Archive | Consumerism RSS feed for this section

WHCC 09 Interview with Ed Batchelor (Humana)

I had an opportunity to sit down with Ed Batchelor from Humana yesterday.  He has an interesting role driving the Stay Smart / Stay Healthy program for them as part of his Corporate Web Strategy role.  From what I could tell, it’s a program done for the greater good of educating consumers about key healthcare topics.  To accomplish that, Ed has a direct reporting relationship to the operating committee at Humana and was brought in from outside the industry.

Here is an example of one of the videos that they are pushing out on YouTube.  I really like the whiteboard communication approach.

Some of the big takeaways from my discussion were:

  1. You have to meet the consumers where they are – Facebook, YouTube, Blogs.
  2. If you create a neutral educational message, consumers will trust information (even from health plans).
  3. You can only deliver information in “bits”.  Don’t overwhelm them.
  4. Fun is good.
  5. Regardless of what many (including myself) might think, seniors don’t all shy away from these social media.  [20% of the 1.1M views on YouTube have been from people over 55 years old]
  6. Success on YouTube doesn’t translate to blogs.

One question that I had was how to get away from the “healthcare speak” so that consumers could actually understand it.  He talked about 3 things:

  1. Bringing in an external person
  2. Using focus groups
  3. Using an outside agency

The other thing we talked about is that pull through that they are getting around employers and brokers.  They are pulling the videos in (like here) and re-using them.

This was a program they were highlighting in their booth and one of the public areas here so I appreciated the opportunity to sit down and learn more.

Medicaid Communications

Interested in hearing more about this topic.  You can hear Margot Walthall from my team talking about this on an upcoming webinar.

The Medicaid Communications Lifecycle:  From Onboarding through Redetermination
April 28, 2009 | 1:00 PM ET | 10:00 AM PT

Introducing your Medicaid members to your plan’s benefits as well as their responsibilities is critical to developing a successful member / health plan relationship. Sustaining positive impressions over the course of the member’s eligibility is equally important to retaining Medicaid members.

Silverlink has developed a broad set of communications outreach programs that have yielded strong results for Medicaid and CHIP populations. Join us for this complimentary webinar where we will explore how Silverlink can help you cost-efficiently support:

  • The Medicaid onboarding process with welcome/HRA outreach
  • Targeted messages about health screenings to drive HEDIS results
  • Communications approaches that can reduce health disparities
  • Effective methods for educating members about the redetermination process that can inspire loyalty

Register Here

Sprint: What’s Happening Now

I am not sure how this helps Sprint sell more phones and/or services, but I enjoyed the advertisement. The concept of leveraging data to understand consumer behavior is essential. This is a topic we [Silverlink] are constantly working with our healthcare clients to address.

  • How do you know what members or patients are doing?
  • Do you understand their preferences?
  • What have they historically done?
  • Can you predict how they will act in the future?
  • What data is needed to do analysis and create a predictive algorithm?
  • How do you leverage that to create interactive and compelling communications?
  • How do you study their behavior change?  (e.g., did they get a flu shot after being reminded)

X-Ray Vision Carrots

Behavioral economics can apply in many instances.  It is the “hot” discussion topic in healthcare about how to understand how members (consumers / patients) make decisions and what factors influence their decisions.

In this article in Newsweek about getting kids to eat healthy, they talk about three things:

  1. Verbal encouragement
  2. Descriptive labels
  3. Improved access

Rather than calling them carrots, they talk about calling them “x-ray vision carrots”.  These 3 “principles” are relevant to a lot of communications.  You have to be proactive and provide encouragement to members to get a flu shot or do other preventative health actions.  You then need to find a way to describe the action in a way that is compelling.  And, finally, you have to make the action easy.

Big Month For Vasectomies

Based on several articles over the past year, this should be a big month for vasectomies.

Last year, Forbes pointed out that the scheduling of vasectomies jumps dramatically before big sports events – The Masters, Final Four, Football.  Apparently, people want to get “snipped” on the Friday and have a good reason to sit around all weekend and recover while they watch their favorite sport.  Talk about planning.

