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Consumer Driven Patients – Healthcare providers are reorganizing themselves in a more patient-centric continuum through care management approaches, where the patient turns into the role of a customer and consumer. According to economist John C. Goodman, “In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care they receive.” Consumerism has been defined as a formidable force in health care, a defining characteristic between its past and future that will impact every stake-holder’s value proposition and business model. While signaling a change in the status quo for many, the trend toward consumerism also presents great opportunity for those stakeholders that recognize the value of connecting with end users who ultimately drive demand for the goods and services sold in the health care system. Healthcare will become a consumer market – individuals will engage in consumer behavior when making decisions about their health care.

most important sources:

Goodman, John (2006), “Consumer Driven Health Care“, Networks Financial Institute Policy Brief, Indiana State University 
Prof. Herzlinger Regina, “Who killed Healthcare

Medical Tourism – Health care costs are increasing at eight percent per year – well above the Consumer Price Index (CPI), thus eating into corporate profits and household disposable income. The safety and quality of care available in many offshore settings is no longer an issue. Consumers are willing to travel to obtain care that is both safe and less costly. By contrast, inbound medical tourism and medical tourism across state lines will continue to be an interesting opportunity for specialty hubs with treatments unavailable elsewhere in the world or in a community setting. The annual growth rate of medical tourism in the US is 100%. Major barriers include the inability of providers in the medical traveling market to enter the networks of the developed markets, and a lack of transparent worldwide data on the quality of healthcare.

most important sources:

Deloitte’s medical tourism study, “Consumers in Search of Value
McKinsey: Mapping the market for medical travel

Transparency and Trust – Due to this new role and demand, it will be necessary for patients to select a suitable service provider among many possibilities. Consumers want information and tools to make their own decisions and manage their own healthcare. Actually in most countries an accurate selection is difficult, as consumers do not have a significant history with many of the healthcare service providers and thus interact, mostly offline, with others such as family, friends or their local general practitioner (GP) to make informed selections. Currently healthcare provider rating platforms are on the rise, and the demand on easy access on transparent information is rapidly growing.

Communication – Next to more transparency patients expect better communication, more information, and a higher degree of involvement and participation concerning their treatment, than they actually receive. Participation of the patient, to the degree he prefers, can lead to improved treatment outcomes. Until now, effective online provider-patient communication tools are not available and not used. The new era of patient engagement in healthcare, calls for providers to make deeper, more fluid, and open connections with their customers. Healthcare providers will be challenged to adapt to this new and rapidly changing environment. Healthcare providers will have to accept patients as their partners and collaborate more intensively with them. Otherwise, their healthcare services will be vulnerable to a widespread loss of confidence. The creation of optimal healthcare services will depend on the ability to embrace this opportunity , and collaborate with this first generation of online patients (e-patients), providing them with more autonomy, and empowerment and inviting them to jointly take decisions. Collaboration, transparency and frequent consistent two way communication are key in this new world.

most important sources:

Kao, Helen, Rebecca Conant, Theresa Soriano, Wayne McCormick. “The Past, Present, and Future of House Calls.” Clinics in geriatric medicine
Yawn, B., M.A. Goodwin, S.J. Zyzanski, K.C. Strange. “Time Use during Acute and Chronic Illness Visits to a Family Physician.”
Ley, P., “Memory for medical information.” British Journal of Social and Clinical Psychology 18.
Ferguson T, Frydman G. “The first generation of e-patients.” BMJ 328 (7449): 1148–9.
Herrick, Devon. “Web Replaces Doctors as Patients’ Top Health Information Source.” Health Care News 01 January 2009.
Fox, Susannah, and Sydney Jones. “The Social Life of Health Information.” Pew Internet & American Life Project June 2009
Fox, Susannah. “The Engaged E-Patient Population.” Pew Internet & American Life Project. August 2008.
Goetz, Thomas. “Practicing Patients.” New York Times 23 March 2008.
Keckly, Paul, and Laura L. Eselius. “2009 Deloitte Survey of Health Consumers.” Deloitte Center for Health Solutions. March 2009
 

 

SOA & Web Technology – Advancements in web technologies offer health care providers and medical practitioners ever expanding solutions to improve the quality and timeliness of care. Service oriented architectures and Web 2.0 technologies offer an effective approach to embrace this new cooperative and participatory model of medical care and in the long run integrate telemedical solutions with social networks to create a new and innovative approach for offering patient centric care. These combined solutions offer the patient and the people who form their primary and extended care networks, a means to communicate, interact and adapt as needs and situations change. Enabling new and creative applications will improve the ability for medical professionals to deliver quality care by combining clinical data with a patient’s own “network effect”.

sources: Dion Hinchcliffe : When the worlds of SOA and Web 2.0 collide

 

 

(c) Bart de Witte

Social Networks and mobile platforms will have an impact on almost every aspect of the healthcare delivery system, from new models of healthcare delivery, tools for patient self care, platforms for business to business operations and mechanisms to accelerate clinical research.  In the US several Health 2.0 startups embraced this opportunity; and have the potential to disrupt Healthcare delivery. Their business models are gaining traction.

follow me on twitter : @swisshealth20

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5 Comments

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  1. Jim Spath
    Bart – your blog predicts many future trends, but I have difficulty seeing the likelihood of many of your speculations, as you have provided very little data to support your claims.  Saying something like “Healthcare providers will have to accept patients as their partners” is all well and good (no pun intended), but it flies in the face of centuries of “doctor – patient” relationships, where the doctor is the expert, keeper of knowledge, and the patient is the passive recipient of (let’s hope) care.

