Retail and work-site clinics – medical homes for younger adults?
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
One-third of U.S. consumers plan to buy a new fitness tech in 2013, but most buyers are already healthy
Over one-third of U.S. consumers plan to buy a new fitness technology in the next year, especially women. They’ll buy these at mass merchants (females in particular, shopping at Target and Walmart), sporting goods retailers (more male buyers here), online and at electronics stores like Best Buy. These potential buyers consider themselves in good or excellent physical health. They’ll see the latest applications on retail store shelves in pedometers, calorie trackers, fitness video games, digital weight scales, and heart rate monitors that will be launched this week at the 2013 Consumer Electronics Show in Las Vegas. In advance of the
Health as long-term deficit driver – the CBO points out tough choices
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
Most smartphone owners seek health information online via mobile
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
Consumers blame insurance and pharma for health costs, but love their primary care doctors
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
What’s on senior Americans’ minds? Medicare and money
What’s keeping seniors up at night when it comes to retirement? #1, according to 6 in 10 seniors, is the future of Medicare, followed by having enough money to enjoy retirement. In particular, 61% of seniors are concerned about future out-of-pocket health care costs. It’s all about Medicare and money for U.S. seniors, found in the Allsup Medicare Advisor Seniors Survey, Medicare Planning and Trends Among Seniors, published in October 2012. Medicare could be the most beloved government program ever, as 89% of seniors say they’re satisfied with Medicare coverage. Given the program’s shaky financial future, Allsup wanted to get
Wired health: living by numbers – a review of the event
Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital
What Jerry the Bear means for Health 2.0
A teddy bear in the arms of a child with diabetes can change health care. At least, Jerry the Bear can. Yesterday kicked off the sixth autumn mega-version of the Health 2.0 Conference in San Francisco. Co-founded by Matthew Holt and Indu Subaiya, a long-time health analyst and physician, respectively, this meeting features new-new tools, apps and devices aimed at improving individual and population health, as well as health processes and workflows for physicians, hospitals, pharma, and other stakeholders in the health care ecosystem – even health lawyers, who met on October 7 to discuss up-to-the-minute e-health law issues. Yesterday was
Not goin’ mobile (yet): health search still mostly done on computers
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
Aging in the US – seniors are health-confident, less financially so
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
The rise and rise of retail clinics: a growing site for primary care, everywhere
There were nearly 6 million patient visits to retail health clinics in 2009. Such visits to retail clinics rose four-fold between 2007 and 2009, according to a RAND study published in the September 2012 issue of Health Affairs. Visits for prevention versus acute care in 2009 were roughly evenly split, with 47.5% and 51.4% of people over 18 seeking prevention vs. acute care from retail clinics, respectively. The most common acute care complaints in the retail setting were upper respiratory infections, pharyngitis, otitis externa, conjunctivitis, urinary tract infections, and allergies. What’s underneath the impressive rise is important to parse out
Thinking about Dad as Digital “Mom”
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
What we can learn from centenarians about health
To get to be 100 years or older requires exercise, social connectedness, and good sleep, according to a majority of centennarians polled in UnitedHealthcare’s 100@100 Survey, 2012 Report of Findings. The key findings of this fascinating survey are that: Centenarians have better eating and sleeping habits than Boomers. One-half of centenarians regularly exercise. The most common forms of exercise are walking or hiking, muscle strengthening, gardening, indoor cardio exercise, exercise classes, and yoga/Tai Chi or other mind/body/spirit forms. Social networks bolster health, with most old-old people communicating with family or friends nearly every day And, laughter is a vitamin, with most
Patients want to collaborate with physicians, but are reluctant to do so
“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
Social media in health help (more) people take on the role of health consumer
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’
Wellness Ignited! Edelman panel talks about how to build a health culture in the U.S.