And, last month, there was an article about the spike in vasectomies due to the economy.  No hard data about why, but the article hypothesizes that people are concerned about the additional costs of children and want to get the procedure done while they have health insurance.

Responsibility Based Healthcare

Are we finally to a point economically where healthy people will get tired of bearing the cost burden of supporting their sicker coworkers?  As costs continue to skyrocket, most people probably don’t realize that those are from a minority of their coworkers who have chronic conditions.  (Or in the case of Medicare, are from the costs incurred in the final year of life.)

If you’re like me, I generally don’t mind the risk pool concept (since I don’t know where I might end up any year).  And, I certainly don”t mind paying for people who are genetically pre-disposed to some condition (we all may be in that bucket someday), but I could take issue with paying for people who don’t comply with their physician’s recommendations (most of us), don’t act preventatively (most of us), abuse their body with things like smoking, and I could go on.

It got me thinking this morning about a model where we were able to push costs to people based on them taking responsibility for their care (i.e., “responsibility-based care”).  While we certainly won’t be at a place in the near future where genomics dominates and we can pull out people who can’t control their health, we can track things like compliance and adherence once we get an integrated HIT (healthcare information technology) system in place.

Additionally, we might get someday to a place where we can offer incentives based on active management and results which are self-reported by remote devices that track blood pressure, weight, cholesterol, etc.  But, many of these have issues around confidentiality and would challenge the risk pool process that we use today to underwrite medical costs.

I am not sure what the right answer is, but I think it’s about time for this debate to rear its head again with more energy.

How Does Optimism Bias Affect Us in Healthcare?

The optimism bias means people are less likely to believe that bad events will happen to them.  They overestimate their likelihood of success.  What are some probable implications in healthcare?

  • Don’t believe they will get cancer or some other disease and not act preventatively.
  • Believe they can improve their cholesterol by exercise and that they will exercise.
  • Don’t believe that the extra calories will add on pounds.
  • Don’t believe smoking will kill them.
  • Don’t believe they need insurance because they won’t get sick or hurt.

glasshalffull1

Is glass half-full or half-empty?

Negotiating Health Care Is Normal

Sure, most of us with employer sponsored care haven’t dealt with this but providers (MD, hospitals, labs) have been negotiating with plans for years.  With over $34B in uncompensated care in 2007 (a number which will certainly go up), your physician would rather get something than nothing.  Talk to them like a professional (not a used car dealer) and see if they can give you a break on the costs.  This article in Patient Money provides some additional thoughts.

Another good article in this area is “Advice To The Jobless On Getting Health Coverage“.

Using Twitter For Health Care

Last week, I talked with a reporter about using Twitter for health care.  It can add a new dimension to communications, but I am not sold on it replacing current communications.

Some of my jumbled thoughts on this:

  • I like the one to many concept of Twitter with the opt-in concept (preference-based marketing), but it doesn’t personalize to the individual the way the information is delivered.
  • It definitely provides a stream of consciousness which is interesting.  I see a lot of application for a reality show type of health tools…like Biggest Loser via Twitter.
  • I like the idea of posting a question to a broad audience for quick response – Does anyone have research showing the impact of statins on asthma patients?
  • I don’t see this helping with patient to provider communications.  Do I really want my blood sugar posted to Twitter and sent to my physician from my smart device?  Do I (the physician) really want to see all that real-time data?  No.  What about HIPAA…from what I know Twitter is not meant to contain confidential information.  There are plenty of rules engines which can be used to capture data; look for things outside the norm; and then send an alert.
  • A lot of healthcare information has caveats and requires more than 140 characters to get across the message.  Most clinical things couldn’t be send this way.
  • As with most inbound things (i.e., I have to register or search it out), Twitter feeds get those that know what they are interested in and are active in their health management.  It still doesn’t help to drive action from those that aren’t engaged in their healthcare.
  • I can certainly see it as an alert to information, but since one tip to productivity is to batch things, do I really want them broken out during the day in a bunch of Twitter feeds.  I would rather get a daily synopsis from a website (which might be created by Twitter feeds).

Some things I found when looking on the web about this topic:

Here is a presentation on Twitter (they even have one of my old posts in there…which was a pleasant surprise to me) around healthcare.

