A blog covering the health/care ecosystem and people.

Among factors that contribute to patients’ positive experiences with health care providers, the doctor’s ability to access ‘my’ overall medical history is nearly as important to consumers as the doctor’s overall knowledge, training and expertise. This enlightening data point comes to us from a Harris Interactive poll conducted in July 2012 and published this week. This news is important because it’s National Health IT Week. I attended the kickoff meeting for #NHITWeek yesterday in Washington, DC, held in the Department of Health and Human Services headquarters building named for Hubert Humphrey – an early public health proponent (and trained pharmacist,

With “Zero” large employers expecting to drop health insurance, as reported in the Washington Post, companies are getting creative and innovative about how to manage workers’ health and wellness, while addressing ever-growing costs. One strategy that’s getting more traction is the re-invention of the onsite health center. Towers Watson‘s 2012 Onsite Health Center survey report, finds that one-half of employers view establishing an onsite health center as a linchpin to enhancing productivity and health in the workplace. Following close behind productivity is the onsite health center’s promise of reducing medical costs, improving access to care, and the traditional reason for providing onsite

Employee benefits make up one-third of employers’ investments in workers, and companies are looking for positive ROI on that spend. Health benefits are the largest component of that spending, and are a major cost-management focus. In 2012 and beyond, wellness is taking center stage as part of employers’ total benefits strategies. In the 2012 Wellness & Benefits Administration Benchmarking study, a new report from bswift, a benefits administration company, the vast majority of large employers (defined as those with over 500 workers) are sponsoring wellness programs, extending them to dependents as well as active workers. Increasingly, sticks accompany carrots for

Most seniors look forward to aging in place, and are confident in their ability to do so. Such is the top-line feel-good finding from the National Council on Aging‘s (NCOA) survey, The United States of Aging, sponsored by USA Today and United Healthcare. A majority of seniors have a sense of purpose and plans for their future. Three-fourths of older Americans say staying physically fit through exercise and proactively managing their health is important. However, only 36% of seniors say they exercise or engage in physical activity every day. 11% never do. The most common chronic conditions noted by seniors

When it comes to customer service, retail, banks, airlines and hotels are tops. Health care? Not so good. This sobering finding comes via PwC’s report, Customer experience in healthcare: The moment of truth. PwC pulled data from the company’s Customer Experience Radar survey of 6,000 consumers across industries. This particular analysis looks at consumers’ service views on banking, hospitality, airline, retail vs. health care providers and insurance companies. The chart shows consumers’ answers to a question of whether they are willing to report positive interactions about a customer experience. The graph shows that people are more likely to share opinions

Target, the beloved retail channel for many design-minded value-conscious consumers, has opted in to mobile health through its purchase of SMARTCOACH mobile health coaching devices. SMARTCOACH is part of a growing category of wearable devices that monitor health behaviors like walking and calories consumed. What differentiates SMARTCOACH is the “coach” element, which provides real-time feedback throughout the day. Most other devices in the market simply track and record data. And it’s feedback loops that more experts say are key to sustaining health behavior change. Target will bring the device into stores for purchase in the fall. Like some other wearable

Two in 3 employees (62%) can’t estimate how much their employers spend on health benefits. Of those who could estimate the number (which is, on average, about $12,000 according to the 2012 Milliman Medical Index), most weren’t very confident in their guess. Some 23% calculated the monthly spend by employers was less than $500 a month — less than 50% the actual contribution. Thus, most U.S. health consumers don’t fully value the amount of cash their employers spend on their health care, according to a poll from the National Business Group on Health, Perceptions of Health Benefits in a Recovering

Amidst uncertainties and wild cards about health care’s future in the U.S., there’s one certainty forecasters and marketers should incorporate into their scenarios: consumers will bear more costs and more responsibility for decision making. The 2012 Deloitte Survey of U.S. Employers finds them, mostly, planning to subsidize health benefits for workers over the next few years, while placing greater financial and clinical burdens on the insured and moving more quickly toward high-deductible health plans and consumer-directed plans. In addition, wellness, prevention and targeted population health programs will be adopted by most employers staying in the health care game, shown in