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
The economics of mHealth – incentives align more easily outside of U.S., but times (and incentives) are a’changing
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
Michael Graves: architect-turned-health designer at Social Media Week
Michael Graves is one of the greatest architects of our, or any, time. He is now dedicating himself to re-imagining what the patient’s experience in a hospital room can be: not just less humiliating and frustrating, but in fact a healing experience in an aesthetically comforting and user-friendly environment. Graves, longtime affiliated with Princeton University, is famous among mainstream consumers as one of Target’s first designers of home products for the past 13 years, from teapots and cooking gear to kitchen cleaning accessories. Sadly for us mass consumers, this will be his last year of designing for Target. He told the
Hey, Big Spender: 1% of US health citizens consume 20% of costs
Cue up the song “Hey Big Spender” from the Broadway hit, Sweet Charity, when you read the January 2012 AHRQ report with the long-winded title, The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009.” The report’s headline is that 1% of the U.S. population consumed 20% of all health costs spent in the U.S. in 2008 and 2009, illustrated by the chart. These Big Health Spenders tend to be in poor or fair health, older, female, non-Hispanic whites and people with only publicly-provided health insurance. Their mean expenditure was $90,061. The top 10%
Health spending in America – self-rationing slows cost increases
The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9% in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts. Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which
Designing health technology for people at home
The Internet, broadband, mobile health platforms, and consumers’ demand for more convenient health care services are fueling the development and adoption of health technologies in peoples’ homes. However, designing products that people will delight in using is based on incorporating human factors in design. Human factors are part of engineering science and account for the people using the device, the equipment being used, and the tasks the people are undertaking. The model illustrates these three interactive factors, along with the outer rings of environments: health policy, community, social, and physical. Getting these aspects right in the design of health technologies meant for
Every picture tells a story, and nowhere more important than in health
A picture’s not only worth the proverbial thousand words, but can save a life. So can a t-shirt…er, TeachShirt. At the Unniched meeting held on 25 October 2011 in NYC, I spent a few minutes talking with two members of Zemoga‘s brain trust: Sven Larsen, Chief Marketing Office, and the firm’s Principal Design guru, Dan Licht. We discussed how design is so critical a factor in health, and in life — particularly, in DIY health, where we are all taking on more responsibility for our own health care — clinical, financial, mental, social. Among Zemoga’s colorful and uber-creative portfolio is its concept, the
Unretirement: the number of Americans planning to retire at 67 is plummeting
Two publications this week reinforce the new reality of health and financial insecurity: The Vanishing Middle America issue of Advertising Age (October 17, 2011 issue) and the Sun Life Financial U.S. Unretirement Index – Fall 2011 with the subtitle, “Americans’ trust in retirement reaches a tipping point.” The chart shows the retirement coin’s two sides: since 2008, the proportion of people in the U.S. who expect to retire by 67 dropped from 52% down to 35%; and, those who believe they will be working full-time (I emphasize “full,” not “part,” time) grew from 19% to 29%. 61% of working Americans plan to
A long-term care crisis is brewing around the world: who will provide and pay for LTC?
By 2050, the demand for long-term care (LTC) workers will more than double in the developed world, from Norway and New Zealand to Japan and the U.S. Aging populations with growing incidence of disabilities, looser family ties, and more women in the labor force are driving this reality. This is a multi-dimensional problem which requires looking beyond the issue of the simple aging demographic. Help Wanted? is an apt title for the report from The Organization of Economic Cooperation and Development (OECD), subtitled, “providing and paying for long-term care.” The report details the complex forces exacerbating the LTC carer shortage, focusing
Verizon expanding into remote and mobile health for senior living – what it means for healthy aging and medical costs
The announcement that Verizon, the telecommunications giant, will partner with Healthsense, a home health monitoring company, indicates that the adoption of telehealth services beyond project pilots and government-funds required to bolster the market is real. Verizon is upgrading the FiOS network, which it will extend to senior housing and assisted living communities that would use Healthsense’s suite of remote health monitoring, personal emergency response systems, wireless nurse call, and wellness monitoring products. The broadband FiOS network is upgradeable to 100 megabits per second, which would enable the bandwidth required by home health technologies that require high performance and reliable network connectivity. These
Telemonitoring for health must be patient-centered and participatory
In December 2010, an article describing a telehealth remote monitoring program for heart failure patients concluded that telemonitoring did not improve patient outcomes. The paper, Telemonitoring in Patients with Heart Failure, written by Sarwat I. Chaudhry, M.D, and nine other authors, analyzed 1,653 CHF patients, 826 of whom participated in a remote health intervention: a telephone-based interactive voice-response system that patients dialed into on a daily basis to report symptoms and weight; this was designed to occur every day over six months. These data were then reviewed by patients’ clinicians who could contact patients when data pointed to the clinical need to adjust patients’ medications and other parameters.
