Enabling Healthy Decisions

There is an article in today’s USA Today about wounded veterans that got me thinking about where this falls on the healthcare reform priorities. As I’ve stated before, I completely agree that the US system needs reform. The question is whether to go “big bang” or focus on change in key areas. I continue to argue that focus on fixing one problem at a time is best. I would initially focus on the uninsured. This article made me realize that another area of focus should be on providing comprehensive coverage for those that serve our country.

While most of us enjoy our freedom, there are a select few which are willing to sacrifice their lives to protect us. We should never forget that. They should be cared for.

In a study by the MarketingProfs, they look at use of social media by industry which is interesting. The full report is something you have to pay for, but they give you a presentation you can download for free and allow us bloggers to use some of the charts.

1. The first one shows users of videos for viral marketing. I was surprised to see healthcare at 18.5%, but this makes sense. There are lots of videos which can be educational.

1. The next one shows social media use by company type. I certainly have seen a lot of companies putting LinkedIn and Facebook pages up. Additionally, a lot of companies are using Twitter for PR and other information. Since I don’t use MySpace that doesn’t surprise me that it’s so low.

1. The last one isn’t shown by industry, but I think it’s interesting. I’d love to know if healthcare is more conservative than other industries. I would imagine they would be. [The other thing to know here is the mix by size.]

Reading a brief summary of this book caught my attention. The Checklist Manifesto hits on one of those sensitive areas in healthcare…can technology make physicians better? YES.

“Medicine today is so complex that even the sharpest doctors can no longer keep everything they need to know in their heads.” (Atul Gawande)

• Only about ½ of heart attack patients get the best care within the recommended window.
• It takes an average of 17 years for a new treatment to reach even ½ of the patients who would benefit.
• Using a “safe-surgery checklist” reduced the number of complications and deaths by 1/3. (The New England Journal of Medicine)

(Or at least that’s a good sensationalist title)

In a study in the American Journal of Epidemiology, it suggests that people who grew up in the Rock ‘n Roll generation are holding on to their hearing longer than their parents. (Will this continue for the iPod generation?)

The odds of having hearing impairments were 13% lower in men (and 6% in women) for every five-year increase in year of birth. (Based on study of 5,300 people born between 1902 and 1962.)

As the blurb in the USA Today mentions, there are other factors – ear protection, less noisy jobs, better treatment for conditions that led to hearing loss.

In a letter to the editor, a consumer was suggesting that one answer for BTC (behind-the-counter) medications such as cold medications would be to require the pharmacist to determine who should get them. Certainly, we need to figure out a way for these medications not to be used to create methamphetamine (meth), but this won’t work (IMHO). On the flip side, requiring a prescription for patients to get these doesn’t make a lot of sense either. It would drive up physician visits and overall healthcare costs.

Why?

• Pharmacists are already very busy (at most pharmacies).
• The margin on these medications probably doesn’t justify applying high cost labor to them. Today, a pharmacy technician that makes significantly less does and can handle “filling” these. [Of course, if this argument worked, pharmacies would stop filling $4 generics and free antibiotics.]
• What’s the proper diagnosis for a cold and how would you screen people?
• If criminals wanted the drugs, wouldn’t they just get sick and come in to get them?

From the Corporate Research Group blog:

One thing is clear, voters do not want the trillion-dollar health care bill that is being forced on the American people.  This bill is not being debated openly and fairly. It will raise taxes, hurt Medicare, destroy jobs, and run our nation deeper into debt….I will work in the Senate with Democrats and Republicans to reform health care in an open and honest way. No more closed-door meetings or back room deals by an out of touch party leadership. No more hiding costs, concealing taxes, collaborating with special interests, and leaving more trillions in debt for our children to pay.

[BTW – On a personal note…It’s always fun to be onsite for big elections.  I was in Boston for this although I’d put it as my 3rd most interesting election.  I was in Brazil in 1989 for their 1st election in 30 years and I was in Prague for the vote to split Czechoslovakia into two countries.  Those were both a little more exciting…although not as relevant to my day-to-day life.]

In one of the most stunning studies ever, the researchers show that people (not all just most) are happier on days that they don’t work. But, let’s drill in since I actually found the study interesting and began to wonder about implications that might have on when healthcare companies should communicate with people.

The study in the Journal of Social and Clinical Psychology showed that people are happier on weekends (when most aren’t working) due to “more connection with other people and more self-direction” (co-author Richard Ryan). (see article in USA Today)

One other aspect of the research was that people were happier when they were competent even if the task was difficult.

So, this brings up lots of questions:

• Since we know that happy call center agents can influence customers, how do you increase their feelings of competency, autonomy, and connectedness?
• Are you better off communicating with members/patients on the weekends when they are happier?
• Who are the people that are happier at work than home?
• Since the general stereotype is that men are less competent with household chores and raising kids, did gender matter? (The article said that age, education, salary, marital status, and # of hours didn’t matter.)

In my opinion, your high school and college years are time to prepare for the future and enjoy life. After that, you start saving for retirement, taking care of a family, and many people end up in that sandwich generation having parents and children to care for. But, we know that kids also feel massive pressures (self-induced, peer pressure, or based on their parents) to perform well in sports, school, standardized tests, and other things that will help them succeed. There are also lots of social pressures at a time when the “right” answer isn’t clear.

Today, young people are also having a very hard time finding a job. A problem that is certain to create long-term issues as these people enter the workforce with less experience. [I know at E&Y the only variable that seemed to correlate with Partnership was whether the person had worked during college.]

A new survey [mentioned in USA Today , 1/12/10, pg. 4D) shows that five times as many high school and college students in the US are dealing with anxiety and other mental health problems than people of the same age in the Great Depression. That’s amazing to me. The Great Depression seems like such a hardship time.

Now, the other view of this is that more people are getting diagnosed with these diseases these days, but this survey was based on diagnosis codes or even Rxs filled. It was based on people taking the Minnesota Multiphasic Personality Inventory, a psychological questionnaire.

This past week was the first time I was in NY since they were required to show calories on menus everywhere. WOW! It really makes you think differently. I went to Cosi to get a sandwich with a client and was stunned. I know I’m not the best, but sitting there seeing my options was both startling and a little bothersome. I hope this gets passed across the country. I would definitely think differently about my food choices.

Now, on the flipside, it definitely makes it much harder to just “cut loose” and grab a hot dog at the baseball game. You now are conscious about the impact that has on your waist (and potentially your health).

One of our clients told me this morning that my blog is blocked within the company. I was surprised. It got me thinking about the power of the SPAM Blocker (or whatever the right name is for the software that keeps people from visiting certain websites). Usually, I thought this was set up for pornography and gambling, but I know these have expanded to social sites like Facebook, LinkedIn, Twitter, and others.

Some, I can agree with others I can debate. Facebook seems unnecessary for work, but I could argue that LinkedIn could provide some work value. Twitter can be used as a distraction or with all the companies using it, it would seem like it could be a work tool.

That puts a lot of power in the hands of the software or IT person who selects which sites or parameters trigger “the big red hand”. [At least that’s what I’ve seen at several companies.]

Or, maybe I am simply too politically incorrect on my blog [doubtful].