I tore out a two-page ad from the June 17, 2012, New York Times Magazine sponsored by Fidelity Investments with the headline, “Your genetic secrets may not be a secret much longer…and we see opportunity.” The ad copy went on to talk about the emerging era of personalized medicine and big data to help patients…and to be an investment growth area. Fidelity has launched a video online as part of its ThinkingBig series at Fidelity.com/thinkingbig which talk about this complex issue. Fidelity is onto something big here. In the first iteration of the Edelman Health Barometer survey, launched in 2008, we

Using social networks for health is no longer a pioneering, first-wave adoption activity: Facebook has gone mainstream in health. What’s the indicator that says we’ve hit the tipping point in consumers going Health 2,0, beyond Paging Doctor Google? A story in the July 2012 issue of Good Housekeeping magazine titled, Miracle on Facebook. What’s powerful about this is that articles on health social networks have been largely focused in health IT trade publications, business magazines like Forbes  (focusing on sustainbale business modeels) and technology channels such as Fast Company and Wired. Looking at Good Housekeeping’s ad pages, its readership is mostly

  On Tuesday, 9 July 2012, health industry stakeholders are convening in Philadelphia for the first CONVERGE conference, seeking to ignite conversation across siloed organizations to solve seemingly intractable problems in health care, together. Why “converge?” Because suppliers, providers, payers, health plans, and consumers have been fragmented for far too long based on arcane incentives that cause the U.S. health system to be stuck in a Rube Goldbergian knot of inefficiency, ineffectiveness and fragmentation of access….not to mention cost increases leading us to devote nearly one-fifth of national GDP on health care at a cost of nearly $3 trillion…and going up.

Calling Don Draper, Donny Deutsch, and the spirit of David Ogilvy: the President needs you. The President must sell the Affordable Care Act to the American people now that Justice Roberts wrote the Supreme Court’s historic 5-4 majority opinion supporting the Act, and especially the individual mandate. He argued for the majority that while the mandate is unconstitutional under the Commerce Clause which would “command people to buy insurance,” he said that the mandate is a de facto tax, as people who would choose to opt out of insurance would have an alternative of paying an IRS fine. Senator Eric

The antidepressant market is worth $20 billion in the U.S. Antidepressants were the third most common prescription drug taken by Americans of all ages in 2005-2008 and the most frequently used by people age 18-44 (according to the National Center for Health Statistics). About one in 10 Americans age 12 and over takes an antidepressant medication. But there is little evidence that pharmacotherapy should be used as a first line of treatment for mild to moderate depression. Why are anti-depressants the first line of treatment for mild to moderate depression in the U.S.? The answer lies in the fact that

The supply-side of healthcare DIY is growing, with the advancement of Castlight Health through its $100mm VC influx and Cakehealth’s new version for managing health spending online. Consumer demand is growing, too, for these services. But don’t get over-hyped by the healthcare, everywhere, scenario. Health citizens also demand face-to-face time with their physicians and clinicians, evidenced by a survey from Accenture titled, Is healthcare self-service online enough to satisfy patients? The answer is a clear, “no.” 90% of U.S. adults like the idea of digital health self-service, 83% want online access to personal health information, 72% want to book appointments

While 2 in 3 U.S. adults are active on social media, we are skeptical about trustworthiness of the content we find there. Welcome to the 13th quarterly Heartland Monitor Poll from Allstate and National Journal, surveying how U.S. adults look at social media, trust, and the political future of the nation. The Poll surveyed, by landline and cell phone, 1,000 U.S. adults over 18 in May 2012. The most common social network used is Facebook, among 51% of U.S. adults, followed by Google+ (28%), Twitter (13%), LinkedIn (12%), Pinterest (6%), and MySpace (5%). While Americans are drawn to using social

What is a Mom, and especially, who is a “Digital Mom?” I’ve been asked to consider this question in a webinar today hosted by Enspektos, who published the report Digging Beneath the Surface: Understanding the Digital Health Mom in May 2012. I wrote my review of that study in Health Populi here on May 15. In today’s webinar, my remarks are couched as “Caveats About the Digital Mom: a multiple persona.” Look at the graphic. On the left, the first persona is a mother with children under 18. Most “mom segmentations” in market research focus on this segment. But what

