By Val Jones MD

I had the chance to speak with John Rother, Executive Vice President of Policy and Strategy for the AARP
about the intersection of online health, information technology (IT),
and the baby boomer generation. Find out what America’s most powerful
boomer organization thinks about the future of healthcare in this
country. > Listen to the podcast

Dr. Val: Recent studies suggest that Americans age 50 and
older are more Internet savvy than ever before. How are AARP members
using the Internet to manage their health?

Rother: People over the age of 50 are the
fastest growing set of online users, and healthcare is the major reason
why they’re going online. They’re looking for health related news, help
with diagnosis, and finding appropriate healthcare providers.

Dr. Val: What role can online community play in encouraging
people to engage in healthy lifestyles that may prevent chronic
disease?

Rother: Our experience is that online
communities can be extremely helpful in several ways. First, it
provides emotional support for people who have a shared experience,
whether it’s as a caregiver, or being recently diagnosed with a disease
or condition. Second, people seem to feel more comfortable asking
questions of others with their condition than they do their own
physicians. And third, online communities can reinforce needed behavior
change. Whether it’s weight loss, exercise, or quitting smoking –
online communities can be just as effective in encouraging behavior
change as a face-to-face community.

Dr. Val: Tell me a little bit about the communities on the AARP website.

Rother: Currently our communities are organized
around medical topics, but in the future I think the communities will
become more geographical. An online community designed to serve the
needs of people in a given location can facilitate information sharing
about how to navigate a particular hospital system, for example,
instead of just general information about coping with a disease or
condition.

Dr. Val: Intel just announced that it has FDA approval for its “Intel Health Guide.”
The unit enables caregivers to provide their patients with
more-personalized care at home, while also empowering patients to take
a more-active role in their own care. What do you think of this
technology?

Rother: I think information technology is going
to have all kinds of beneficial applications for people with health
challenges. Personal health records and this Intel Health Guide are
very well suited to the needs of individuals with chronic health
conditions, and I expect to see more Internet based tools developed to
help people to make appropriate decisions and change their behavior.

General information is helpful, but personalized information is
the key. The more these technologies allow you to have your own
individual information at your fingertips and allow that to be the
basis for recommendations and decision support, the more powerful it’s
going to be. This is all very promising technology – the next question
is, can people afford it and will the people who need it be able to use
it?

Dr. Val: In your opinion, what role does health IT have in reducing healthcare costs and improving access to care?

Rother: Health IT can support almost every
aspect of healthcare. It can decrease costs by reducing duplication.
Many people with chronic conditions see different doctors – and if you
have to go through the same set of X-rays or CT scans every time you
see a different doctor, that can get very expensive. A good, common
medical record system is critical in reducing costs and improving care.

IT can also reduce the cost of health insurance, in the way that
online car insurance has reduced car insurance premiums. If we reform
our health insurance market, this could offer substantial savings to
individuals.

People often use the Emergency Department inappropriately – for
minor issues instead of true emergencies. A good decision support
system that helps people to figure out when they need to go the ER
could be helpful in reducing costs.

Dr. Val: What are the AARP’s major health-oriented initiatives?

Rother: The AARP is very focused on healthcare
because our members tell us that it’s their top priority. The cost,
quality, safety and accessibility of healthcare are important to us, so
we are involved in a broad spectrum of initiatives.

First of all, extending coverage to all Americans, regardless of
their age or health condition, is a top priority for the AARP. Second,
In terms of health quality, it varies quite broadly among hospitals in
the US. If we could get everyone to copy the best hospital practices,
we’d have a much more manageable problem.

Dr. Val: What needs to happen to America’s healthcare system
in order for it to serve the needs of baby boomers on its limited
budget?

Rother: We spend almost 2.5 trillion dollars
for healthcare in the United States, so I don’t think of it as a
limited budget, but quite an expansive budget. There is enough money in
the system to fully respond to the needs of the population. It’s just
that we’re not organized very well and the system has become
fragmented.

The healthcare system needs to be organized in a more
person-centered way, and we need it to shift from a focus on acute care
to a chronic care model. We need a different system of health delivery
– one that relies more on nurses and other physician extenders. People
need to join support groups to modify their behaviors and risk factors
and rely on IT to help them make appropriate decisions.

So you put that all together and you have a pretty big agenda
for change. I don’t know if we can achieve this all at once, or if it
will occupy us for several years. The upcoming election gives us the
opportunity to do this at the Federal level, though there are many
private sector initiatives that are currently making important
contributions.

Dr. Val: Can you give me an example of someone in the
private sector who’s making an important contribution to improving
healthcare?

Rother: The AARP just met with the leadership
of the Mayo Clinic, one of the most outstanding medical institutions in
the country. They provide excellent care at a cost that is less than
most other parts of the healthcare system – and with improved outcomes.
We asked them about their secret to success.

Mayo has an electronic medical record and all their patients
have their information online. The physicians are on salary, so there’s
no incentive to order unnecessary tests or procedures, and Mayo has an
ethic of patient-centered care, with a long history of attracting the
best people and rewarding them.

If Mayo can do it, why can’t everyone else? The AARP believes
that the potential is there for most communities to have excellent care
– we must emulate the care delivery of institutions like the Mayo
Clinic, and put in place payment and information systems that will
coordinate care management better. It’s a big job and will take some
investment, but we have many opportunities to do a better job than
we’re doing today.

Val Jones, M.D., is the President and CEO of Better Health, LLC. Most
recently she was the Senior Medical Director of Revolution Health, a
consumer health portal with over 120 million page views per month in
its network. Prior to her work with Revolution Health, Dr. Jones served
as the founding editor of Clinical Nutrition & Obesity, a
peer-reviewed e-section of the online Medscape medical journal. She currently blogs at Get Better Health, where this post first appeared.