A blog covering the health/care ecosystem and people.

Consumers who patronize Walgreens can get rewarded for tracking their physical activity   For the Steps with Balance program kickoff, self-tracking consumers can earn 20 points for every mile walked or run and 20 points for tracking weight. Walgreens implemented the Walk with Walgreens program in 2012. The program won an Effie Award for an outstanding marketing program. With the success of Walk with Walgreens, the retail pharmacy company has expanded the program beyond simple steps to include weight tracking and health goals for earning loyalty points. The program enables a few of the most popular self-tracking devices to sync so

While health care cost growth has slowed nationally, most Americans feel they’re going up faster than usual. 1 in 3 people believe their own health costs have gone up faster than usual, and 1 in 4 feel they’re going out about “the same amount” as usual. For only one-third, health costs feel like they’re staying even. As the second quarter of 2013 begins and the implementation of the Affordable Care Act (ACA, aka “health reform” and “Obamacare”) looms nearer, most Americans still don’t understand how the ACA will impact them. Most Americans (57%) believe the law will create a government-run health plan,

  As the Affordable Care Act, health reform, aka Obamacare, rolls out in 2013, American health insurance shoppers will look for sources of information they can trust on health plan quality and customer service satisfaction — as they do for automobiles, mobile phone plans, and washing machines. For many years, one of a handful of trusted sources for such insights has been J.D. Power and Associates. J.D. Power released its 2013 Member Health Plan Study (the seventh annual survey) and found that most consumers currently enrolled in a health plan have had a choice of only “one” at the time

Digital health is attracting the likes of Bill Clinton, Lupe Fiasco, Deepak Chopra, Dr. Sanjay Gupta, Arianna Huffington, and numerous famous athletes who rep a growing array of activity trackers, wearable sensors, and mobile health apps. Will this diverse cadre of popular celebs drive consumer adoption of mobile health? Can a “cool factor” motivate people to try out mobile health tools that, over time, help people sustain healthy behaviors? Mobile and digital health is a fast-growing, good-news segment in the U.S. macroeconomy. The industry attracted more venture capital in 2012 than other health sectors, based on Rock Health’s analysis of the year-in-review. Digital health

Only one-third of U.S. physicians believe that patients should have “full access” to their electronic health records, according to Patient Access to Electronic Health Records What Does the Doctor Order?, a survey conducted by Accenture, released at HIMSS13 in March 2013. Two-thirds of doctors in the U.S. are open to patients having “limited access” to their EHRs. However, the extent to which doctors believe in full EHR access for patients depends on the type of health information contained in the record. Accenture surveyed 3,700 physicians in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States, and found the doctors’

I endured what very few people could (or would) do in the past ten days: I traveled to New Orleans to the annual conference of HIMSS, the Health Information Management Systems Society, which features hundreds of suppliers to the health care information technology industry. I returned home to kiss my family hello and goodbye, and a day later flew to Austin for the annual South-by-Southwest conference for music, movie and digital folks. The health track at SXSW has grown over the past five years, and provides a start contrast to “health care” as embodied at HIMSS, and “health” translated through

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected. President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star. Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the

At HIMSS13 there are the equivalent of rock stars. Some of these are health system CIOs and health IT gurus who are driving significant and positive changes in their organizations, like Blackford Middleton, Keith Boone, Brian Ahier, and John Halamka. Others are C-level execs at health IT companies. In this latter group, many avoid the paparazzi (read: health trade reporters) and stay cocooned behind closed doors in two-story pieces of posh real estate on the exhibition floor. A few walk the floor, shake hands with folks, and take in the vibe of the event. We’ll call them open-source personalities. The

Here’s Ann R., who is a patient in the not-too-distance-future, when passive sensors will be embedded in her everyday life. The infographic illustrates a disruption in health care for people, where data are collected on us (with our permission) that can help us improve our own self-care, and help our clinicians know more about us outside of their offices, exam rooms and institutions. In Making Sense of Sensors: How New Technologies Can Change Patient Care, my paper for the California HealthCare Foundation, I set out to organize the many types of sensors proliferating the health care landscape, and identify key

