Tag: The Insider’s Guide To Health Care

Can “consumerism” work in health care?

May 6, 2008• 14

By Brian Baum

“Consumerism,” — free market, open competition – regardless of the term used to describe this market behavior, can the concept of “natural market forces” exist in health care? It seems as though observers of the health care “market” fall into two distinct points of view:

POV 1: Consumerism in health care is a train that has already left the station.POV 2: Health care is different and true market forces can never prevail because the players’ roles are so polarizing, and the “buyer” and the “consumer” are so disconnected.

I suspect that for anyone reading this, you have already checked off your respective point of view. (While the merits of this topic are worth debating, ultimately, time and events will answer this question.)

In the meantime, let’s consider the following:

Ratings games

Mar 31, 2008• 9

By Jane Sarasohn-Kahn

Most Americans believe there are fair and reliable ways to gauge the quality of health care. 9 in 10 Americans are interested in their health plans having a website where you could rate doctors on issues like trust, communications, medical knowledge, availability and office environment – and participating on such social networks (think: The Health Care Scoop, or Zagat/WellPoint).

The latest Wall Street Journal/HarrisInteractive survey published March 25 finds that 3 in 4 consumers favor patient satisfaction surveys – once again asserting they value opinions from peers (aka “people like me”) even more than those coming from institutions, whether private sector (e.g., employers or health plans) or public (e.g., government agencies).

Nonetheless, consumers still do value other sources for ratings:

– 66% like medical boards
– 65% value assessments by third parties, such as JCAHO
– 64% of consumers like measurements on preventive screening tests
– 58% believe the use of EMRs is a proxy for quality
– 42% see malpractice suits as a useful measure of quality health care.

The timing of this poll nicely coincides with the news that Angie’s List – known for its home repair service ratings – launched a health care ratings service earlier this month. On Angie’s List, consumers will be able to rate some 50 types of health care providers – including doctors, dentists, pharmacies, hospitals and health plans.

Medicare releases hospital patient satisfaction data

Mar 29, 2008• 8

By Sarah Arnquist

Before choosing a hospital for an elective procedure, patients can now use the Centers for Medicare and Medicaid Services’ Hospital Compare Web Site to see how former patients rated their experiences at various hospitals. Patients can compare hospitals based on how well patients felt the doctors and nurses listened to them, whether the patients felt respected by the hospital staff, and whether patients understood the instructions on what to do after leaving the hospital.

Patients can also use the Hospital Compare Web site to compare how many patients were treated for heart attacks, pneumonia, and various surgeries at nearby hospitals and see how much Medicare paid.

These are the federal government’s latest steps to promote "value-driven health care."

"Everyone ought to have a motivation to get better quality and lower costs," said Michael Leavitt, secretary of the U.S. Department of Health and Human Services.

CMS launched the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data Friday before a group of hundreds of journalists gathering in Washington D.C. for an annual conference.

Average Time of Discharge: Why a Hospital is Not a Hilton

Mar 26, 2008• 7

By Robert Wachter

Do you get as annoyed as I do about being pressured on your “Time of Discharge?” I just received my monthly report, and we’re in The Doghouse again: our average TOD – 3:28 pm – is hours after “check-out time.”

But when did we turn into the Holiday Inn?
Robert_wachter

Let’s start by appreciating where this comes from. Many hospitals, including mine, tend to run full – given the huge fixed costs of operating a modern hospital, being full is probably the only way you can be profitable, just like the airlines. Queuing theory (don’t tell me you’ve forgotten your queuing theory!) tells us that, when you’re full, you should look for fundamental choke points and do your best to relieve them. There are PhDs working for McDonald’s whose lives are dedicated to figuring out how to avoid lines at lunchtime rush hour, and others working in aviation who model the best ways to load passengers onto planes (latest answer courtesy of a Fermi Lab astrophysicist: start in the back and load every third row, back to front, sequentially).

The main stenosis in hospitals occurs in the early afternoon: the morning’s OR cases are finishing, the ED is heating up, the clinics are sending over elective and urgent admissions, the respiratory therapists have done their weaning and “liberated” a few patients from vents… and everybody needs a floor bed. Now! But they’re all taken, since nobody’s gone home yet.

Gridlock. Bad for business.

