Millenson in Forbes: How Mayo's "Dr. Google" Deal Disrupts Medicine

In his latest column in Forbes, health care quality consultant Michael Millenson examines the implications of Google joining with the Mayo Clinic to provide consumers with medical information, which he says quietly signals a powerful disruption for all of medicine.

Now when people search their health questions on Google they will get relevant medical facts up front that have been reviewed by teams of doctors including expert clinicians at Mayo Clinic for quality and accuracy.

Millenson writes:

Recommending a Google search “as the first stop for those needing health information,” in the words of a Mayo physician executive, represents a true paradigm change.

But there’s much more going on here than search. From the Fitbit to medicine’s front lines, information technology is forcing a new doctor-patient relationship with new rules for new roles.

If information is power, digitized information is distributed power. While “patient-centered care” has been directed by professionals towards patients, collaborative health – what some call “participatory medicine” or “person-centric care” ­– shifts the perspective from the patient outwards.

Genuine collaborative health will require incorporating information technology into relationships that harmonize both those views

Employee Benefit News Profiles Three Successful Wellness Programs

Employee Benefit News reports on three different employers whose wellness strategies go beyond basic biometric screening and poorly targeted initiatives to address the whole person, including things like behavioral psychology, physical health, social well-being, and career well-being. EBN profiled three progressive employers - Nationwide Insurance, Heartland Health and Cerner Corporation - who have developed strategic and innovative wellness initiatives that succeed in part because benefits and business leaders have ingrained wellness as a core part of their business strategy and culture.

HFMA Releases Proposed Guidelines for Patient Financial Interactions

The Healthcare Financial Management Association (HFMA) has announced the release of a draft of new best practices that will bring more consistency, clarity, and transparency to patient financial interactions.

The guidelines were released during ANI: The Healthcare Finance Conference on June 16 in Orlando, Fla. The proposed best practices were created by a steering committee that met monthly over the past year and included leaders from HFMA, the National Patient Advocate Foundation, the American Hospital Association, Harvard Medical School, and America’s Health Insurance Plans, among others.

The proposed best practices focus on financial interactions when medical services are scheduled as well as when emergency and non-emergency care is delivered. These practices provide guidance regarding when and how communication should take place about patient insurance coverage, financial counseling, patient financial responsibility for service, and any existing balance the patient may have. The best practices emphasize open and early communication, the sharing of clear information, and the identification of a path for financial resolution that is fair for patients and health care organizations alike.

The draft of Patient Financial Interaction (PFI) best practices can be viewed online, where comments on the proposed best practices may be submitted through July 31. Patient feedback also will be solicited in the coming months. The resulting final practices will be released in the fall for voluntary adoption by health care organizations across the country.

Companies Use Scoring Models as Part of Wellness Plans

According to the Minneapolis Star-Tribune, the future of employee wellness programs may be an individual health score, much like a consumer has a credit score. Allina Health of Minneapolis is among a growing number of employers using employee health scoring models, such as myHealthCheck and HealthCheck360°. The programs work by rating each employee based on health screening data. At Allina, employees who score high on myHealthCheck can get up to $1,690 to put toward health insurance premiums.

The idea behind health scoring is not to be punitive, and the scoring is designed to be fair and take into account factors that are within an individual's control.

A person with a score of more than 90 is very fit, with blood pressure that is controlled, a low percentage of body fat and no evidence of smoking. As he could not really do much better, a financial incentive on health insurance premiums is earned just by staying at an upper level.

Folks who cannot reach the top tier can still earn an incentive by improving. Even someone with a score of 40, not very healthy, can earn incentives by moving to 45 the next year.

A much smaller group of people with a chronic health condition, or perhaps a genetic predisposition to disease, may never get a great score. They can still earn the full incentive by showing they comply with doctors' recommendations on care.

This initial work on employee incentives could have far reaching implications for value-based insurance design. Simply gathering data about what motivates employees to stay or get healthy is valuable.

AHRQ Seeks to Tap Patients for Safety-Event Data

The Agency for Healthcare Research and Quality is seeking approval to design and test a system for collecting information from patients about healthcare safety events, according to a Federal Register filing (PDF).

Based on a growing body of evidence that many medical adverse events go unreported by providers, AHRQ is seeking to create a way for patients and their families to report healthcare safety events. “Most reporting systems do not presently accept or elicit reports from patients and their families,” AHRQ wrote, and “the unique perspective of healthcare consumers could reveal important information that is not reported by healthcare providers.”