  The U.S. economy is largely built on consumer purchasing (the big “C” in the GDP* – see note, below Hot Points). Americans have universally embraced their role as consumers in virtually every aspect of life — learning to self-rely in making travel plans, stock trades, photo development, and purchasing big-dollar hard goods (like cars and washing machines). Consumers transact these activities thanks to usable tools and information that empower them to learn, compare, and execute smarter decisions. That is, in every aspect of life but in health care. While the banner of “consumerism” in health care has been flown

“ACOs most assuredly will not…deliver the disruptive innovation that the U.S. health-care system urgently needs,” wrote Clay Christensen, godfather of disruptive innovation, et. al., in an op-ed in the Wall Street Journal of February18, 2013. In the opinion piece, Christensen and colleagues make the argument that Accountable Care Organizations (ACOs) as initially conceived won’t address several key underlying forces that keep the U.S. health care industry in stasis: Physicians’ behavior will have to change to drive cost-reduction. Clinicians will need “re-education,” the authors say, adopting evidence-based medicine and operating in lower-cost milieus. Patients’ behavior will have to change. This requires

Overuse of health care is defined as the delivery of health care services for which the risks outweigh the benefits, according to a study into the utilization of ambulatory care health services published in the January 28, 2013, issue of JAMA Internal Medicine (the new title for the Archives of Internal Medicine). “Trends in the Overuse of Ambulatory Health Care Services in the United States” found that, of the estimated $700 billion that is wasted annually in U.S. health care, overuse comprises about $280 billion – over one-third of waste — equal to over 10% of total health spending in

The wealthiest Americans’ top financial concern is being able to afford healthcare and support they’ll need in old age. The #2 financial concern among wealthy investors is worrying about the financial situation of their children and grandchildren, closely followed by a major family health problem occurring and someone to care for them in their old age. These health-financial worries come out of a survey among 2,056 U.S. investors age 25 and over who have at least $250,000 in investable assets conducted by UBS in January 2013. UBS found that staying health and fit is investors’ top objective, with 73% of wealthy

While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average

The restaurant chain business employs 10% of U.S. workers and accounts for $660 bn worth of the national economy. Where restaurant chains are growing fastest is in serving up lower-calorie meals, and it’s been a boon to the bottom-line. The case for lower calories leading to better business is made in Lower-Calorie Foods: It’s Just Good Business from the Hudson Institute‘s Obesity Solutions Initiative, published February 2013. In the report, researchers analyzed nitty-gritty restaurant chain data on servings and traffic from 2006-2011 to sort out whether sales of so-called lower-calorie menu items in 21 chains led to improved business. The chains

On a recent Whole Living segment on Martha Stewart’s Sirius XM radio channel, I learned of the artisan chocolatier, Gnosis. The company, whose name is Greek for “knowledge,” grew out of the kitchen of a holistic health counselor, Vanessa Berg, who began to make nutritionally-infused sweets for her private clientele. Word-of-mouth made its way to a buyer from Whole Foods, who subsequently did a deal with Berg to sell Gnosis goods in some of the company’s stores in New Jersey and New York. Here’s a link to the radio interview. Chocolate is a health food for this company, and for

There are many ways to measure and express “patient engagement.” One such metric is “patient activation,” innovated by Dr. Judith Hibbard, long affiliated with the University of Oregon. Dr. Hibbard has written extensively about the Patient Activation Measure, PAM, first described in 2004. She and a team of researchers have determined that the higher a patient’s PAM score, the lower their health costs. Hibbard et. al. published these findings in the February 2013 issue of Health Affairs, which is entirely devoted to patient engagement – a top topic in Health Populi. The team analyzed the medical records of 33,163 patients

