As the United States moves toward a health care system that gives individuals more power and control over their health care decisions, many experts worry consumers will be bewildered by the large number of complex financial and medical issues. Some argue against consumer-directed health care because they don’t believe people can or should be left to make these difficult decisions.
But those difficulties don’t mean we have to turn our back on consumerism and lock in the old paternalistic, top-down system. People do need expert help in navigating the growing complexities of treatment options, and the health sector is beginning to respond by offering health coaches and disease and chronic-care management programs.
And that’s just the beginning: The new information economy will offer even more options, including health care advisors, to help people make better care and health spending decisions.
Today, when people are seriously ill or have a child with multiple medical needs, they find they must become actively involved in informing themselves about the nature of the illness and treatment options. They rely on their doctors, of course, but they also become experts themselves, gathering information from disease groups, real and virtual discussion groups, medical libraries, and trusted Web sites.
In addition, many people seek the security of having expert advice available through “concierge medicine.” Here, people agree to pay a physician a fixed fee for ready access to appointments, attention to wellness care, help in locating specialists, and expert advice in the event of a medical problem.
Tens of millions of people would like to have that kind of access, but so far only a small number do.
This kind of trusted, expert health advisor will be an emerging force in the new world of consumer-directed health care–trusted agents people call on for routine health care advice and for help in making complex medical decisions.
Information technology will make this expertise available to anyone with an Internet connection. New companies will allow millions of people to get clear and understandable information, and will even provide access to one-on-one consultations.
Several new companies are providing such medical-decision support for individuals and companies. One is Health Dialog, a Boston-based company that helps patients understand treatment options and choose what’s best for them through a network of health coaches who are available by phone 24 hours a day.
According to the Health Dialog Web site, “In an increasingly consumer directed healthcare environment, it is critical that individuals have the information and support they need to become more involved in their healthcare. Health Dialog is built upon the idea that when individuals are more actively engaged in managing their care with their physicians, they are more satisfied with their care, quality goes up, and costs go down.”
Health Dialog uses information from the Foundation for Informed Medical Decision Making, a nonprofit group also based in Boston, which reinforces this point on its Web site:
“When patients get sick, they sometimes face treatment decisions that can be confusing and frightening. … Very often doctors make these decisions for patients, and many patients prefer that model. …
“However, a growing body of research shows that when patients are well informed and play a significant role in deciding how they are going to treat or manage their health conditions … patients feel better about the decision process. Their decisions are more likely to match up with their preferences, values, and concerns. These patients are more likely to stick with the regimens the treatment requires, and they often end up rating their health after treatment as better.”
Don Kemper, chairman and CEO of Healthwise in Boise, Idaho, has worked for 30 years to help people understand the crucial importance of “information therapy” as a vital and integral part of medical care. He says doctors’ actions in writing prescriptions and ordering surgery or chemotherapy must be accompanied by high-quality information for the patient in a clear and understandable format.
“Empirical research suggests that appropriately prescribed, decision-focused, evidence-based health information empowers consumers,” Kemper said, “enabling them to participate as active partners in their own care and improve their health outcomes.”
And this is just the tip of the iceberg. Quality and price data are coming from thousands of sources. New companies will soon begin aggregating and translating this data to become branded sources of reliable quality information. A whole new discipline of medical professionals is likely to emerge–health advisors–to help people seeking one-on-one expertise.
Information needs can be solved by an information economy. Technology is increasingly allowing consumers to access information instantly at little or no cost. As this is applied to health care, patients will get smarter, and they will force the health care economy to become more efficient and patient-centered.
This new era is not coming. It’s already here.
Grace-Marie Turner ([email protected]) is president of the Galen Institute, a nonprofit, free-market organization in Alexandria, Virginia, devoted to researching health policy.
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