Enabling Healthy Decisions

We all know that communications around our healthcare are critical to (a) educate us; (b) engage us; and (c) help us make better decisions within this overly complex healthcare system.

So…with that in mind, what would we (you) as consumers do to help healthcare companies and providers (physician, hospital) better communicate with you?

1. Would you complete a personal health record (PHR)?
2. Would you do a survey on how you think about healthcare?
3. Would you do behavioral tests to understand what motivates you?
4. Would you help create a longitudinal record that could be used to provide you history across plans?
5. Would you help them integrate data?
6. Would you provide them with consumer data about yourself (e.g., what magazines you read)?
7. Would you give them access to your credit score?
8. Would you provide salary data?

All of these things are accessible today and can be used. BUT, if you had total control, what would you share?

It would help people determine how to educate you. It would help companies know how to motivate you. It would help them understand what information is valuable to you.

Let’s take it to an extreme…

Today, we allow direct-to-consumer (DTC) advertising from the pharmaceutical manufacturers to the general population. This is a shotgun approach. Why not spend that money to really focus on the people that need it. We could use algorithms to determine who was most at risk for certain conditions and provide targeted educational messaging to them in the medium that they best respond to with messaging that is personalized to their situation. Would you want that?

This was an interesting discussion earlier today between several PBM executives and pharma people. Since 80% of chronic disease is treated today primarily with prescriptions, it would seem like prescriptions are being used as a scalpel. On the other hand, we have created the most medicated generation with people thinking of medication as the instant solution for all their medical issues.

So, if we give everyone a prescription even though it might not be right for them given their genomics or there might be a better answer for them – diet, exercise, surgery, we’re using prescriptions as a blunt (one size fits all) instrument today.

Can we drive down the costs to make it a personalized solution? Probably…but when.

And, given our expectations around healthcare, will we wait or will we become a generation of people who are so focused on taking a pill to fix all the ailments that we have and believe we have (c/o DTC advertising) will it matter?

We all talk about obesity as an epidemic while at the same time we know that people aren’t changing behavior. The answer to being thin is easy…eat less; exercise more. If that’s all it takes, and we know the downside of being obese…why don’t we take action.

We’re lazy…that’s certainly one answer. It’s not easy to pick the right foods and exercise. It’s time consuming. It’s certainly faster to drive thru the fast food restaurant and fill up with their empty calories.

It’s less expensive. We can say that exercise is free, but for most of us, there is a time value of money whether it’s time to work or time with kids or time to do our own thing. Time is money. AND, we’ve made bad calories cheap. I talked about this a few years ago…It costs more to buy fruits and vegetables and good food than high calorie meals with salt and sugar.

We don’t penalize people although this is likely to come in the future.

On the flipside, I bet obese people who say that it’s no fun being obese. You have trouble moving around. You are socially stigmatized at times. Your clothes choices are limited.

But, we continue to make it easier…most of the health problems associated with obesity are solved by taking a pill. We’re all waiting for that magic pill that makes us thin, changes our appetite, or raise our metabolism so we can eat the same crap without having to exercise. Is that our only answer? I hope not!

Maybe they’ll be a device that will regulate our eating or some type of mental device that can “hypnotize” us. Maybe we’ll get a shock every time we grab for the sugary desert.

Ideally, we could train our genes (or taste buds) to only like healthy food and only eat in moderation, but that seems far off.

Today’s healthcare environment is difficult enough. You have data with your provider (MD, hospital, clinic); your pharmacy; your health plan; your worker’s comp carrier; your personal health record (PHR); your grocery (vitamins, supplements); your gym; and your lab. People communicate with you based on those different pieces of data or perhaps consolidated components of that data.

Each entity has a different agenda or purpose and potentially different opinions. Combine this with direct-to-consumer (DTC) advertising, research you do yourself, and word-of-mouth and it can be overwhelming.

As we move into an “apps” culture where everyone has an application for you to put on your smart phone, are we simply going to continue this defragmentation, accelerate it, or actually address it. I suspect we will accelerate it. You will have all these traditional players along with all the Health 2.0 players that are trying to leverage their cool Internet functions into applications for managing what you eat, your workouts, your condition, sharing data, etc.

I think this is a problem.