4 in 10 Americans got flu shots in this epidemic season, and most of these didn’t receive their immunization in their doctor’s office. The Flu Vaccination Survey from Ipsos Public Affairs, conducted in January 2013, paints a picture of U.S. health consumers who are project managing their personal approaches to preventing the flu in this historically hard-hitting flu season. The most expressed demand for flu shots has been among people 55 and over, one-half of whom have received vaccinations, with the lowest use been in the 25-35 year age group. Geographically, the most covered health citizens live in New England

Health and wellness motivations among women cross all generations, driving them to purchase products that bolster health as they define it…not how media and stereotyping advertising have typically portrayed it, according to a survey report from Anthem Worldwide, What Women Really Want From Health and Wellness. Over all generations, 3 in 4 women say they make choices to benefit their health and wellness. Anthem asked women about the “external voices” of health/wellness messaging versus their “internal voice.” The external represent societal expectations: over 80% of women expect to take responsibility for their family’s health, and about 70% of women say the

Most of us keep track of some aspect of our health. Half of all people who track do so “in their heads,” not on paper, Excel spreadsheet, or via digital platform. Furthermore, 36% update their health tracking data at least once a day; but 16% update at most twice a month, and 9% update less than once monthly. Tracking for Health from the Pew Internet & American Life Project paints a portrait of U.S. adults who, on one hand are quantifying themselves but largely aren’t taking advantage of automated and convenient ways of doing so. Overall, 69% of U.S. adults track

U.S. consumers’ desire to take an active role in their health decisions is growing, according to the Altarum Institute Survey of Consumer Health Care Opinions. 61% of people want to make health decisions either on their own (26%) or with input from their doctor (38%). The proportion of people wanting to be “completely in charge of my decisions” rose 4 percentage points in one year, from 2011. This statistic skews younger, with 33% of people 25-34 and 31% of those 35-44 wanting to be “completely in charge.” Only 17% of those 55-64 felt like being totally in charge of their

On this day celebrating Martin Luther King, Jr., I post a photo of him in Detroit in 1963, giving a preliminary version of his “I Have a Dream” speech he would give two months later in Washington, DC. As I meditate on MLK, I think about health equity. By now, most rational Americans know the score on the nation’s collective health status compared to other developed countries: suffice it to say, We’re Not #1. But underneath that statistic is a further sad state of health affairs: that people of color in the U.S. have lower quality of health than white

The use of retail and work-site health clinics is up, and their consumers skew young. Overall, 27% of all U.S. adults have stepped into a walk-in clinic in the past two years. But only 15% of people 65 and over have used such a clinic. This begs the question: are retail and on-site clinics at the workplace filling the role of medical homes for younger adult Americans? The Harris Interactive/HealthDay poll published in January 2013 discovered that use of retail clinics grew from 7% in 2008 to 27% in 2012. The largest age cohort using walk-in clinics is people between

There’s good news on the macro-health economics front: the growth rate in national health spending in the U.S. fell in 2011, according to an analysis published in Health Affairs January 2013 issue. Furthermore, this study found that consumers’ spending on health has fallen to 27.7% of health spending, down from 32% in 2000, based on three spending categories: 1. Insurance premiums through the workplace or self-paid 2. Out-of-pocket deductibles and co-pays 3. Medicare payroll taxes. A key factor driving down health spending is the growth of generic drug substitution for more expensive Rx brands. Generics now comprise 80% of prescribed

Reed Tuckson of UnitedHealthGroup was the first panelist to speak at the kickoff of the Digital Health Summit, the fastest-growing aspct of the 2013 Consumer Electronics Show (#2013CES). Tuckson implored the spillover audience to all, “self-deputize as national service agents in health,” recognizing that technology developers in the room at this show that’s focused on developers building Shiny New Digital Things have much to bring to health. As Andrew Thompson of Proteus Medical (the “invisible pill” company) said, “we can’t bend the health care cost curve; we have to break it.” This pioneering panel was all about offering new-new technologies

