compared with 17.7% in 2018 — still several

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