So, my general perspective is that there is some value in pushing basic information out, reality show type of healthcare (Twitter surgery), capturing feedback, and developing community, but it’s not a tool for the corporate to individual communications that I typically deal with.

Walgreen’s vs. CVS PBM Ownership

Another question I got yesterday was on retailers (specifically Walgreen’s versus CVS) owning PBMs.  The question was since they make so much money on foot traffic and selling non-pharmacy items why would they want to be in the PBM business.  DATA!

They both have similar fundamental concepts which are aggregating patient touchpoints – PBM, Clinic, Retail, Specialty.  If they can figure out how to aggregate and mine the data to better serve the patients and the plan sponsors, they can be a key influencer in driving health outcomes.  

The follow on question was what’s different.  Without getting into behind the scenes, the one thing that I think is publicly different is the CVS ExtraCare program.  They have a loyalty program that gives them visibility into the non-medical behavior of members.  Why is that important?  From a PBM perspective, it’s important because they can make sure to focus on channel optimization.  By that I mean that people that go to the pharmacy and shop at a CVS are people they want to keep in the stores.  But, patients that simply pick up prescriptions are probably people they want to move to mail.  Mail order is a lower cost fulfillment option for them and if those consumers aren’t buying other stuff, then they should look to convert them to mail.

What’s In A Voice?

In the most recent copy of AHIP’s Coverage Magazine (JAN+FEB.09), there is a nice feature called “What’s In A Voice?” which talks about Silverlink Communications. You can find the whole article (“Motivating Change“) here, but I pulled out a few quotes:

“When the phone rings, it takes just the right voice to motivate a member to overcome the tendency to put off receiving preventative care.”

“Silverlink calls allow us to communicate with our members in a really personalized way without incurring the costs associated with hiring and training additional customer service representatives.” Linda Lyle, Cariten Healthcare Vice President of Operations

“This mammography campaign contained scripting that allowed the members to respond, [indicating] whether or not they had had a mammogram. We received a large number of ‘yes’ responses that we will pursue for HEDIS improvement, as well as to identify gaps in our data collection. This method of collecting data about our members is unique to telephone outreach. We are anxious to explore our findings.” ” We know how many listened to the message and how many hung up. We know how many people we actually reach.” Michael Bryne, Assistant Director of Quality Management at EmblemHealth.

The article also talks about using non-professional voices such as the Chief Medical Officer or a customer service representative who was really good with members. In one example, Eleanor Sorrentino, the Managing Director of Quality Management at EmblemHealth, talks about getting 50 calls from members thanking her for the automated call which was recorded in her voice.

A few other items talked about include the use of data and reporting which is available real-time to make decisions along with the use of natural sounding voices to drive a conversational experience which leverages internal and professional scripting resources to develop the best content.

Debate And Real-Time Changes

As he typically does, e-patient Dave has started a very interesting discussion on sites like Medpedia and the concept of participatory medicine. As Dave and others have shown, information flows slowly such that physicians (or others) cannot digest all of it and be constantly up to date on everything. Patients facing a chronic or life-threatening condition are motivated to do a deep dive on one topic.

Finding, sharing, and having access to information that is relevant, timely, and peer-reviewed (by patients and professionals) is critical.

“Participatory medicine is a phenomenon similar to citizen/network journalism where everyone, including the professionals and their target audiences, works in partnership to produce accurate, in-depth & current information items. It is not about patients or amateurs vs. professionals. Participatory medicine is, like all contemporary knowledge-building activities, a collaborative venture. Medical knowledge is a network.” (Wikipedia)

The posting and comments are interesting and demonstrate the power of web 2.0 where the founder of Medpedia comments and even makes some real-time changes to address the patients and professionals weighing in on the discussion.

Buyology: Best Book of 2009

I am finally getting around to writing this up. I mentioned the book – Buyology – a few weeks ago. It is definitely the best book I have read this year. It is by Martin Lindstrom and is all about neuromarketing.

For those of you that don’t think it’s relevant to healthcare, think again. Healthcare is all about compelling individuals to take action and become responsible for their health. That is about understanding how they interpret information and what drives them.