When it comes to taking on personal responsibility, the #1 New Year’s Resolution is to engage in fitness and exercise, cited by 43% of U.S. adults, followed by healthy eating, noted by 37% of people. Other resolutions involving personal responsibility are Family (26%) Spirituality and faith (22%) Managing personal finances (22%. This survey was undertaken as part of Liberty Mutual’s The Responsibility Project (RP), which is taglined: “Explore what it means to do the right thing.” Launched in 2008, Liberty Mutual’s RP has been diving into the many aspects of daily living for which we, each of us, could take responsibility…including

People enrolled in consumer-directed health plans (CDHPs) and high-deductible health plans (HDHPs) are more cost-conscious than those enrolled in more traditional plans, according to Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey from the Employee Benefit Research Institute (EBRI), published in December 2012. The logic behind CDHPs and HDHPs is that if health plan enrollees have more “skin in the game” — that is, personal financial exposure — they’ll behave more like health “consumers.” By 2012, 36% of employers with over 500 employees offered either HRA- or HSA-eligible plans. About 15% of working age adults are enrolled

“The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more helath information online and will take more responsibility for their care. The doctor/patient relationship will be altered. Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but

Two surveys of American consumers point to their growing concern over (1) rising costs and (2) wanting control over their care. More than 1 in 3 U.S. adults put off health care due to costs in the past year, a Gallup poll found. As shown in the graph, this is the highest proportion of people forgoing care due to cost since Gallup began asking the question in 2012. This survey was conducted in November 2012. There are differences between people without insurance and those with commercial or public sector plans such as Medicare and Medicaid. Over one-half of uninsured people

This week-after-the-mHealth-Summit gives us the opportunity to synthesize several interesting studies on the state of mobile health in the U.S. with a few days of distance from the excitement of the conference. Deloitte’s report on mHealth in an mWorld asks how mobile technology is transforming health care.  Consumers are driving mHealth growth, Deloitte believes, with mobile apps “enhancing overall consumer engagement” they say. In a future scenario, Deloitte sees health consumers using social health networks for information, motivation and support, self-directing care, and using sensors to monitor and communicate health metrics. Clinicians will have clinical dashboards informed by Big Data

  One in two doctors is burned out. Physicians are seeing more patients in a day and spend less time with each of them. This leads to job burnout, and greater probability for medical errors and eventual liability challenges, along with feeling pushed toward early retirement. In a study published in August 2012 in the Archives of Internal Medicine, Mayo Clinic researchers learned that physicians are more burned out than workers in any other profession. And those at greatest risk of “being on a hamster wheel,” as Dr. Jeff Cain, president-elect of the American Academy of Family Physicians describes the scenario, are primary

Mobile technology will change the delivery of health care, according to 2 in 3 health IT execs polled in the 2nd Annual HIMSS Mobile Technology Survey, sponsored by Qualcomm Life. Only 2% of health IT management says mobile won’t impact the delivery of health care in the future. This week finds the mHealth Summit convening in Washington, DC, hosting some 3,000 interested stakeholders looking at the intersection of mobile devices and platforms and health and health care. The 2012 theme is Connecting the Mobile Health Ecosystem, and the exhibitor area of the Summit speaks to the broadening of that ecosystem, including

Reducing health care costs far outranks improving quality and safety, improving the public’s health, and upping the customer experience as Americans’ top priority for President Obama’s health care agenda, according to a post-election poll conducted by PwC’s Health Research Institute. In Warning signs for health industry, PwC’s analysis of the survey results, found that 7 in 10 Americans point to the high costs of health care as their top concern in President Obama’s second term for addressing health care issues. Where would cost savings come from if U.S. voters wielded the accountant’s scalpel? The voters have spoken, saying, Reduce payments

