I’ve written and lectured extensively on worldwide health trends, one of which is “increasing personal responsibility”. In both private and public health systems there is growing recognition that we must do a better job engaging our patients in the the quest to lower healthcare costs and soften the toll of chronic disease. Depending on the health system and how healthcare is financed, this may include putting some patients at greater financial risk for poor health behaviors, or creating tax incentives or other rewards that will encourage people to lead healthier lifestyles. Besides the pressing need to reign in healthcare costs, there is increasing concern about a shortage of qualified healthcare professionals to meet the demands of a growing elderly and world population.
One of my Microsoft colleagues in Europe, Dr. Octavian Purcarea, recently brought to my attention a rather unique approach towards getting patients to “take on more responsibility” for their care while lessening demand for services. He writes:
Talking about new business models – I have met with the Chairman of HIT Telecom from Kuwait who is also a doctor and director of a private clinic. They are trying to make a real revolution because, according to them, even with all the IT resources and telemedicine – the demand for qualified healthcare will be higher than they can offer. As a new approach, his clinic is training chronic patients for 3 months by giving them courses in anatomy, physiology, semiology, and pathology. Then the patients undergo a very tough theoretical and practical exam which will give them a certification allowing them to refill their prescriptions, modify their medications and avoid medical encounters. Moreover, they are able to treat other patients with the same disease. According to his preliminary observations, the economic impact is huge – with 40% reductions in cost and complications.
The message seems to be, “Patient heal thyself!” (and once trained to do so, perhaps help heal some others too). Maybe this isn’t such a bad idea in a world struggling to pay for, and provide care for, all those who need it.
Next week I’ll be at the World of Health IT in Copenhagen, Denmark, where I’ll be delivering a keynote address at the WOHIT Physician Symposium on November 3rd. I hope to see some of you there.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft Corporation
Your concerns about the role of the patient and how to engage them is spot on. As a Health 2.0 sponsor and Deep Dive presenter, we share the same concerns about how best to transform healthcare. We created a unique program over 4 years ago that uses an innovative incentive system for doctors and patients that both improves their communications and relationship as well as holds them accountable for better health. Lowering healthcare costs begins with doctors and patients.
We have proven that empowering the doctor-patient covenant relationship lowers costs. We use both financial and social incentives to engage and motivate doctors and patients to use health improvement tools...that keep both of them on track and the same page. We are now integrating our model into other health improvement programs to drive participation by doctors and patients. Using our program as the catalyst to engage doctors and pateints, disease management, health risk assessments, drug compliance and personal health records will produce an ROI for the purchaser/payer.
There is a great need to have a more effective approach towards mitigating chronic health conditions than what our current health care system currently provides. Certainly many chronic health conditions such as type II diabetes, hypertension, congestive heart failure, asthma, mental health disorders, and others, are conditions for which a "telemedicine" approach could be invaluable.
In my field of weight loss surgery, a significant number of patients have reductions or elimination of chronic health conidtions such as diabetes, hypertension, asthma, and sleep apnea. A signficant amount of time is required by myself and other health care providers to ensure these patients are handling these changes appropriately.
I have no reason to doubt the dramatic reduction in health care costs cited in your excerpt above. There are many potential benefits to this type of system: decreased costs for patients, decreased costs for the "medical system", increased patient compliance, decreased time on "mundane tasks" for health care providers, and most importantly, improved patient health and outcome.