Here are some of my notes from the book:

  • One of the processes used was fMRI (functional Magnetic Resonance Imaging) which measures the amount of oxygenated blood throughout the brain. Scientists can see what part of the brain is working at any given time.
  • The other process used was SST (steady-state typography) which tracks rapid brain waves in real time.
  • One of his first studies looked at the effect of cigarette warning labels and found that they not only failed to deter smoking but activated the nucleas accumbens.
  • What people say on surveys and in focus groups does not reliably affect how they behave. [although it is often the best we have]
  • Brand matters…He re-conducted the Pepsi Challenge and showed that if people knew what they were drinking they preferred Coke to Pepsi. When they didn’t know, 50% of people liked Coke. When they knew, 75% of people liked Coke.
  • He showed that consumers have no memory of brands that don’t play an integral part in the storyline of a program. Just putting something in the movie, TV show, or video game isn’t enough to get you mindshare. AND, those successful placements also weaken our ability to remember other brands.

“Our irrational minds, flooded with cultural biases rooted in our tradition, upbringing, and a whole lot of other subconscious factors, assert a powerful but hidden influence over the choices we make.”

  • In the Smiling Study that he references, they revealed that people are far more positive and have a better attitude toward the business when the person they are dealing with is smiling. [Maybe a key thing for avatars and real agents as they talk to people over the computer and/or phone.]
  • Our mirror neutrons allow us to get pleasure just by observing or reading about people doing something that would give us pleasure – e.g., opening a present with a new Wii in it. [You can go to www.unbox.it.com or www.unboxing.com to enjoy this.]
  • Logos are dead. They showed that images that are associated with smoking (for example) were far more potent in creating a reaction in the brain than the logo.
  • “Secret Ingredients” matter…he shared several examples of how things sold differently when there were non-existent things listed on the label.
  • When people viewed images associated with strong brands – iPod, Harley-Davidson, Ferrari – their brains registered the same activity as when they saw religious images.
  • They studied and showed that odor can activate the same brain response as the sight of the product. He talked about an interesting study that showed that “feminine scents” such as vanilla were sprayed in women’s clothing sections, sales of female apparel actually doubled.
  • Sex, extreme beauty, or a celebrity in an advertisement can hijack attention away from the information in the advertisement.

“I predict that soon, more and more companies (at least those who can afford it) will be trading in their pencils for SST caps. That traditional market research – questionnaires, surveys, focus groups, and so on – will gradually take on a smaller and smaller role, and neuromarketing will become the primary tool companies use to predict the success or failure of their products.”

Some interesting facts:

  • 300 million people, including 60% of male doctors, in China smoke.
  • 8 out of 10 new product launches fail within 3 months.
  • In 2005, 156,000 new products debuted globally (or one product every 3 minutes).
  • In 1965, a typical consumer could recall 34% of advertisements from TV. In 1990, that number dropped to 8%. In 2007, consumers could only remember 2.21 advertisements from all advertisements they had ever seen. [Talk about saturation.]
  • We walk almost 10 faster than we do a decade ago. 3.5 mph
  • A study in Denmark showed that people talked 20% faster than they did a decade ago.
  • And, if you don’t believe that culture matters…In Asian cultures, four is an unlucky number and one researcher found that heart attacks among US residents of Chinese descent spiked as much as 13% on the fourth day of each month.
  • Children that experience social difficulties in school are more likely to be preoccupied with collecting.
  • Both J&J and Play-Doh have lost their original fragrances and haven’t been able to replicate it.
  • When classical music was piped over loudspeakers in the London Underground, robberies, assaults, and vandalism dropped by over 25%.

Some of the interesting companies mentioned:

I thought he had a great story about a rock. If I gave it to you for your birthday, you’d be offended until I told it was from the Berlin Wall. And then when I told you it was from the moon, you would be even more impressed.

For more information, there is also a neuroscience blog.

Limited Networks

I was reading Charlie Baker’s post on Narrow Networks, and it made me think about this concept from a pharmacy perspective.

In general, this is a default solution for mail pharmacy.  You can’t chose between Medco’s mail pharmacy and Express Scripts.  You have one or the other.

And, Mandatory Mail is an expansion on this.  It not only limits the network size, but it forces you to use the network in certain ways (i.e., if you have a maintenance drug you have to fill it at the lowest cost location).

