When we think of healthcare, we often think of the doctors office or a hospital. We’ve talked many times before how doctors and hospitals today are really about sick care and not health care. If we were really worried about caring for the health of patients, we’d need to do so much more outside of the 4 walls of a doctor’s office or hospital. In fact, we know that it’s the 99% of time at home, work, etc that most influences our health.
With this as background, I was fascinated by this HP article which talks about a new kind of Big Data for healthcare. The article interviews Rebecca Onie, Co-Founder of Health Leads. This excerpt from the article describes the problem they’re trying to solve:
The work was borne out of conversations with physicians who professed profound frustration with delivering care to vulnerable patients. Patients would come into the clinic on a regular basis, and let’s say a kid has an ear infection. A physician can prescribe antibiotics, but the real issue is that there’s no food at home or they’re living in a car. Ninety percent of health outcomes are actually not dictated by clinical healthcare but by these other factors.
Doctors told me, “We don’t ask about these issues, because there’s nothing we can do. We know [healthful food] will have a more profound impact on our patients than anything we’re going to do in the next 13 minutes inside the four walls of the doctor’s office.”
I had a similar conversation with Mandi Bishop, Health Plan Analytics Innovation & Consulting Solutions Owner at Dell Healthcare and Life Sciences, when we were chatting at the Dell Healthcare Think Tank event. She highlighted to me how payers are now looking at how they can pay for ramps in people’s homes in order to help reduce the number of falls that occur.
I love how these simple ideas are so powerful. Obviously, the doctor who treats a person’s cough and cold isn’t very effective if that person goes back to a house which has no heat. We’re treating the symptom, not the problem. We can take care of the broken bones, bruises and other damage that comes from falls, or we could spend much less money preventing the falls by putting in a ramp at someone’s house.
We all intellectually understand why these changes should happen. However, there’s a massive challenge in being able to actually execute these programs. No payer wants to build out the “ramp building” capabilities that are needed to solve this problem. No doctor wants to be calling the utility companies to make sure that someone’s heat gets turned back on. However, they could partner with organizations like Health Leads to get this accomplished.
I know I’m still chewing on this idea. It’s absolutely expanded my thinking when it comes to healthcare and how we can really improve health. I hope it does the same for you. I also love describing it as a prescription for heat or a prescribing a hot meal. Maybe that’s corruption of the word prescription, but it definitely illustrates the idea so well.
Which EHR vendor is going to build in this new subscription service? Yeah, that’s right. None of them. Thus why the EHR vendor needs to open up the kimono for other people to deliver this type of service on top of the EHR platform.
This is what I’ve heard called the “$800 A/C vs. $8000 E/R” problem. We’ll pay $8000 for an asthmatics emergency room visit but won’t pay $800 to get them a window A/C unit to prevent the ER visit.
Or $1000 for an ambulance ride but not $100 to Aunt Susie’s nephew Billy to drive her to a dialysis procedure. Whacked.
Yes, John, you’re right. If a doc is “prescribing” the cure for what ails someone who can’t heat their home or afford fresh fruit and vegies, then I guess it technically meets the definition of “prescription”. Food, shelter, a warm place to sleep, that’s where health starts!
For me, it’s always very interesting to hear the patient perspective on this topic. Sure, I think most would get on board with the surface mantra “treat the cause, not the symptom.” But I’ve spoken with a number of concerned patients who, in practice, say they would find this mentality hugely obtrusive. The example, albeit slightly more extreme than yours, I hear all the time is “if I’m overweight or diabetic, I still don’t want my doctor to know if I cheat every once and a while and buy some doughnuts.”
Obviously payer, vendor, and provider hurdles are seemingly endless too. But I think we’ve got a ways to go with the patient perception in this mentality shift. Patient engagement, patient engagement, patient engagement…
Steve,
Good examples. That is the challenge.
Peggy,
I think it’s a good change in perspective that’s needed.
Megan,
There’s certainly a balance and you have to have a willing patient. Although, in most cases I’ve seen it’s a collaborative thing. Especially when the health situation is not good.