February 6, 2013 
I remember when I first started working in the healthcare industry in 1998, people kept reinforcing for me that “Healthcare is Local”. As we move into a national effort to transform healthcare, the question is how will healthcare transform to gain scale efficiencies while still taking advantage of this simple reality.
With that in mind, I found a WSJ article today about hospitals trying house calls very interesting. It talks about how insurers and health systems are using the old fashion model of house calls to engage patients to reduce re-admissions and improve outcomes…while lowering costs. Since healthcare costs are massively concentrated with 1% of patients driving 22% of healthcare costs, this becomes possible. Additionally, as you focus . on people at high risk based on some model like the Johns Hopkins ACG model or people who have been recently discharged or people with multiple co-morbidities and other risk factors, you have a chance to make a difference. It will be interesting to see how this takes off.
Another example of how healthcare is going local is the use of health apps. I saw a number earlier today where someone was saying there’s now 50,000 health apps. I usually talk about 16,000, but it’s obviously going up all the time. Employee Benefit News recently had an article about how health apps were changing the engagement rates for wellness programs. Obviously, the phone is the ultimate in local allowing the creation of an app that’s with us all the time and can be real-time in terms of interactivity.
Enabling Healthy Decisions 
Reblogged this on health it rant and commented:
Really enjoyed that WSJ article about house calls in NYC. Its the balance act of personalized medicine vs. Standardization that we’ll continue to struggle with. We’re at an interesting intersection in healthcare because technology has introduced a new platform for local delivery of healthcare services – question is, how are we going to maximize the value of this new channel.
definitely agree with Jim here on this, surprised with how many health apps there are out there.
Health care has been in a deteriorating paradigm of complexity. Previous health care solutions that were put forward continued to get more complex in an attempt to account for their previous lack of success. However, the reality is that producing significant and long lasting improved health outcomes, with positive ROI, is not complex. The production of improved health outcomes will come only with a change in patient behavior, and a change in patient behavior will not come from a complex central dispersal of information. Rather it will come from face to face communication between patient and motivated community providers. Previous health care solutions did not treat health as an on going process, which it is, but rather looked at health as an event that occurs once or twice a year.