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Tag: Scott Shreeve

Going off the Grid – The Rise of ‘Direct Practice’ Medicine

Grid (grĭd) n.

1. Something resembling a framework of crisscrossed parallel bars, as in rigidity or organization

2. An interconnected system for the distribution of electricity or electromagnetic signals over a wide area, especially a network of high-tension cables and power stations.

3. The interconnected system employed by the Medico-Industrial complex to create a third party payment systems which artificially creates complexity, increases costs, reduces quality, eliminates accountability, and destroys the patient-physican relationship.

As has been documented in this blog, I have been on a health care finance reform journey for the last six months. I was fortunate to be given the opportunity to work with Lemhi Ventures (outstanding group of health care innovators) on looking at new models of health care delivery, financing, and insurance. During the course of that project, I learned a ton about the nature of health insurance, current status of health plans (there has been plenty of interesting news the last six months on them here, here, here, and here), followed closely the presidential debates on health care reform and become familiar with many of the innovators within this space (Prometheus, Alan Goroll, etc)

A new article just published by MDNG Live (the same magazine that featured my cover story “Meet Your New Patients” last month) showcases Jay Parkinson with the catchy title, “Jay Parkinson Sells Out!” Catchy because one thing I don’t think you will be able to call Jay is a sellout. In fact, his “stick to my guns; this is how I believe medicine should be practiced” approach has enamored him to the public media and vicariously documented the groundswell of interest in this “new” health care delivery model. “New” in quotes, of course, because there is nothing new about this model of care delivery – a patient and a physician entering into a trusted relationship wherein the physician provides services that are valued by the consumer who pays cash for them. The millennial update is that physicians can now do this in new ways, with new devices that have become commonplace in every day life except for in the inane and archaic world of health care.

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New demands of ‘Millennial patients’

"Millennial patients are the first generation of Americans to grow up with the Internet as a pervasive part of their lives. … They are amazed, bewildered, and ultimately angry with the inability to access their health care services in this way. They cannot understand, and they will not tolerate, this disparity in the ability to manage health care transactions as simply as they manage their financial transactions."

Those are the words of regular THCB contributor Scott Shreeve in an article he wrote for the April issue of MDNG magazine. Shreeve adeptly describes the next generation of patients, whom he calls millennial patients. All at once, he says, they are consumers, providers and partners in managing their health.

Then, he talks about what it means to be a millennial provider in a new technology-dependent world. Shreeve says the health care industry’s initial lag in adopting health IT can play out to its advantage — so long as it hurries up.

"By observing the wider technology adoption patterns in fast-adopting industries like  financial services, we can reliably predict what trends will soon be impacting health care. We can also get a  sense of how consumers, traditionally called patients within health care, will respond as they adopt—and push their providers to adopt — the technologies that will simplify their health care interactions."

Personalized Medicine: Back to the Future

Personalized Medicine

  1. The type of sing molecular analysis to achieve optimum medical outcomes in the
    management of a patient’s disease or disease predisposition,
  2. Right treatment for the right patient at the right time.

As I have mentioned in several of my posts, I have been working on a
couple of health care finance reform initiatives over the last six
months. After banging away now for awhile, I am starting to see some
emerging ideas that are starting to bring out that old revolutionary
feeling of doing something that can have an industry changing impact.
The opportunity lies in the ongoing pace of innovation, with new forms
of health care delivery, with new models of health care financing, and
that fact that eh American public and politicians are slowly waking up
to the fact that our health care system is headed toward radical surgery (not the cosmetic kind).

So lets start this out by talking about the personalization of medicine.
This is typically thought of in a genetic sense, wherein people are
customizing medications and therapies based on your individual genetic
profile. Said in other words, the “Right treatment for the right patient at the right time”.
However, most consumers already assume Right/Right/Right is happening,
and more likely consider personalized medicine as a type of practice
delivery style. This is where the physician knows the patient
intimately, their social and demographic context, and the correct
diagnostic or therapeutic approach given the patient’s preferences that
have been learned throughout the relationship. The only physician I
have ever had whom I had this type of relationship with was Dr. Richard Jones who took care of me from age 6-21 (when the front office lady finally told me that I “really should find another doctor“).

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Health 2.0: The Long Tail of Healthcare

  • Long Tail: New business phenomenon in which low distribution and storage cost enable significant profits to be realized by selling small volumes of niche items instead of large numbers of popular items.
  • The potential for online retailers to make more money than their bricks and mortar counterparts because there is virtually unlimited “shelf space” to offer products.
  • Chris Anderson of Wired magazine editorial fame, coined the term and described the phenomenon in a 2004 article called The Long Tail. For the unfamiliar, the Long Tail is best described as the ongoing niche interest in something once the large pulse of public interest has died off. Essentially, so the theory goes, when distribution and storage costs of a business are very low, they can realize significant profit by selling small volumes of hard to find items to many customers instead of selling large volumes of a few popular items. Given the length, or the area of the curve under the “tail”, it turns out there is actually a greater opportunity for profits pursuing this niche strategy if the right distribution and cost elements exists.

    LongtailThe Long Tail Explained. As demonstrated by the above example, while Walmart sells the bulk of popular music at their stores, the distribution and storage costs elements of online retailers like Rhapsody are such that they can actually mine a very large, underserved niche market that proves to be just as, if not more, profitable.

    In my closing remarks yesterday on the final reactor panel at the Health 2.0 conference (totally off the cuff by the way as I was unaware I was going to have an opportunity to make a statement), I had mentioned this concept. However, given my uncharacteristic lack of preparation and desire to offer a coherent closing statement. I have including the following:

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