Empowered Consumers: The New Dawn of Healthcare
by Gopal Chopra, M.D., F.R.A.C.S., M.B.A, and Associate Professor
at Duke's Fuqua School of Business.
(Republished with permission from Strategic News Service)
Gopal is a key opinion leader, investment banker, strategic advisor
and entrepreneur in healthcare. He is the co-host of Duke's Medical Innovation
and Strategies Conference 2010: Wireless and Consumer Health. According
to the Strategic News Service, this article is an…"eloquent piece
on our fixing [the] healthcare thread…and…[a] more credible way out of
the mess we call healthcare in the U.S."
The crippled, troubled, confused, multifaceted, burdensome – the list of negative and problematic descriptors goes on – healthcare system should be given a "Do Not Resuscitate" status.
I ask a very simple, but not straightforward, question: Why fix the healthcare system?
I wonder why we are spending so much time trying to fix a system we should be focused on radically excising, as it has clearly failed on two critical accounts. First, it has limited our access to care by inefficient use of resources that are addressed by cost-saving measures that ration the service. And second, it has incentivized care in a way that defeats its very purpose, spurring doctors to perform procedures that are not only unnecessary, but may also be actively harmful.
View into the Future
Imagine a child's acute health issue that the parent discovers because a sensor alerts her to an anomaly. Information about this anomaly is transferred immediately to her careprovider, who then drives a protocol back to the parent through a virtual interface and checks that the management has been instituted successfully.
This technology-enabled exchange helps avoid a potentially dangerous clinic or emergency department visit and allows physicians to improve their capacity to see more patients. This solution relies on a sophisticated, cutting-edge technology known as... email! So when one adds additional technologies, including multimedia, search engines, tagged data, and cloud computing, we are talking about a paradigm shift in healthcare access.
The Democracy of Healthcare
Is there a prescription for the healthcare system? Yes: Accelerate the current system's demise.
How? Innovate to re-create the value by empowering the consumer. Do not convert institutions to specialty shops, but rather into better-equipped places of holistic and integrated consultation combined with consumer education that goes beyond the current model. Force technology companies to service more than the device or pill by participating more intimately in the consumer need. Do not perpetuate disease with disease management, but pour resources into disease prevention.
We need solutions companies, not efficient provider systems. By re-creating the dynamic of a true marketplace, we will force change. The democracy of our health begins with the democratization of access: access to data about one's options, choices, and opinions from expert communities.
This access to our data and the system's will enable a whole new class of services that will exploit the consumer technology platforms and provide other attributes, such as mobility with cellular.
The iron curtain of health has a crack in it. We are a very savvy and engaged consumer planet. We are able to transform our reach and our knowledge via technology. We will redefine the system and the way we engage with health. We will see the greatest innovation outside of the punitive and burdensome worlds of regulatory process, and then we will demand change.
Our insecurity of privacy, our tethered ties to visiting the primary-care physician, our expectation that choice will come to us, our dependence on institutions of insurance, and provider advocacy will all fall as we start to realize that innovation has a more disruptive pathway and that we can get access to this innovation wherever we are.
I am currently personally focused on the problem that the consumer is not able to access timely and relevant information to navigate health triage and choice.
The doctor is restricted and not fully enabled with technology, protocols, and relevant information that would improve his or her productivity. The consumer and the prescriber in this environment are hamstrung, and the opportunity here is to re-engage them in a more meaningful dialog and improve the health literacy on both sides of the equation.
The consumer barrier to decision processing centers around the lack of clarity and incompleteness of information. With regard to the consumer's health, the greatest uncertainties are how applicable the prescribed investigation and treatment are to their condition, what it is they are undergoing, and whether there are options to the pathway and methodology.
The decision tree is largely an internal medical paradigm that we need to expose intelligently and simply to the consumer. There is no reason this could not be consumer-driven, based on what we do with financial reporting and with online purchasing of various complex technology merchandise.
The mobile health solution paradigm of Dauphin is the focus on the dialog that occurs between consumer and physician and the critical elements of data transfer that empowers the consumer to be in charge of decision making and empowers the provider to provide better, more productive care. [Ed. note: Dr. Chopra is the founder and chairman of Dauphin Health.]
Consider the scenario of a routine peak flow breath test performed by a child with asthma.
When the test result is returned as normal, it is wirelessly loaded onto the parent's smartphone. That day the child then goes to sports camp, where the pollen count is high outdoors, and comes home breathless as a result of environmental allergen-induced asthma.
The parent has guidance protocols for intervention that manage the steps to control this recurrent event, and the active information gathered from the peak flow and an oxygen monitor applied to the child's finger are transmitted to the pediatrician on call for expert opinion on the status of the child.
A linked history of past events is delivered to the physician, and other vital parameters are screened. The vitals are being monitored virtually, and signs and trends of potential adverse event or unresponsiveness to therapy alert the pediatrician and parent, allowing triage to occur for more acute management.
When one considers the fact that we can provide this at home, on vacation, during school, at camp, with the doctor at home or in the office, the platform becomes very powerful, obviating the issues of access and delivering more than what one could hope to deliver over the phone.
This is a capability we bring today. By linking information with knowledge of protocols and data trends, we can manage consumer health needs remotely and successfully alleviate an overburdened acute-care setting.
I am encouraged and enthused by several early-stage endeavors that are also following this logic and working hard to change the landscape of healthcare delivery and refocus us on health promotion. The information may seem complex, but once it is appropriately labeled and packaged, we can act upon what is relevant when we need it.
There are new devices that incorporate seamlessly into the consumer environment, interpret the data, provide the uplink to the expert, and alert the consumer regarding the next step in the management protocol. The financial models for companies in this realm vary: some charge a premium for the product choice made at the end of the simple exam, and others sell a contracted service to manage the clinical condition, short- and long-term.
Employers are engaging companies that are rewarding healthy lifestyle choices made by their employees and renegotiating rates with their large payer contracts for better insurance premium tiering based on the risk reduction. These programs can be general and/or highly specific to chronic conditions or predisposed genetic conditions.
Information sharing is making this possible, and protocols and paradigms are being provided with clearly documented positive impact and outcome benefit. Data mining companies are preparing for the significant transaction environment of the online consumer in the healthcare market, where significant choice and guidance data can be generated from an involved and empowered consumer group that will detect and intervene in high-risk behaviors such as non-compliance or the wrong prescription.
I hope to see many more companies taking a support role in the consumer's life to make the navigation of choice and the awareness of outcome and delivery of better options for managing these transactions.
Taking Charge of Our Health
As a populace, we need to search long and hard about where we stand with our own health and that of our loved ones.
We need to actively get involved in the activities, diet, and screening of those around us so that we obviate the need for healthcare and the dependency on the system to provide maintenance and correction, and thus invest in improving our health with intelligent choice.
As an innovator, I am building and exploring these highways to disrupt and unravel this ailing system and encourage the world to move naturally toward a new dawn of health promotion.
(Republished with permission from Strategic News Service)
- The Second Annual Medical Innovation and Consumer Strategies Conference:The Future of Healthcare, Wireless and Consumer Healthcare – September 15, 2010
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