In specialty pharmacy, this has certainly been the trend.  More and more companies are limiting the choice of specialty pharmacies that you can choose from.  In some cases, this is dictated by the manufacturer who limits distribution of their drug to only certain pharmacies.  And, then Mandatory Specialty will drive you to a specific mail site for your specialty medications.

Within the retail network, this has been tried a few times, but without much adoption.  That being said, I found retailers very willing to offer lower prices to clients if they were part of a limited network (where they expected to get more marketshare).  Another option is to treat the network like a formulary (or drug list) with tiers and where members pay more to use certain pharmacies (which likely are higher cost or offer lower quality / service).

In this economy, I have to believe that we will see this take off.  Of course, consumers don’t like it, but it’s better than losing your benefit all together.  It seems like a logical change to the benefit…you limit choice without impacting outcomes in order to save money.  There are some times when it may not make sense.  For example, excluding CVS from the retail network in Boston would be a very difficult sell.  It’s all a question of marketshare, options, and ultimately the savings per disrupted (or upset) member.

Of course, the pharmacy network is very different than physicians.  I would think you could basically have any primary care physician, but everything else could be limited short of emergency care.

Is Your Conversation With The MD One-Sided?

USA Today had an article earlier this week called “Doctors Take Decider Role” which is about the fact that patients are often not asked about their opinions.  This is a problem on many fronts.  If you’re not discussing the pros and cons, you are not as likely to buy into the recommended treatment plan leading to lower compliance.

“In the real world, people agree to take drugs, have surgery and undergo tests after a much more one-sided process, new studies show. As a result, researchers say, too many people get care they don’t want or need and miss out on options that make more sense for them.”

In a scary example, the research showed the 69% of men heard the procs of taking a blood test for prostate cancer, but only 18% heard about the downside.  The research also showed that only 41% of patients were asked how they felt about taking blood pressure medications.  But, this obviously varies since 76% were asked to weigh in on their back surgery.

It begs the question of how aware doctors are of patients concerns and priorities.

Is Choice Good?

In recent discussions, I was talking with some clients about helping members or consumers save money in healthcare.  On the one hand, you can educate them about all the different opportunities.  On the other hand, you can focus them on one or two opportunities.  Those could offer the most value, be the simplest to execute, be the easiest to understand, or have some other logic in prioritization.

The question in my mind was what would drive the best results.  If you look at the research around consumer products and 401K’s (for example), it is clear that choice is not always best.  When presented with more options, people don’t always make a decision.  They get overwhelmed.

So, think about focus and simplification.

A Few Quick Things

Found this new blog – Drug Channels.  Lots of good posts.

Ron Lyon unfortunately doesn’t blog a lot, but several of his recent posts are very interesting on the Pharmacy Rants and Raves blog.

Bruce Temkin from Forrester blogs at the Customer Experience Matters and has some great insights across industries.

McKinsey has jumped into the social networking fray with their McKinsey Quarterly which is available with a Facebook page and Twitter feed.

A report on Medicare spending on healthcare by the Kaiser Family Foundation.

A new eBook on Finding Dr. Right.

Personalized Medicine Webinar

I don’t have anything to do with this, but it sounds pretty interesting.  Medco and Regence are talking.  Here is the teaser.  (Click here for more info and registration.)

Personalized medicine is moving rapidly. The FDA in December considered requests to require genetic testing for the colon cancer drugs Vectibix and Erbitux. Approval of such labeling changes could pave the way for a slew of other personalized therapies and diagnostics now waiting in the wings. Stakeholders anticipate significant clinical and financial savings. Recently approved genetic testing for the blood thinner warfarin, for instance, is projected to avoid 85,000 serious bleeding events annually and save roughly $1.1 billion a year!

On the other hand, questions remain whether the model actually provides a favorable return on investment (ROI). A new study finds that genetic testing for warfarin does not appear to be cost-effective in certain patients. And health plans and PBMs are trying to sort out which of the numerous diagnostic tests on the market actually provide clinical utility and improved results. One large health plan, for example, says its costs for diagnostic testing are growing at nearly 20% a year.

