Making Health Care Cheaper
GiveForward - like kickstarter for Health
Enabling people to raise money towards health costs. This helps families meet the non-covered costs for major health care events.
People can donate and leave words of encouragement.
Arnie Milstein Professor of Medicine and Director of the Clinical Excellence Research Center, Stanford University
The real cost of care is hidden to all that are involved in giving and receiving care. It is completely invisible.
[Ed: Saying that the Health Plan knows the cost is not exactly true. Surely it is the billing department in the hospital or Doctor's office. They end up charging different costs based upon situation. Cash settlement, In network, out of Network, Medicare]
Dealing with chronic diseases is 50% of costs in the US Health system.
Things to do:
- Show that a patients health matters
- Make following a care plan easier
- Specialists vary in use of health resources to deliver care. We need help to measure care effectiveness.
Health Reform has made the Medicare data accessible. Opportunities for developers to make sense of this effectiveness data.
Primary Care Coaching model. Focus on a subset of patients with multiple chronic disease. Key to engagement is a human being. instead of a Nurse in a call center they are in the practice to meet face-to-face with patients.
The EMRs are useless - they don't improve care or lower costs. Tools are need to help with outreach.
Need tools to monitor the population.
Consumer direct model. REinventing the payment and delivery model. Outside the insurance market. approx. $65/month in place of insurance.
This is typically coupled with a High Deductible Plan. The net savings are often around 50% when these costs are combined.
Their system reduces ER visits by 65%. Inpatient by 40%. Open 7 days/week and 12 hours/day to provide easy access.
Working with large hospital systems. We have a shortage of properly used primary care physicians.
Rise Health addresses cost and access.
Using technology to take low value tasks off the Doctors plate.
Why now - Because we have our backs against the wall. Cost increases are unsustainable.
We will see change if Medicare reimburses based on results rather than volume. Affordable Care Act is setting the stage for this.
Here are some lightweight technologies:
Working with Health Systems in the ER direct patients to more appropriate care settings.
The patient's Medical Card as their Health Record. USB flash card embedded in a card that can be the patient's medical card. The software loads via USB to point to an online health record page.
Nice interface with BlueButton to enable doctor download of data.
Arnie: we need tools to make it simpler. We need to go further.
[Ed: what Arnie is saying - The Doc wants Ques to act on not be deluged with data.
The Humetrix Blue Button process just provides Data Deluge. There is a massive opportunity to provide Doctors with tools to manage the data deluge and enable them to act effectively on the essential data and the exception indicators.
Eric: We are pushing to replace Paper and Process Anarchy with Digital Anarchy. No anarchy is the same across hospital systems. They each have their own anarchy.
Creating Infrastructure Independent Care.
Right Treatment, Right Time, Right Place.
SensorBaby - measures remotely at 96% of accuracy of hospital monitoring.
Bluetooth kit. iPad App to capture and display data.
First deployment will be in Mexico. This can be deployed to trained health workers. The kits cost is around $150. Not yet FDA Approved.
Self service technology is popular with consumers. This needs to move in to health.
Coinstar/RedBox just invested in SoloHealth.
Kiosks are networked. You can use any kiosk.
30M people a year are at risk of vision loss.
Arnie: Will improve access. Will they improve cost - TBD
Norm: Data is invaluable in the Medical Home.
Rushika: It is crazy how we manage chronic disease using 3 month snapshots in the doctor's office.
Raw data streams are not useful but monitors that evaluate the stream and point out exceptions are useful.