By Matthew Holt

Today venerable health content creator Healthwise merged with the Informed Medical Decisions Foundation which was previously funded by (and had an exclusive relationship up until last month with) Health Dialog. I asked Healthwise CEO–and old friend of Health 2.0–Don Kemper what was happening and what it meant. I also snuck in a smidgen of snark about a conference we worked on together five years ago.–Matthew Holt

Matthew: Don, you’re merging Healthwise with the Informed Medical Decisions Foundation. So I know the two organizations are both non-profits but as a poorly informed outsider I always thought of you as rival content creators, with Healthwise selling your content and services to insurers and providers and Informed Medical Decisions being funded by Health Dialog which then got to use and sell the content and decision support aids it created to its customers. Am I wrong?

Don: You aren’t completely wrong—but then not overly well informed either. We have always thought of ourselves as sister organizations rather than rivals. We have collaborated well in advocacy efforts to promote the role of the patient. Health Dialog has had a near exclusive relationship with the Foundation until recently. Health Dialog has been a long-term client of Healthwise, too—just not an exclusive one. When the restructured Health Dialog-Foundation relationship dropped the exclusivity requirement it allowed us to proceed with the merger discussions.

Matthew: Now that change occurred for Informed Medical Decisions and you two can merge, what do they have that Healthwise hasn’t got, and vice versa?

Don: The Foundation has three things that will add greatly to the Healthwise mission:

1. Medical Evidence—Their assessment of medical evidence in key areas goes deeper than we have been able to go. Whereas we have often waited for treatment guidelines to change before reflecting the changes in our content, their medical editors are often involved in making the guideline changes. Getting that information into the patient’s hands six months earlier could make a life or death difference.

2. Value Demonstration—The Foundation has developed research relationships with many health services researchers around the country. By setting up and evaluating demonstration sites for shared decision making (SDM) they have proven how SDM improves decision quality and reduces the use of expensive but preference-sensitive treatments.

3. Practice Change Management—The Foundation has gained a great deal of experience in helping clinicians build SDM into their workflow. Those learnings will help as we integrate patient engagement into the mainstream of care.

What they get from us is “reach.” People now turn to our information, tools and solutions over 340 times a minute. (180 million times a year). Fifteen percent of US physicians can now prescribe Healthwise patient instructions through their EMRs.

Healthwise has invested heavily in the technology needed to integrate into EMRs and has excelled at building broad-based solutions that fit within a health plan’s or health system’s workflow. It would have been hard for the Foundation to have matched that without us.

Matthew: So how will this actually work. How many people do you have, how many do they? Who gets to keep their jobs? Is this a real merger or a takeover?

Don: This is a merger made in heaven. No one will be out of work. Part of the Healthwise culture is “to do the right thing”. That is a good fit for the Foundation’s culture as well and it will apply to all of our employees. Plus, our missions are so well aligned that full integration is both desirable and possible. The only real loss is that, since the new board size is limited to 13, we will have to drop a few really great people off of each board.

Still the resulting 13 board members are fantastically strong, diverse and passionate about the mission. The merger will add the Foundation’s 31 employees to our 234. It is a 13% increase in staff size but a far greater increase in impact.

Matthew:What do you expect to see different for Healthwise clients in a few years as a result of this merger?

Don: Beginning immediately our health systems clients will see a higher level of support for the integration of our solutions into their delivery systems. Practice change management is never easy. Most systems are facing the daunting task of shifting from purely fee-for-service to a mix of payment models for which the patient’s role can contribute to financial success. With the help of the Foundation’s experience we can help those systems in the very near future.

Longer term, our clients can rest assured that the quality of content coming from Healthwise is unsurpassed. It will be hard for others to match the rigor that our combined teams will apply across such a broad array of health conditions. And, our clients will also be thrilled with our increased research ability to measure and quantify the benefits that they receive from our solutions.

One thing you will see in the years ahead is a new generation of decision aids that can be personalized to each person’s situation and interests. The new generation will also focus more on patient engagement after the decision is made. No matter what informed choice you make, we want to help you make the choice a successful one for you.

Matthew: Five years ago another non-profit you started, the Center for Information Therapy did a conference with my organization Health 2.0 in which we debated the topic of whether validated information via provider prescription, or general crowd-sourced wisdom online would be more powerful in the future. I know it was a bit of a false dichotomy but 5 years on, has your view of any of this changed?

Don:  No, my view has not changed. Just as food and air are both needed for life, evidence-based information and shared experiences are both needed to guide a person’s decisions. Know what the science says about risks and benefits of the choices you face, but also learn what those who have experienced the same choices have thought of their results. Both eat and breath for a better life.

Matthew: Isn’t the fact that the Center for Information Therapy snuck “information prescriptions” into the Meaningful Use legislation in 2010 (note: see #21 here) and then declared victory and shut itself down proof that the wider epatient movement has more legs than “information therapy”?

Don:  Quite the opposite. The Meaningful Use rules have inserted information therapy into the mainstream of American medicine. They require clinicians to prescribe well-vetted information to their patients. After that victory, the Center’s job was done. For a non-profit, it’s the mission that counts the most.

Now, we are trying to get the patient’s response to information prescriptions included in the Meaningful Use Stage 3  rules under the tag of “patient-generated data”. The ePatient movement embraces all aspects of expanding the patient’s role. We feel like we are a big part of that.