Inclusive Healthcare – Taking charge of our own healthcare
How often
are you aware about cost and quality before attending a care provider? Does
your provider involve you in your healthcare decisions?
For most
of us, these questions wouldn’t elicit a positive response. Historically we
have been used to unidirectional doctor patient communications wherein the
individual patient has been passive, underutilized, or excluded from choices
about care in a system that overcomplicates and sometimes hides useful data
about safety, price, and quality.
However, in
the face of mounting economic pressure in public and private systems, no one
can afford to ignore the transformative potential of informed, empowered
consumers. Patients are morphing into health care consumers with growing use of
technology for medical shopping and health engagement
According
to a survey conducted by Altarum , the
health services research organization, virtually all (99%) of U.S. health
citizens want to play a role in medical decisions about their care. However, consumers vary in just how much of
that responsibility they want to assume:
-35% want to make the final decision
with some input from doctors and other experts
-29% want to be completely in charge
of their decisions
-28% want to make a joint decision
with equal input from their doctor
-7% want their doctor to make the
decisions, providing some input themselves
Just
1% wants the doctor to be completely in charge of treatment decisions.
The cost of care is an issue consumers
are keen to know more of in health care. Altarum asked consumers about two
health behaviors when receiving advice or services from a health provider —
looking for information about doctor quality ratings before choosing where to
go, and asking before a visit how much the cost would be. Overall, fewer than
half of consumers asked about prices (42%) or investigated quality before
receiving the health service (39%).
Importantly, engaging in these two
health behaviors was less likely among
folks who were in poor/fair health than those in excellent health, with 29%
looking for quality information on providers and 34% asking about cost —
compared with 62% of people in excellent health asking about quality and 60%
asking about cost.
The survey found, consistent with
other polls that most consumers trust
and like their doctor. Furthermore, 76% of consumers also believe that
their doctor would “never” recommend a test or procedure unless it was
necessary.
Role of technology
Many patients would engage more fully in the
management of their own health, but they face barriers caused by information
asymmetry and a tradition of paternalism in provider-patient relationships. Communications
technology plays a prominent role in erasing barriers and enabling consumerism
in health care.
Consumerism
is about giving every person the information and tools they need to choose
safe, high- quality, affordable health care. When safety, quality, and cost
metrics are widely available, all consumers benefit. When actively involved in
making choices about care, patients experience fewer errors, fewer unnecessary
procedures, and higher satisfaction.
Altarum looked into peoples’ use of
computers and smartphones for everyday life tasks, such as playing games,
locating stores and theatres, comparing gas prices, and conducting health care
activities.
The findings: 35% of computer and
smartphone users have used these tech’s for finding a doctor, 19% have
downloaded a health app, 18% have compared prices of medicines, and 16% have
compared prices for medical services. It is early days for comparative shopping
in health, but this aspect of health-shopping is poised to substantially grow
toward 2014 as health insurance exchanges and consumer-driven health plans put
health citizens into the role of health shoppers.
What’s
concerning in Altarum’s findings is that the poorer health the consumer
perceives, the less consumer-empowered that individual feels. While 75% of those in excellent health say
they’re confident they can reduce costs of care by shopping for better prices,
only 30% of those in poor/fair health are confident in doing so. Thus, 70% of
those in poor/fair health are uncertain/not at all confident that they’ll be
competent health shoppers, able to reduce their health costs.
Yet
it’s those in poorer health who tend to be higher cost patients.
The Internet has changed both the way
we live and the way that companies operate.
The past decade has seen several entrepreneurial companies are positioning
themselves to play starring roles in shedding light on prices and quality in
health care — such as Castlighthealth , Changehealthcare, Clearhealthcosts Consumers
have been empowered by more information on price and quality, more choices in
products and services, and more voice through review sites and online self-help
options
New platforms have harnessed the “power of the crowd” by tapping into a
broader base of intellectual capacity. Many of the services are giving
patients new tools to understand and manage their own medical conditions and
interact with peers. A good example is Patientslikeme , an
online community of patients united by shared experience.
The large
and growing “quantified self” movement, in which people measure and track the
metrics that are important to them, is another facet of this. The Fitbit , and
other such devices that let measure workouts and track them, are not just a
fad. They’re an indication of the way people want to take charge of their health
and decisions surrounding it
Finally, organizations from the public and
private sectors are using digital innovations to target specific populations,
promote broad-based campaigns across sectors, and facilitate interactive
communications to prevent disease and promote health. These are digital initiatives for social impact.
A prominent example is Michelle Obama’s Lets Move campaign, a multi-year, multichannel
initiative to reduce childhood obesity.
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