    What (substantiated) data do you have to claim that medical tourism is growing at 100% annually in the U.S? (and I presume you mean _from_ the U.S. to elsewhere) What does this include – cancer treatments? cosmetic surgery? prescriptions?

    I think you’re stretching credibility to claim that software changes such as service-oriented architecture, social networks, or mobile platforms are going to “disrupt” health care delivery.  While it’s likely new technologies will deliver information to health providers more quickly (lab test turnaround time, record retrieval simplification), the increasing complexity of regulations such as HIPAA (Health Insurance Portability and Accountability), data density growth, and increased legal and competitive pressures would seem to me as more of the same, not anything revolutionary in scope.

    Jim

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    1. Anonymous
      Dear Jim,

      Thank you for your feedback. first of all to make you more comfortable with my predictions on what I think are important trends to watch at, I added my resources which went lost when I copied and pasted my blog.

      According to your profile you might be a Jack of all Trades, but I feel that you are not aware on all recent developments in healthcare and the world of health 2.0.

      Take PatientsLikeMe and CureTogether for example. These patient driven health 2.0 platforms can be seen as a direct challenge to physicians’ omniscience. These startups can be seen as collaborative PHR’s, where members not only track their disease progression, they tacitly encourages them to try to turn those progression curves in a positive direction. This is probably unnerving to many doctors. The information generated by patients  is robust enough for advanced research. In fact, a Belgium Pharmaceutical called UCB, singed a strategic partnership with patientslikeme. UCB hopes to better understand patients, their lives and treatment experiences. I have been working in healthcare since more than 15 years, and truly believe that health 2.0 has the potential to revolutionize healthcare, in this case healthcare research.

      sources:
      http://www.ucb.com/media-room/newsdetail/?det=1322542

      http://www.wired.com/magazine/2010/01/ff_decisiontree/4/

      I also disagree with your comments regarding HIPAA, which by the way only affect the US ( I live in Switzerland): PHRs, once placed online, are not covered by HIPAA, since they’re yours and you can share your data with who you will.

      source: http://www.worldprivacyforum.org/pdf/WPF_PHR_02_20_2008fs.pdf

      Of course there is the risk that regulations could slow down these great developments, but watching other big industries struggle with empowered online customers (eg. HELL DELL), I don’t think this will happen soon. In the in contrary, stakeholders in the healthcaqre sector that embrace this new opportunity will gain significantly.

      One last comment (comming from Alan Greene MD – http://www.drgreene.com) regarding the changing doctor-patient relationship: Recently Michelle Obama was in the news because she touched the queen of England. A royal faux pas, and against the protocol. Greene told me that this was the tradition to in the US. When George Washington John Adams were president, you were not allowed to touch the president. It was first in the beginning of the 19th century that Thomas Jefferson changed protocol. He decided to shake hands as equals with people. People with different roles, with different expertise, but shake hands as equals. It is time in the 21sth century, in medicine for doctors to begin shaking hands as equals with patients. Equals with different roles, equals with different responsibilities and expertise, but no longer hide behind their prescription pads, or hide behind their white coats.

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      1. Anonymous
        PS: with copy & paste reffered to not using the not so user friendly editor of SDN.
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  2. Nikesh Hajari
    I would like to say I completely agree with you. I just recently took a class on healthcare accountability and strategy (you posted an article by regina herzlinger -> she was the author of my textbook on consumer driven healthcare).

    Consumer-Driven Health Care: Implications for Providers, Payers, and Policy-Makers

    It’s very good and it outlines a lot of things you actually mentioned. One thing I have noticed is the challenge will be in creating mutual incentives for each party. It will be hard to regain consumer’s confidence and trust, but I think another interesting change that will have to occur is a consumer paradigm shift in which we actually proactively take a role in our healthcare. One interesting idea is to use the car insurance industry model such as providing incentives (i.e. free co-pays or insurance discounts) for staying healthy.

    Another interesting idea is to educate consumers on how to properly utilize health care services. Just an example I read was about an Eastcoast HMO (in regina’s book) which has a 3:1 ROI savings because a nursing hotline redirected the flow of care effectively reducing emergency room utilization by half and doubled the number of patients that could self-treat. The question to ask is did they deny care? (That was not mentioned and neither was the efficacy, but AccessHealth uses a series of expert systems and trained nurses). If consumers were educated on how to use healthcare resources -> think about the bundle insurers, consumers and providers would save just from the correct use and utilization (not over utilizing -> i.e. going to an emergency room for a severe cold, but going to an urgicare center)

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    1. Anonymous
      Thank you Nikesh for your additional comments. Cuting costs in the emergency room can be done using a triage system. As diagnostic tools and communication possibilities become more cheaper, it is to expect that such triage services will be offered by online service providers. In Switzerland we have call centers in place, staffed by nurses, physiotherapists and doctors. In the states startups such ar “american well” and “hello health” focus on doing the same, but use the internet to enhance the patient-doctor relationship.

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