Health care professionals (HCPs) have adopted smartphones and tablets faster than the man-and-woman-on-the-street. As a result, mobile devices have become an all-important channel for communicating information to all clinicians: doctors, nurses and pharmacists. Today, medical practice is “done” via computers: the chart, from MedPage Today’s survey of physicians conducted in July 2012, shows that 100% of doctors get their learning via desktop and laptop computers (THINK: continuing medical education, for example). 88% of doctors go social online, including using point-of-care tools based on MedPage’s definition of “social interactions.” 9 in 10 doctors have increased the use of the internet in

The godfather of evidence-based medicine, Dr. David Sackett, said that the practice of evidence-based medicine integrates: Individual clinical expertise A patient’s values and expectations The best available external clinical evidence. If a physician’s got the first issue covered, and a patient is very engaged in their health in full collaboration with their physician, there’s still the third issue to deal with: the proliferation of medical information and keeping up with the literature. It’s impossible to be an expert, claimed two Welsh med school professors in the British Medical Journal in an honest appraisal of the “avalanche of information.” Today, med

There are many forks in the road facing us in the U.S. for deficit reduction, as the picture shows. This is the cover graphic for Choices for Deficit Reduction, a report from the Congressional Budget Office (CBO) published November 2012. Those roads could be labeled “Medicare” and “Medicaid,” as health is the #1 deficit driver for the American economy — most notably, Medicare and long-term care services financed via Medicaid. The CBO expects that per capita spending on health care, already at 18% of the national economy in 2012, will continue to grow faster than spending on other goods and

The ubiquity of mobile phones, increasingly smart ones (one-half of all mobile phones in the U.S. ), means people are walking around, working, playing and driving with self-tracking devices and ultra-mini computers in their pockets and totebags. 52% of smartphone owners seek health information on their phones, and overall 1 in 3 people seek health information on all mobile phones — nearly doubling the percent of those seeking health info via mobile in 2010 (17%). People who are sicker, caregivers, and those who have had a big change in health are also more prone to using phones for health, as

When the phrase “health care innovation” is considered, most people think about technologies like digital imaging, breakthroughs in cancer treatment, and robotic surgery. But before clinicians order or prescribe the use of any of those choices, there’s a cognitive process that gets them to that decision. It’s a cerebral mash-up of information, learned knowledge, and that special art of medicine embodied in the provider’s experience with patients, well-honed over time. How can innovation improve this process? “Healthcare innovation can be defined as the introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention and

In the wake of Hurricane Sandy, there are strange bedfellows coming together this week. First strange bedfellow moment for me this week was the video of Governor Chris Christie and President Barak Obama embracing and working together in storm-turn New Jersey yesterday. Saints be praised! to see a Republican and Democrat coming together, working together, consoling citizens together. In health care this week, another welcome strange bedfellow event is the statement issued by Catalyst for Payment Reform (CPR), an advocacy group of business, labor unions (notably, the AFL-CIO), and consumer advocates promoting broadly available information for consumers about the price and quality

Bob Blendon and his can-do team at the Harvard School of Public Health have done the heavy lifting for us by analyzing 36 telephone polls (that’s “polls,” not “poles”) looking at the role of health reform in the 2012 election cycle. I knew Bob Blendon when I was affiliated for a decade with Institute for the Future, and Blendon was affiliated as well as health politics consultant to the health team. He is the guru on this topic, so when I spotted his article, Understanding Health Care in the 2012 Election in this week’s New England Journal of Medicine, I dashed

The 78% of U.S. adults with primary care physicians (think: medical homes) are very satisfied with their doctors’ visits. The main reasons for this high level of satisfaction include communication (listening, talking), customer service (caring, personable), and clinical (good diagnosis and treatment). More women than men have a primary care physician relationship, more college grads do, and more people with incomes of $75,000 a year or more do, as well. 90% of those 55 and over have a primary care doctor – a stat heavily influenced by the fact that Medicare coverage kicks in for older people. This consumer profile