Therapy is now a click away, whether on a computer, a smartphone or a tablet. Drs. Freud, Ellis and Beck, heads-up: the Internet is the new couch of psychiatry. That is, at least for people with mild to moderate depression and those with anxiety, as I report in my latest paper for the California HealthCare Foundation, The Online Couch: Mental Health Care on the Web. Many factors are aligning that make therapy online an effective extension of face-to-face therapy for the right patients at the right time in the U.S.: An undersupply of psychologists, psychiatrists, and other therapists, especially in rural and

The idea of value-based purchasing in health care has been around since the 1990s, when 3 researchers named Meyer, Rybowski and Eichler wrote, “The concept of value-based health care purchasing is that buyers should hold providers of health care accountable for both cost and quality of care. Value-based purchasing brings together information on the quality of health care, including patient outcomes and health status, with data on the dollar outlays going towards health. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers. This strategy can be

There’s a long-held belief among us long-time health industry analysts that Americans spend more time shopping around for cars and washing machines than for health plans and doctors. Consumer Reports is betting that’s going to change, now that Consumers Union has decided to lend its valuable, trusted brand to developing report cards on physicians, having already rated hospitals and heart surgeons. CR will call their version of the doctor’s report card Patient Experience Ratings. CR has first entered the competitive medical market of Massachusetts, and has unveiled reports on 500 primary care physicians in the state. CR worked with  physician survey

Increasing intake of fruits and vegetables, coupled with remote health coaching and financial incentives, together help people adopt and maintain healthy behavior changes. This is the conclusion of a randomized controlled trial using mobile technology, published in the May 28, 2012, issue of Archives of Internal Medicine. Dr. Bonnie Spring of Northwestern University’s Department of Preventive Medicine led the study. The researchers developed the trial, called Make Better Choices, to sort out which behavior changes would enable people to reduce major risk factors for cardiovascular disease, cancer and diabetes. Four combinations were assessed in the intervention among 204 people: Increasing fruit

9 in 10 Americans who know the health system — those with a serious illness, medical condition, injury or disability — believe that health care costs are a serious problem for the nation. This problem has gotten worse over the last 5 years, according to 70% of sick Americans. The Sick in America Poll, from National Public Radio, Robert Wood Johnson Foundation, and the Harvard School of Public Health, was released May 2012. The survey presents a picture of the 27% of Americans who use the health system and, as a result of their illness or disability, encounter financial challenges. When

Transparency, data-based pharmacy decisions, incentivizing patient behavior, and outcomes-based payments will reshape the environment for marketing pharmaceutical drugs in and beyond 2012. Two reports published this week, from Express Scripts–Medco and PwC, explain these forces, which will severely challenge Pharma’s mood of market ennui. Express-Scripts Medco’s report on 9 Leading Trends in Rx Plan Management presents findings from a survey of 318 pharmacy benefit decision makers in public and private sector organizations. About one-half of the respondents represented smaller organizations with fewer than 5,000 employees; about 20% represented jumbo companies with over 25,000 workers. The survey was conducted in the

The saying goes, “you pays your money and you makes your choice.” In 2012, if you have a bolus of $20,700 to spend, you can choose between a health plan for a family of four, or a sedan for the same family. That’s the calculation from the actuaries at Milliman, whose annual Milliman Medical Index is the go-to analysis on health care costs for a family of four covered by a preferred provider organization plan (PPO). While the 6.9% annual average cost increase is lower than the 7.3% in 2011, it is nonetheless, a record $1,335 real dollar increase at

“Knowing they may need to return at some later time, patients felt they were vulnerable and dependent on the good will of their physicians. Thus, deference to authority instead of genuine partnership appeared to be the participants’ mode of working,” asserts a study into physician-patient relationships published this week in Health Affairs. The study’s title captures the top-line research finding Authoritarian Physicians and Patients’ Fear of Being Labeled ‘Difficult’ Among Key Obstacles To Shared Decision Making.  Researchers at the Palo Alto Medical Foundation Research Institute analyzed data on patients participating in focus grooups, from the age of forty and over, from