So where does all of this leave Rx payers in February 2009?

Ix for Rx Management

Josh Seidman from the Center for Information Therapy today announced on their blog that the center is going to begin focusing on “Ix for Rx Management” that will look at adherence along with other critical issues.  As I talk about all the time, finding the right way to deliver information to people in a way that they can accept it and act upon it is critical.  Given that we use more and more medications, this is a critical area where the center’s leadership can help build awareness of the problems.

“Although awareness certainly is an important precursor, it may be the easiest step in the pathway that takes the average consumer along the road to information consumption, then knowledge accumulation, and ultimately leading to behavior change. We know there’s a large body of research that tells us that, in order to be successful, our Ix initiatives need to “meet people where they are.” More specifically, we need to target the information to the individual’s particular moment in care and tailor it to their particular needs and circumstances.”

The Young Invincibles

“I could have gone to a major university for a year. Instead, I went to the hospital for two days.”

The New York Times had a good article about young people without insurance.  According to the article, there are 13.2M within this group or 29% of the age bracket (which I believe is limited to people in their 20’s).  The article talks about borrowing medications, setting their own bones, and using the Internet to self-diagnose.

“We see people with urinary tract infections taking meds better suited for ear infections or pneumoniaDr. Barbie Gatton explained (ER doctor in NY) “Or they take pain medicine that masks the symptoms. And this allows the underlying problem to get worse and worse.” — the problem is, they haven’t really treated their illness, and they’re breeding resistance.”

My impression is that most people in this age group only act as “invincible” since they can’t afford coverage.  The article does talk about legislation that would allow people to be covered under their parents insurance until they are 29.  That certainly helps some, but it puts a burden on employers that may not be fair.

Cigna And Social Media

I usually hold Humana out as an innovator in the area of established health care companies using social media and other tools to drive awareness.  I was pleasantly surprised to find out more about Cigna’s activities on Facebook, MySpace, and Twitter along with their deployment of games (like Humana) from the World Healthcare Blog.

its_time_image_5

Coupoing Back in Vogue

I don’t know what the statistics were before, but these statistics published this morning in the USA Today seem high.

    65% of people 18-39 examined mail more carefully for coupons versus six months earlier

    73% of people 40-49

    And, 57% of people 50+.

coupon

With unemployment expected to come out today at 7.5% (the highest in 17 years), we shouldn’t be expected, but it certainly puts new focus on using incentives to drive healthy behaviors.

Will Plans Cover Genetic Testing?

I came across this fact the other day from Systemed Group, a division of Medco. According to the 300 health plans they surveyed, 38% of them said they will definitely (3%) or probably (35%) cover genetic testing within five years.

Interesting. What will this mean? What will these test consist of? What will they cost? How will they be used? Will they cover the drugs that are personalized based on genetic makeup?

7 e-Patient Conclusions

Thanks to e-patient Dave’s reminder on the e-Patient blog

Here are 7 conclusions from the white paper that came out last year on this topic. Very important in diffusing some of the myths around the role of social networking in healthcare and the use of the Internet for information.

1. e-patients have become valuable contributors, and providers should recognize them as such.
“When clinicians acknowledge and support their patients’ role in self-management … they exhibit fewer symptoms, demonstrate better outcomes, and require less professional care.”

2. The art of empowering patients is trickier than we thought.
“We now know that empowering patients requires a change in their level of engagement, and in the absence of such changes, clinician-provided [information] has few, if any, positive effects.”

3. We have underestimated patients’ ability to provide useful online resources.
Fabulous story of the “best of the best” web sites for mental health, as determined by a doctor in that field, without knowing who runs them. Of the sixteen sites, it turned out that 10 were produced by patients, 5 by professionals, and 1 by a bunch of artists and researchers at Xerox PARC!

4. We have overestimated the hazards of imperfect online health information.
This one’s an eye-opener: in four years of looking for “death by googling,” even with a fifty-euro bounty for each reported death(!), researchers found only one possible case.