There are many definitions of mobile health, and Elsevier is adding another to the list. The world’s largest medical publisher has taken its new clinical search tool, ClinicalKey, on the road. Coined the ClinicalKey Experience Tour, Elsevier is coming to a medical center near you to enable clinicians, medical librarians, and health care administrators to give ClinicalKey a spin in their hospital’s parking lot. The challenge: the amount of new medical information doubles every 5 years, while 4 in 5 physicians say they have less than five hours a month to keep up with this, according to a DoctorDirectory survey. At the same time, health care providers feel hard-pressed

Grocery stores are incorporating farmers market-like shelves into produce departments, offering shoppers locally grown fruits and vegetables. Kraft Foods is reinventing itself as a health brand, with   Consumers are shifting away from white starchy breakfast foods toward beans and greens. These are a few of the food-meets-health trends from the past quarter that reflect how American health citizens are incorporating new food habits into overall health behaviors. Let’s begin with the October 11, 2012, issue of The New England Journal of Medicine, which focuses on obesity, food, and health policy. Along with an excellent overview of Obama v. Romney

The first day of the Health 2.0 Conference in San Francisco kicked off with a video illustrating the global reach of the Health 2.0 concept, from NY and Boston to Mumbai, Madrid, London, Tokyo and other points abroad. Technology is making the health world flatter and smarter…and sometimes, increasing problematic fragmentation, which is a theme that kept pinching me through the first day’s discussions and demonstrations. Joe Flowers, health futurist, offered a cogent, crisp forecast in the morning, noting that health care is changing, undergoing fundamental economic changes that change everything about it. These are driving us to what may

Being a doctor isn’t a happy profession in 2012: 3 in 5 doctors say that, if they could, they’d retire this year. Over three-fourths of physicians are pessimistic about the future of their profession. 84% of doctors feel that the medical profession is in decline. And, over 1 in 3 doctors would choose a different professional if they had it all to do over again. The Physicians Foundation, a nonprofit organization that represents the interests of doctors, sent a survey to 630,000 physicians — every physician in the U.S. that’s registered with the AMA’s Physician Master File — in March-June

Transparency in health care can bring greater empowerment and enable more rational decision making for health consumers. Physicians acknowledge this: “We believe that increasing transparency in the health care system can be beneficial to both patients and physicians,” said J. Fred Raslton, Jr., MD, FACP, president of the American College of Physicians. There’s an indication that patients will embrace transparency in the form of accessing their physicians’ notes about them, based on the OpenNotes project research published in the Annals of Internal Medicine this week. The objective of the study was to measure the impact on doctors and patients of extending

As the Web Goes Mobile, Healthcare Stands Still, sums up a survey from Makovsky Health and Kelton. Their research finds that, while consumers have beloved relationships with their mobile devices (phones and tablets) and use them regularly for aspects of daily living, healthcare information search is still largely managed via desktop and laptop computers. The infographic organizes some of Makovsky-Kelton’s findings. Of note is that parents are more likely to seek health answers online, Wikipedia has gained in health use since 2011, women are more likely than men to research before filling a prescription, and recommendations from friends and family are

  Consumers’ online access to electronic health records is growing in and outside of the U.S. — particularly evident in the U.K., where the National Health Service (NHS) patients are being given online access to their health records held by primary care providers (GPs). This program is termed “Record Access” and could morph into the larger concept of personal health records which, today, aren’t prevalent in the U.K. A new report analyzes U.K. consumers’ perceptions about online health record access called, Personal Health Records: Putting Patients in Control? The report was published in the UK by 2020health.org with support from Microsoft. The report is written

Americans find health insurance decisions the second most difficult major life decision only behind saving for retirement (36%) and slightly more difficult than purchasing a car (23%), via Aetna’s Empowered Health Index Survey. Why are health insurance choices so tough? Consumers told Aetna that the available information is confusing and complicated (88% percent), there is conflicting information (84%) and it’s difficult to know which plan is right for them (83%). Based on this survey’s findings, millions of Americans indeed feel dis-empowered by health care decision making. Who is empowered? Aetna says the empowered are likely to be more affluent, insured, married, take