Once upon a time, patient satisfaction with visits to doctors’ offices used to be a function of bedside (exam room) manner, demeanor and responsiveness of the reception and insurance staff, and the age of magazines in the waiting room. Today, waiting time is a key factor, and social media is raising expectations around response time in health care. See the first chart, based on data from PwC’s survey, Social Media “Likes” Healthcare, published in late April 2012. The poll found that when U.S. adults use social media in healthcare, at least 4 in 10 people want complaints and information requests responded to

You can now carry a doctor with you in your pocket. Two top telehealth companies that support online physician-patient visits have gone mobile. This upgrade was announced this week at the 2012 American Telemedicine Association conference, being held in San Jose, CA. In enabling mobile physician visits, American Well and Consult A Doctor join Myca, which has offered mobile phone-based visits for clients for at least two years to employer clinic customers. In April 2010, my report, How Smartphones Are Changing Healthcare for Consumers and Providers, talked about Myca’s work with Qualcomm: the telecomms company armed traveling employees with mobile phones that could connect

One-half of physicians believe they’re not fairly compensated for their work – in particular, those working in primary care. Only 11% of doctors considering themselves “rich.” Medscape’s 2012 Physician Compensation Report compiled data from over 24,000 U.S. physicians across 24 specialties and found the bulk of physicians to see themselves working harder and 1 in 4 making less money than last year. This has led to growing frustration and worry, where some physicians are resenting the large pay gap between specialists and primary care. That frustration looks poised to increase with doctors concerned that accountable care will further eat into

Even though Inside-the-Beltway economists have said The Great Recession of 2007 is officially over, it doesn’t look that way when you ask consumers about health spending in 2012, based on results from a survey conducted on behalf of the American Osteopathic Association (AOA). One in 5 U.S. adults is trying to lower their personal health spending. One in four is seeking free or alternate sources of health care. Overall, 1 in 5 people says their health has been negatively impacted by the economy. The AOA discovered that people in the U.S. whose health has been negatively impacted by the economic downturn were

One in 3 Americans uses social media for health discussions. Health is increasingly social, and PwC has published the latest data on the phenomenon in their report, Social media ‘likes’ healthcare: from marketing to social business, published this week. PwC polled 1,060 U.S. adults in February 2012 to learn their social media habits tied to health. Among all health consumers, the most common use of social media in health is to access health-related consumer reviews of medications or treatments, hospitals, providers, and insurance plans, as shown in the graph. Social media enables people to be better health “consumers” by giving them peers’

A $10 increase in a health plan premium drove up to 3% of retired University of Michigan employees to leave the plan, according to a study from U-M published in Health Economics, The Price Sensitivity of Medicare Beneficiaries. The U-M researchers analyzed the behaviors of 3,182 retirees over four years, to assess the impact of price on beneficiaries’ health plan choices. During the four years, the premium contribution for retirees increased significantly. The researchers conducted this study, in part, to anticipate how Americans will respond to health insurance exchanges in 2014 as they bring health plan information to the market

It was Dr. Charles Safran who said, “Patients are the most under-utilized resource in the U.S. health system,” which he testified to Congress in 2004. Seven years later, patients are still under-utilized, not just in the U.S. but around the world. Yet, “when patients have an active role in their own health care, the quality of their care, and of their care experience improves,” assert researchers from The Commonwealth Fund in their analysis of 2011 global health consumer survey data published in the April/June 2010 issue of the Journal of Ambulatory Care Management. This analysis is summarized in International Perspectives on

Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative

While most Americans largely believe in motorcycle helmet laws, seatbelt-wearing mandates, and regulations to reduce sale in packaged foods, most are also concerned about the nation turning into the United States of Nanny. The Harris Interactive/Health Day poll of March 20, 2012, finds a health citizenry “pro” most public and safety regulations, from banning texting while driving to requiring the HPV vaccination (e.g., Gardasil). Specifically, as the chart shows, – 91% of U.S. adults are for banning texting while driving – 86% are for requiring vaccination of young children against mumps, measles, and other diseases – 86% also like to