* “[But] the Institute of Medicine estimates the number of hospital deaths due to medical errors at 44,000 to 98,000 annually” … [and other researchers suggest more than twice as many]
* We can only conclude, tentatively, that adopting the traditional passive patient role … may be considerably more dangerous than attempting to learn about one’s medical condition on the Internet.” (emphasis added)

5. Whenever possible, healthcare should take place on the patient’s turf. (Don’t create a new platform they have to visit – take yourself wherever they’re already meeting online.)

6. Clinicians can no longer go it alone.

* Another eye-popper: “Over the past century, medical information has increased exponentially … but the capacity of the human brain has not. As Donald Lindberge, director of the National Library of Medicine, explains ‘If I read and memorized two medical journal articles every night, by the end of a year I’d be 400 years behind.”
* In contrast, when you or I have a desperate medical condition, we have all the time in the world to go deep and do every bit of research we can get our hands on. Think about that. What you expect of your doctor may shift – same for your interest in “participatory medicine.”

7. The most effective way to improve healthcare is to make it more collaborative.
“We cannot simply replace the old physician-centered model with a new patient-centered model… We must develop a new collaborative model that draws on the strengths of both systems. In the chapters that follow, we offer more suggestions on how we might accomplish this.”

Improving Your Healthcare Communications

I put up a new page off the site that talks about HealthComm that many of you might find interesting.

Healthcare communications is a strategic opportunity for most healthcare entities. This framework should help you think about how to design solutions to drive behaviors within your membership.

Gartner’s Predictions

Gartner put out there top 10 predictions.  Three of them stood out to me as relevant for what I like to discuss.

By 2012, successful enterprises will actively encourage and reward more failures in order to find the optimal approach they want more quickly.

By year end 2013, 40 percent of enterprise knowledge workers will have abandoned or removed their desk phone.

By the end of next year 2010, wireless operators will cease to offer unlimited (flat-rate) mobile data plans.

Rewarding failure…finally.  This is how healthcare will learn and improve.  As consumerism continues to dominate, it is going to be more and more important to test new ideas quickly realizing that many will fail before we “solve” the problem.  Everyone is always looking for the silver bullet which usually doesn’t exist.  AND, if it does, it’s often temporary as things change both with the patient’s condition and/or with the treatment options that they have.

The death of the desk phone is rapidly happening today.  I like to have one when I am in the office, but if I make 30 calls a month from my desk phone, I would be amazed.  I don’t even have voicemail set-up.  Any calls just get forwarded to my mobile phone.

No more unlimited plans…That would be unfortunate.  Talk about driving adoption and then taking away the incentive.  The convenience of the mobile devices blended with the low cost has created an “addicted” culture that loves their phones.  As the economy lags, I would see this trend having a negative impact or being completely met with negative reaction creating opportunity for new players.

Walgreens Complete Care and Well-Being

Walgreens has just announced their offering to push into the on-site clinic market.  It is not completely new for them, but this is certainly a broader offering leveraging several assets they have acquired.

The program’s foundation is the pharmacy and health centers located on employer campuses or manufacturing facilities, along with Take Care’s in-store retail clinics and Walgreens nationwide pharmacies. Take Care’s employer health centers can offer complete pharmacy and health care services ranging from acute (e.g. strep throat) to primary care, occupational health, infusion services, specialty pharmacy, prescription mail services and disease management and are staffed by a combination of Walgreens clinicians including physicians, nurse practitioners, physician assistants, nurses, pharmacists and other health care professionals. Take Care Clinics, walk-in health care clinics open seven days a week and located at neighborhood Walgreens drugstores nationwide, are staffed by nurse practitioners and physician assistants who offer health care services built around a family’s needs.

I have always found this model to make a lot of sense, but it is hard to scale beyond massive employer sites.  In general, I think you have to have at least 1,000 people at one site to even begin to see this as a profitable investment (if I remember my analysis from years ago).

I am not really sure what the “all prices transparent to the employer” means in their press release.  Are they really going to reveal the acquisition cost of drugs?  The cost of their private label medications?  The cost of a clinic visit?  I am not sure that’s necessary.

Providing convenience without increasing costs should be enough.  Employees will love it.  Of course, I have heard that once you put it in that it is impossible to pull these out without very negative employee reaction.  And, I do believe that convenience (as it does with 90-day Rxs) can help improve adherence with mixed with the right education and counseling.