Showing posts with label innovation. Show all posts
Showing posts with label innovation. Show all posts
ePatients The Disruptive Innovation for Shared Decision Making
Tuesday, February 4, 2014
As readers may recall, the Disease Management Care Blog is a big fan of shared decision making (SDM). Using unbiased, state-of-the-art and interactive media that presents a set of treatment options, patients with the help of their doctors are surprisingly able to input their values, make trade-offs and come up with the best choice. Research suggests that patients tend, in aggregate, to be both reasonable and conservative.
The DMCB is also a fan of the ePatient movement. Based social media, this is the networked and two-way sharing of medical information in a virtual community of like-minded patients that also facilitates informed patient decision-making. Compared to SDM, ePatients have been less well studied, but there is some good research that suggests that these on-line communities are remarkably disciplined and accurate. In fact, advocates argue that ePatient communities, compared to physicians, are better able to alert its members about the latest medical updates.
Which makes the DMCB wonder if the ePatient movement represents a classic disruptive innovation that is threatening the SDM business model. Commercial SDM typically is made up of video content (much like a DVD) that is developed by credentialed experts and has to be updated periodically. Contrast that approach with the ePatient community (on-line, on demand whenever you want it) that harnesses the wisdom of crowds and is so organic, it really never stops being updated.
Think music CDs vs. iTunes. Or DVD movies vs. on-line streaming.
But the most important distinction? The former is being sold by physicians or content developers, while the latter is being given away.
The DMCB speculates:
The shortage of primary care services, increased cost sharing, spreading consumerism, the explosion of medical information, distrust of authority, ease of use for social media, less concern about privacy, the rise of self-educated experts and a curious immunity from actually having to make money all make the DMCB think that the ePatient movement is here to stay. Its value will trump the inevitable anecdotes of waylaid web users, e-mistakes and death by internet.
In order to stay relevant, commercial shared decision support tools will begin to direct users to medical e-communities. Physicians will "outsource" their own SDM to online ePatients. This will give IBMs Watson a run for its money. Architects of clinical guidelines, point of care decision support, EHR portals and health information exchanges will successfully ignore the ePatient movement - for now.
On-line bulletin boards will be the first stop for any new symptom and to second guess physician advice. The doctor-patient relationship will turn into a menage a trois.
"eApps" will appear for the persons with diabetes, mothers of leukemics and the children of persons with Alzheimers.
Health insurer perred provider networks will have one more reason to die off.
e-Communities will add value in helping its ePatients figure out how to get insurers to cover services that would otherwise be denied.
Some mainstream health organizations will host ePatient communities. Authentic and trustworthy ones will learn from them. None will successfully commercialize them.
Researchers will tap into e-communities to recruit patients for research. The pooling of users data for observational research studies will grow.
Unfortunately, this will exacerbate the medical digital divide for persons without reliable access to the internet.
The DMCB is also a fan of the ePatient movement. Based social media, this is the networked and two-way sharing of medical information in a virtual community of like-minded patients that also facilitates informed patient decision-making. Compared to SDM, ePatients have been less well studied, but there is some good research that suggests that these on-line communities are remarkably disciplined and accurate. In fact, advocates argue that ePatient communities, compared to physicians, are better able to alert its members about the latest medical updates.
Which makes the DMCB wonder if the ePatient movement represents a classic disruptive innovation that is threatening the SDM business model. Commercial SDM typically is made up of video content (much like a DVD) that is developed by credentialed experts and has to be updated periodically. Contrast that approach with the ePatient community (on-line, on demand whenever you want it) that harnesses the wisdom of crowds and is so organic, it really never stops being updated.
Think music CDs vs. iTunes. Or DVD movies vs. on-line streaming.
But the most important distinction? The former is being sold by physicians or content developers, while the latter is being given away.
The DMCB speculates:
The shortage of primary care services, increased cost sharing, spreading consumerism, the explosion of medical information, distrust of authority, ease of use for social media, less concern about privacy, the rise of self-educated experts and a curious immunity from actually having to make money all make the DMCB think that the ePatient movement is here to stay. Its value will trump the inevitable anecdotes of waylaid web users, e-mistakes and death by internet.
In order to stay relevant, commercial shared decision support tools will begin to direct users to medical e-communities. Physicians will "outsource" their own SDM to online ePatients. This will give IBMs Watson a run for its money. Architects of clinical guidelines, point of care decision support, EHR portals and health information exchanges will successfully ignore the ePatient movement - for now.
On-line bulletin boards will be the first stop for any new symptom and to second guess physician advice. The doctor-patient relationship will turn into a menage a trois.
"eApps" will appear for the persons with diabetes, mothers of leukemics and the children of persons with Alzheimers.
Health insurer perred provider networks will have one more reason to die off.
e-Communities will add value in helping its ePatients figure out how to get insurers to cover services that would otherwise be denied.
Some mainstream health organizations will host ePatient communities. Authentic and trustworthy ones will learn from them. None will successfully commercialize them.
Researchers will tap into e-communities to recruit patients for research. The pooling of users data for observational research studies will grow.
Unfortunately, this will exacerbate the medical digital divide for persons without reliable access to the internet.
Harnessing Market Forces to Achieve Quality and Promote Innovation
Saturday, February 1, 2014
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| Maybe theyll put up a plaque honoring Mr. Obama? |
In a striking policy about-face, the Obama Administration has adopted a market-based approach to setting prices and controlling utilization. Everyone agrees that letting prices rise in response to demand disproportionately harms lower income Americans. We also know its another drag on an already fragile economy. Last but not least, its vexing the Presidents political base.
Nonetheless, the Administration is being resolute. Putting political expediency aside, the White House has courageously put their faith in an unabashed conservative philosophy by arguing that long-term benefits of higher prices will ultimately pay dividends in wise consumerism, innovation and quality.
Wow.
As a result, the White will House forgo any "demand" or "supply" side interventions. There will be no price regulation based on prevailing costs and projected outcomes. Theyll spurn the suggestions of myriad legal, economic and regulatory expert panels. Theyll resist activist calls to expand the role of the Federal government.
Politics? Sure, but the machinery in West Wing knows how to manage that. They know a normally friendly news media will report some inflammatory anecdotes about how low income Americans are being forced chose among lifes other basic necessities. Theyll just ride out the news cycle and counter with populist attacks about "profits" and "fat cats" and "corporate jets." While the messy politics sort themselves out, Mr. Obama has faith: supply, demand and the marketplace will take us where we need to be.
Is this about health care you ask? Hardly. Education? Nope. Housing? Negative. The Disease Management Care Blog points out that this is the Administration posture on an arguably equally important part of our collective national well-being: transportation and energy prices. Mileage standards and Detroit bail-outs aside, The DMCB thinks this is quite a reversal.
A harbinger of things to come? We can only hope.
Image from Wikipedia
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