Reflecting on a new world of Consumer-driven Health Care

I have been back from the Health 2.0 Conference and HealthCampSf for a week now. I also attended SocialDevCampEast this weekend and presented a session on Data Portability. That session was given from the perspective of how Data Portability can be applied to Health Care. I was encouraged by the turnout to the session. Microsoft's announcement this week of OpenID support, that helped push the number of compatible accounts over the 900 Million mark, certainly didn't hurt to put DataPortability in the spotlight!

This week we also enter in to a momentous election here in the USA. Whatever the result we are set to see major changes in Health Care in this country.

When I reflect back on the past couple of weeks and the transformation of Health Care it is becoming clear that the industry is set to switch from being a business-to-business market place to not just a business-to-consumer market place but potentially to a point where there is a complete inversion of the market place - becoming a Consumer-to-Business market place. There are two factors that seem to be driving this transformation:

Information is becoming more readily available to consumers. We are already seeing "invested" consumers embracing this. They are not only consuming information but generating their own content to add to the growth in knowledge and resources. Just look at innovative sites like PatientsLikeMe for an example of this. We are also seeing the next generation of systems for health care from companies like AmericanWell that will capture and share consumer ranking information as a by product of the transactions that they enable.

Making information available is just one aspect. The invested Health Consumer to date has typically been someone with a health condition that is not being adequately serviced by the traditional health care system. These consumers have embraced email lists, social networking, blogs, wikis and other simple tools to find each other and create ad hoc support groups.

The industry has tried to ignore these emerging patient support resources but that is becoming harder to do. These support groups are now being enabled by startups and we are seeing situations where these groups are able to organize and conduct clinical trials that are bigger than anything even major players have been able to organize.

Like it or not the industry is going to have to recognize the power of the invested consumer and the ranks of the invested consumer will continue to grow. The cost of health care is continuing to rise with no moderation in sight for the rate of increase. Employers and Health Plans are reacting to this by offering new products like Consumer Directed Health Plans. The impact of these plans is that the consumer can find themselves shouldering a greater share of health costs. This is triggering two things:

• A greater focus on Health and Wellness. It is more cost effective to encourage healthy lifestyles that aim to avoid consumers becoming patients.
• Consumers are moving from apathetic to engaged.

The rise in out of pocket expenses for consumers is set to drive changing behaviors where consumers will leverage the information available to them to take a more active role in managing their health because failing to do so can have a major impact upon their financial health.

Health Plans will be increasingly supportive of this transition. The current system focuses on managing claims. If Health Plans continue to focus on the point at which their members have become patients then they have lost the battle and must become resigned to continually rising costs. Switching to helping members lead a health life can avoid unnecessary claims and provide an opportunity to contain medical costs.

One of the themes that has kept surfacing through out the election period has been the idea that we, the people can make change happen. It is that idea that is behind the HealthCamp initiative. We don't have to wait for the industry to organize itself to solve some of the challenges. We can push for change. If we get the new wave of startups in the Health industry to adopt open standards, to leverage the interoperability work that is being done in the Social Networking world, then we create a platform for change.

Let's build on the shoulders of the great work that is being done in the Data Portability world. The Health Industry doesn't need to invent its own mechanisms for secure authentication and information sharing. It can leverage the de facto standards like OpenID and OAuth. If information exchange standards are not established let's build on the great work being done by people around microformats.

The message I present to anyone that will listen at CareFirst, where I work, or any other Health Insurance Provider, Hospital System or business partner in the industry is that we need to adopt the standards that are establishing themselves in the consumer space. Failure to do so will only serve to frustrate our customers, because the last thing they want is yet another user id and password to remember. This is especially true as we move in to a world of electronic health records. The health care industry has so many specialties that there will always be a wide variety of organizations that a consumer will need to interact with in the course of their care. Let's make it easier for our customers by allowing them to use services that they are already familiar with. Why can't a Yahoo, Google, AOL or MSN user use the same user id and password that they use everyday in order to access health information?

Yes we have to be cognizant of Data Privacy but we need to balance that with the needs of an increasingly engaged customer.