How do you fix this? About a decade ago, some smart consultant (I can’t figure out who, but he or she must have had a terrific PowerPoint slide making this point since every hospital I know of picked up on it) came up with the solution: let’s measure and report the time of discharge by service, shining the holy light of transparency on service chiefs like me to get them cracking. And since everybody likes Goals, how about we set a guideline – “The Discharge Time on 5 South is 11 am” – and post it in every room and nurse’s station. Then it won’t be a shocker to the patients when we try to hustle grandma into the wheelchair and roll her out of her room before noon.

Mother-Power Online

Mar 21, 2008• 2

By Jane Sarasohn-Kahn

4 in 5 moms go online at least once a month, according to My Mommy’s Online. The report is based on 2007 data from Simmons Consumer Research Survey published by eMarketer.

"Being a parent makes going online almost a necessity," according to eMarketer.

40% of all women who go online in the US are mothers with kids under 18. There are 35 million of them (including me).

Intriguingly, virtually all women who are pregnant (94%) use the Internet, and half of the mothers surveyed use the Internet more since having a child.

What do Moms do online?

94% visit portals
88% visit retailers
74% go for news and information
70% go for conversation.

BabyCenter found that 68% of moms regularly make purchases online. This makes sense: moms are busy people, shopping online is convenient and substitutes trips to the store.

Speaking of BabyCenter, it was arguably the most heavily shopped site in 2007 according to comScore (even though it is categorized the site as a media site).

In any case, BabyCenter reaches 78% of pregnant women and mothers of kids up to 24 months in the U.S.

The site also maintains a 60,000-mom panel for market research which is a rich mine for finding out What Moms Want. Since mothers are primary caregivers in the household, this is an important site for health.

HEALTH 2.0/CONSUMERS: Susannah Fox on e-Patients and Health 2.0

Mar 6, 2008• 1

Two fantastic video clips from a fantastic researcher. (Susannah runs the health research program at the Pew Internet and American Life program.

Susannah’s (brief) keynote including the seven word meme that dominated the day!

Her interview afterwards:

BLOGS: Diabetes Year in Review

Dec 18, 2007

Our friend and colleague Amy Tenderich has a just excellent Diabetes Year in Review up at DiabetesMine. It covers Health 2.0 (of course) but also drugs devices, design, and the growth of people with diabetes as a social force.

Amy knows that she’ll always be the #1 blogger in my heart!

CONSUMERS: icyou goes to the Consumer Congress

Nov 13, 2007

Our friends at icyou (who by the way are doing a fabulous job with the forthcoming Health 2.0 DVD) are at the 3rd Annual Consumer-Centric Healthcare Congress this week. They have a raft of interviews with some of the smartest people in the pro-consumer care crowd (Michael Cannon and John Goodman), some people from technology (Sheila Mehan from WebMD) some from the old world of health care (Neal Miller from Kaiser talking about how to bribe people to go to the gym ($150 for going 90 times a year! and Bridget Duffy from Cleveland Clinic on patient advocates— Health navigation they call it )—all talking about consumer driven health care.

CONSUMERS/TECH: Molly and Don write a Gray Paper

Oct 10, 2007• 2

So this morning and yesterday afternoon at the Ix Conference I’ve heard some really interesting technology presentations from Silverlink (disclosure Ix and THCB sponsors!) & Eliza, who are both in the voice automated outbound call space. Popped in on Resolution Health, which looks like it’s emerging as a big time competitor to Active Health Management, and saw an interesting lite-weight messaging system for docs to communicate with patients (and vice versa) called CareNav. Then quick look at how Healthways working with Pro-Change Behavioral Systems is really tailoring (that’s the big Ix word this year!) HRAs—although not all Americans have taken one or even know about HRAs!

CONSUMERS/TECH: David Sobel stars on Tuesday morning at the Ix Conference

Oct 9, 2007

Yesterday (Monday) there was a great session about advertising in health care—but actually impossible to blog about as it was mostly funny videos! Great stuff from Hollywood writer Marty Montgomery who works with Vic Stretcher, HealthMedia Inc, & also from Michelle Sobel, Emmi. Go look at their sites, but briefly, people are prepared to learn about stuff that they are interested in and entertained by!

Ix this morning started with Earl Steinberg from Resolution Health and Jim Prochaska from Pro-Change Behavioral Systems. Lots of data but shorter version is, targeting and tailoring data to those targeted patients works pretty well.

Next, an award for Susan Edgman-Levitan pioneer in patient information and advocacy who actually founded Picker Institute—the originally patient survey organization. Apparently finding out what patients actually thought and wanted was a new idea before Susan showed up!