There’s a shift in power in health care moving away from providers and suppliers like pharma and medical device companies, toward patients and payers. This is the new health world according to Ernst & Young‘s latest Progressions report called, The third place: health care everywhere. What’s underneath this tectonic shift is the need to bend that stubborn cost curve and address public health outcomes through behavior change. E&Y says look for new entrants, like retailers, IT companies, and telecomms, to be part of the solution beyond traditional health care stakeholders. These participants will be part of both delivery of care

Employers expect total health costs to reach $11,664 per active employee this year, over $700 more than in 2011. Employees’ share of that will be nearly $3,000, the highest contribution by workers in history. In 2012, workers are contributing 34% more to health costs than they did 5 years ago. The metric is that for every $1,000 employers will spend on health care in 2012, workers will pay $344 for premium and out-of-pocket costs. Still, health care cost increases are expected to level off to about 6% in 2012, that’s still twice as great as general consumer price inflation. with

Most U.S. companies will increase the dollar value of health incentives offered to workers in 2012, based on the annual survey from Fidelity Investments and the National Business Group on Health addressing employers’ plans for health benefits. 3 in 4 employers used incentives in 2011 to engage employees in wellness programs, with an average incentive value of $460. This number was $260 in 2009. The poll found that employers expect employees to improve their personal health, and will increasingly ration access to benefits based on employees’ engagement with health criteria. Employers’ approaches to incentives have begun to adopt value-based benefit design strategies that

A global analysis of mobile health (mHealth) by the Boston Consulting Group (BCG) for Telenor, the telecomms company, illustrates many forms of return-on-investment using mobile platforms in health: Improved quality of life for individuals and families A more educated society Lower absenteeism for employers, and Greater incomes for people. Together, these micro-benefits yield macro societal benefits such as freeing up (acute) health systems due to a lower burden of chronic care; positive impacts on people, labor participation, and productivity; and, long-term economic growth. BCG believes that, “the smartphone is the most popular technology among doctors since the stethoscope.” That phone can

Every patient carries her or his doctor inside, said the great Renaissance man, Albert Schweitzer. Based on Euro RSCG Worldwide’s Prosumer Report – My Body, Myself, Our Problem: Health and Wellness in Modern Times, health citizens globally have begun to take on Dr. Schweitzer’s vision. Clement Boisseau of Euro RSCG points out that people, globally, are fairly schizophrenic when it comes to thinking about empowerment over illness: check out the chart for perceptions by condition and disease state. Boisseau says that people perceive health today both in modern terms (such as feeling empowered to control some conditions), and archaic or “magically

The record attendance at HIMSS12, in terms of both attendees (numbering some 38,000) and exhibitors, illustrated just how hot health information technology has become in the 20 years since I first began attending this meeting — when it was only a few thousand hospital computer geeks and materials managers picking up pocket protectors and calculators from vendors. At this year’s conference, the major concerns were when Stage 2 meaningful use details would be revealed. HIMSS communications leadership in the press room thought it would be Tuesday, then Wednesday. Finally, it was Thursday the 23rd of February when Farzad Mostashari, National Coordinator for Health IT at the Department

With $3.1 billion awarded to doctors who are buying and learning how to use electronic health records (EHRs), Secretary of Health and Human Services Kathleeen Sebelius told a Kansas City community college that 41,000 doctors and 2,000 hospitals were on the road to meaningfully using the technology — double the number of EHR users in 2 years. That’s how “stimulating” the ARRA HITECH stimulus funds have been — a glass half-full interpretation of the data. A survey of health providers conducted by the American Hospital Association learned that the proportion of EHR-using providers grew from 16% to 35% between 2009

How electronically connnected and communicative are nations’ health information infrastructures? Accenture has answered that question in its report, Making the Case for Connected Health. Accenture built a “connected health maturity index,” analyzing a nation’s level of health information exchange among users along with their level of health IT adoption among specialists and primary care doctors. Adoption was defined across four HIT functions: administrative tools, electronic patient notes, electronic alerts/reminders, and computerized decision support systems. Health information exchange was defined across seven connectivity dimensions: electronic communications, e-notifications, e-referrals, e-access to clinical data about patients who see a different provider, e-prescribing, and