The Post-Health Plan Health Plan: Humana
“If nothing else, the health reform bill has signaled the beginning of the end of the health plan as we know and love it,” David Brailer, once health IT czar under President GW Bush and now venture capitalist, is quoted in Reuters on Hot Healthcare Investing Trends for 2011. One health plan Brailer called out that could be relevant in the post-reform, post-recessionary US health world is Humana. I had the opportunity to spend time with Paul Kusserow, Chief Strategy Officer for Humana, during the HIMSS11 meeting. Our conversation began with me asking why the chief strategist for Humana would
Meeker & Murphy on Mobile – through the lens of health
We technology market data junkies look to several thought leaders throughout the year for updates on their forecasts: one of these, for me, is Mary Meeker. Now with KPCB (who some of you know as Kleiner Perkins Caulfield & Myers, the Silicon Valley venture capital company), Meeker has surveyed the morphing field of mobile and finalized her snapshot in Top Mobile Internet Trends, along with her colleague Matt Murphy. Meeker’s Top 10 (drum roll, please) are that: 1. Mobile platforms have reached c4itical mass 2. Mobile is global 3. Social networking is accelerating growth of mobile 4. Time shifting is driving mobile use
The home health hub is digital, mobile and personal
Bet on it, live from Las Vegas at this week’s Consumer Electronics Show (CES): the new home health hub is digital, mobile and personal. More consumers are morphing TV and video watching from the “set” to the computer and mobile platforms, and DIYing more activities of daily living. Health (for both wellness and sickness care) is transforming in this process. This transformation is enabled through consumers’ adoption of technologies that they’re using in their daily lives for entertainment, household management, and communications. Broadband and wireless provide the infrastructure for health care to move beyond the doctor’s office and the hospital, so engaged patients who choose to do
Be Thankful: Engage With Grace
Now that the turkey, champagne, stuffing and other glorious carbs have been consumed. the real dessert is whipped cream on the pumpkin pie: the gift of a conversation about Life and Grace. We each have our stories about how a loved one’s life has ended. If we’re lucky, that beloved person had a good death: in sleep, perhaps, or of simply old age with no hospital events or trauma. Then there are the Rest-of-Us who have the stories of long and painful endings. When you’re already in the situation of making tough health decisions, it’s tough, it’s emotional, it’s irrational,
Broadband: part of the prescription for people with disabilities
6 in 10 U.S. households connected to the Internet via broadband in 2009, rising from 9% in 2001. In the U.S., the gap in the adoption of broadband between lower-income households and higher-income people is 33% — 61% of people with $25,000 to $50,000 household income connect to the Internet at home via broadband; that proportion is 94% for households with over $100,000 a year. Adoption gaps in broadband persist in the U.S. based on income, urban/rural location, race, education, and level of disability. Differences in socio-economic and geographic characteristics explain much of the broadband adoption gap associated with disability
Seniors Are Happy With Rx Plans, Five Years After Part D Begins
Contrary to stereotypes, older people can adapt, learn, and use new products and services. The introduction of Medicare Part D five years ago was an experiment in public policy, with some policymakers fretting about seniors’ ability to navigate a new system. It appears Medicare Part D is a hit, and people are working well with it across gender, age cohorts, incomes (from very low to upper-income strata), educational levels, and especially very sick and disabled people. Among all seniors, 90% have prescription drug coverage. 61% of U.S. adults 65 and over have a Medicare prescription drug plan, 16% are covered by an employer-sponsored
Being Digital Doesn’t Always Mean You’re Young, Demographically Speaking
Being younger demographically doesn’t mean you’re younger, digitally-speaking. Your Real Age isn’t your Digital Age, according to Wells Fargo‘s survey into Americans’ use of advanced tools for daily tasks. The categories of peoples’ digital maturity include: – Digital teens, who are people who are online but don’t use all tools at a ‘high level’ – Digital novices are those people who manage basic tasks online but aren’t yet connecting with others online or managing more complex tasks – Digital adults have the highest digital age, as demonstrated by their using online tools for daily tasks, interacting with others online, and





Thanks to Jennifer Castenson for
Jane joined host Dr. Geeta "Dr. G" Nayyar and colleagues to brainstorm the value of vaccines for public and individual health in this challenging environment for health literacy, health politics, and health citizen grievance.
I'm grateful to be part of the Duke Corporate Education faculty, sharing perspectives on the future of health care with health and life science companies. Once again, I'll be brainstorming the future of health care with a cohort of executives working in a global pharmaceutical company.