AHRQ already has funded the development of a prototype Consumer Reporting System for Patient Safety, and the agency's current request to the Office of Management and Budget would test the prototype's effectiveness.

The project is being conducted by AHRQ through a contractor, Rand Corp., with Brigham and Women's Hospital, Dana Farber Cancer Institute, both in Boston, and ECRI Institute, Plymouth Meeting, PA.

Use of Patient Navigators Increasing

The Wall Street Journal reports that a growing number of professionals are helping individuals and families find their way through an increasingly complicated and costly health-care system. These specialists—known as patient navigators, health advocates and medical consultants—research treatments, grapple with bureaucrats, and process and appeal medical claims, among other tasks.

One such organization, Patient Navigator, based in Vienna, VA, was founded in 2009 and has expanded to 200 professionals. Fees typically run between $60 and $250 an hour. Various nonprofits offer similar advice for free, as do a growing number of hospitals, clinics, health insurers and employers.

Services vary. Some, including Healthcare Navigation of Shelton, Conn., primarily evaluate insurance options and resolve insurance and billing disputes. The nonprofit Patient Advocate Foundation in Hampton, VA handles appeals of claims denials and negotiates access to medications and medical services for those with chronic or life-threatening illnesses. Others aim to facilitate medical decision-making; for example, locating clinical trials, securing expedited medical appointments and helping those without a diagnosis find appropriate specialists. Some navigators serve a niche clientele, such as Medicare recipients or cancer patients. While some navigators have degrees in social work, nursing, or medicine, no specific training is required.

Many of these organizations are members of the National Association of Healthcare Advocacy Consultants (NAHAC). Members of NAHAC are bound by a code of ethics that, among other things, bars them from making treatment recommendations.

Under the health-care law, federal and state-sponsored health-insurance exchanges must hire navigators to help individuals and businesses evaluate and enroll in health plans.

Free Patient Educational Tools Available To Help Improve Health Outcomes

The U.S. Agency for Healthcare Research and Quality (AHRQ), part of Health and Human Services, has launched a new public education initiative to help improve patient health outcomes. The initiative, called “Questions are the Answer,” offers valuable free materials that organizations can use for patient education.

These free educational tools help patients come to their medical appointments well prepared, making more efficient use of the time they spend with their doctor or other clinician.

The goal of this public education initiative is to empower patients and their doctors to establish effective two-way communication to help make health care safer and to improve health outcomes.

Transforming Health Care: A Growing Movement Is Happening in Your Hometown

Across the United States, a genuine transformation has begun in health care. It's rooted in improved transparency. Increasingly, we can now see which doctors' practices and hospitals are delivering great, quality care, and those that need to improve, thanks to a new wave of public reports about their performance.

Moreover, health care providers are borrowing quality improvement techniques from the airlines, manufacturing and other industries that we count on to get it right every time. And then there is a quiet revolution taking place among patients and their families, who are learning how to make sure they and their loved ones are getting the best care for their conditions. Read the full article...

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Informed Patient Institute Posts New Reports

www.informedpatientinstitute.org

1) State-of-the-Art of Hospital and Physician/Physician Group Public Reports is an analysis of 126 hospital public reports and 27 physician/physician group public reports done for AHRQ for their March 2011 Summit on Public Reporting in Washington, DC.

2) State Health Insurance Exchange Websites: A Review, Discussion and Recommendation s for Providing Consumers Information About Quality and Performance is a report conducted for AARP that examined 70 managed care websites in the context of performance information for consumers on health insurance exchanges.

3) Rating the Raters: How the Informed Patient Institute Assesses Health Care Quality Reports - A podcast of an interview with Talkingquality.gov staff from July 2011.

e-Patient Networks on the Rise

In this era of government gridlock and the 15-minute doctor’s appointment, a growing number of consumers are no longer waiting for the political establishment to solve the nation’s health care crisis. Instead, they are banding together to fix problems themselves.

Using the latest technology and a lot of moxie, all sorts of innovative organizations have popped up, delivering the same essential message: patients who actively participate in their own care can improve their health – and help others, too.

People can now join online groups for almost every disease imaginable, analyze health statistics from thousands of patients dealing with the same medical condition, and even get decision-making tools based on the latest scientific evidence to help them choose what treatments to pursue. Read the full post...