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CONSUMERS/TECH: Data and more impressions from Information Therapy conference

More from Park City….

Shorter Mark Bard (Manhattan Research)– two thirds of docs are suggesting that younger female patients go to the web, but there’s no financial mechanism for it, and no real business case for physicians to do better websites, eVisits, or anything much else so far.

Shorter Susan Denzter (PBS NewsHour Corespondent) (via phone as she’s on the way to cover Rita) — Consumers don’t understand numbers, they don’t understand simple instructions, and simple numeracy and literacy is a big challenge especially among the elderly and less educated, which is a lot of people. Plus no-one understands (and this includes journalists and drug detail people) the difference between relative and absolute risk. And people make irrational choices even when presented with the correct information. She calls it not Information Therapy, but Information Fughedaboutit. So she asks her sources to talk to her on air as if she’s an intelligent 12 year old. So there are lots of reasons why information is good but no way is it enough to explain behavior.

I’m reminded of the time that at IFTF we put the California HEDIS measurements up on one chart and asked the audience to pick their health plan by looking at it. It was a rainbow of conflicting color-coded circles. No one could figure out until about a year after we’d been showing it one bright guy said "look you should join Cigna Southern California as they do the best on the most measures".  And he was right.  Then we told him that Cigna Southern California was the staff-model Medicaid HMO with clinics in Compton and South-Central LA.  Somehow we felt that that information, even though it was irrelevant to objective care measures, may well have swayed his choice of plan.

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  1. //Consumers don’t understand numbers, they don’t understand simple instructions//
    Another factor is consumers may not have time for understanding or engaging in learning curve. Often efforts to educate the consumer are accompanied by a massive disrespect for the consumer’s time. It’s not just about the consumer’s family, job, and other responsibilities – it’s about all the different sectors who are foisting small print on the consumer. Then bad things happen – and it’s not because the consumer was stupid or irresponsible, it’s because the reality is that people have to prioritize their time, and they have to make choices about which thing they are going to educate themselves on each day.
    As for physician web sites – I worked specifically on this at Kaiser, and I have some specfic things to say:
    1) Physicians in general don’t have time to maintain a web site, much less learn how to use new web applications used to create and manage these sites. Some physicians might be interested in buffing up their web skills for personal reasons, or perhaps to develop credentials to sidle into a Health IT Executive position. Someone else has to be hired (in this case me) to edit, format, and ghost write all these sites. So why sap the physician’s time in the first place, and why not just hire someone to produce the content of these sites?
    2) Physicians often know nothing about design. When left to produce their personal sites, they will often produce something that looks unprofessional. They will use gaudy colors and tacky text. They will cover their site with cute animated gifs with no understanding whatsoever of the legal issues involved with snatching gifs from the web and then using them on a business site. These sites undermine the reputation of a corporation and may put it at legal risk. Physicians should not be *expected* to understand these issues. Physicians-turned-IT-executives should not be in charge of such operations. Someone who actually knows something about web production should be managing physician web sites.
    3) Physicians are only starting to understand the concept of information aggregation. Information they post about themselves on their physician web site may be combined with information found in other places on the web. I demonstrated this issue to a physician I worked with: I started with seemingly innocuous information found on his physician site and came up with all sorts of other information about him in a matter of minutes. Sooner or later there is going to be an incident where aggregated information is exploited for harmful purposes, and when that happens I suggest the first person to be sued should be the employer who forced physicians as part of their job to post personal information about themselves on the web.
    I have a lot of other thoughts on this, but it’s probably not appropriate to put them here…

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