35% of consumers who have been altering their food intake to lose weight are eating fewer processed foods, according to a recent Nielsen Global Survey. This percentage has grown from 29% in 2008. Health and wellness is one of three driving forces shaping food in 2012, according to JWT‘s What’s Cooking: Trends in Food. The other two forces, technology and foodie culture, combine with health/wellness and yield some interesting consumer trends in the milieu of food. JWT’s top food issues to watch are: – Fooducate – Nutrition scores – Fat taxes – Health and fresh vending machines – Gluten-free –

A health system that’s built to last: this is the latest sound-bite echoing through health policy circles. The theme of sustainability is permeating all matters of policy, from education and business to health care. Enter IBM, with a rigorous approach to Redefining Value and Success in Healthcare: Charting the path to the future, from the group’s Healthcare and Life Sciences thinkers. What’s inspiring about this report is the team’s integrative thinking, bridging the relationship between operational effectiveness built on a robust information infrastructure that enables team-based care (the “collaboration” aspect in the middle of the pyramid), which then drive personalized healthcare

Chronic illness represents $3 of every $4 of annual health spending in the U.S. That’s about $1.5 trillion. Living Well With Chronic Illness, a report from The Institute of Medicine (IOM), issues a “call for public health action” to address chronic illness through: – Adopting evidence-based interventions for disease prevention – Developing new public policies to promote better living with chronic disease – Building a comprehensive surveillance system that integrates quality of life measures, and – Enhancing collaboration among health ecosystem stakeholders: health care, health, and community non-healthcare services. The IOM recognizes the social determinants that shape peoples’ health status

There are few issue areas within the Beltway of Washington, DC, that have enjoyed more support across the political aisle than health care information technology. In 2004, George Bush asserted that every American would/should have an electronic medical record by 2014. Since then, Democrats and Republicans alike have supported the broad concept of wiring the U.S. health information infrastructure. With the injection of ARRA stimulus funds earmarked in the HITECH Act to promote health providers’ adoption of electronic health records, we’re now on the road to Americans getting access to their health information electronically. It won’t be all or even

“Older patients, caregivers, and family members face growing challenges in understanding and navigating the nation’s increasingly complex healthcare system,” begins a well-articulated column called Why Consumers Struggle to Understand Health Care, in U.S. News & World Report dated January 27, 2012. Health literacy isn’t just about understanding clinical directions for self-care, such as how to take medications prescribed by a doctor, or how to change a bandage and clean an infected area. Health literacy is also about how to effectively navigate one’s health system. The first graphic is a schematic published in the New Republic in 2009 which illustrates the arcane Trip-Tik

At the ConvUrgent Care Symposium in Orlando, attendees from the worlds of clinics, ambulatory care, hospital beds, pharmacies, medical devices, life sciences, health information, health IT, health plans, academic medical centers and professional medical societies came together to share and learn about the morphing landscape of retail health. The topline message: primary care is everywhere, and based on the response to my keynote talk this morning, every stakeholder segment gets it. My mantra, courtesy of the U.S. Surgeon General Regina Benjamin: don’t look at health in isolation, that is, where the doctor and hospital are. Health happens wherever the person

Less is more when it comes to health care utilization and outcomes. The U.S. allocates too many resources to a huge line item of waste in the health system – administrative (in terms of too many paper processes and staff to deal with them) and clinically (especially involving duplicated tests and ineffective treatments that aren’t based on evidence based medicine). “Take less” is the tagline of the company called help which is found at the URL http://www.helpineedhelp.com/.  This is a consumer-facing over-the-counter drug supplier. Their product line counts 7 mature products each packaged with the health complaint they target: “Help,” I have

Congrats to the 2012 Top 15 Health Systems as crowned by Thomson Reuters today, shown in the chart. They are segmented by size, with large systems (>$1.5 bn), medium ($750mm – $1.5 bn), and small (<$750 mm). No matter their size, though, across the segments, these best hospitals share several traits: They demonstrate better patient outcomes in terms of better survival rates and fewer complications Better long-term outcomes They adopt evidence-based medicine They have better patient safety track records Their patients leave hospital sooner, which could result in the fact that Patients are more satisfied than consumers at other hospitals (with higher HCAHPS scores). To