Health Experiences
Peter Heywood wrote this on October 01, 2014 / no comments

“The definition of health needs to expand to include life”Flickr_BrokenBridgeMED_EvaTheWeaver611546983_e06981c11c

Alexandra Drane, founder of the health experience and behavior change company, Eliza, made this comment while chairing the Unmentionables panel at the recent Health 2.0 Fall Conference. There were many interesting technologies at the conference, and equally many compelling speakers, but her comment stood out for me. It’s not its clarity that compels, but really, the fact that she needed to say it.

I hadn’t been to Health 2.0 in some years. It was a lot of fun in its early days (it still is) but back then there was a tremendous amount of hype around solutions that didn’t actually exist, work or ultimately failed to deliver (hello, Google Health). That has certainly changed, as the range of in-the-market monitoring, digital therapy and analytics apps and platforms so clearly demonstrated.

But a significant gulf still remains between the promise of all of these new advances (which in most cases are based on real patient empowerment) and the traditional world of healthcare.

This was Jane Sarasohn-Khan’s observation. She’s a health economist and great blogger who asked Dr Jacob Reider of the ONCHIT about the gap and what can be done about it.

Dr Reider didn’t have a convincing answer, because he and the ONC are as challenged by the gap as so many of the innovators we saw at Health 2.0. There are the usual suspects – the system’s (and doctors’) reluctance to embrace any new technologies, the lack of compensation for their adoption, the complexity and lack of interoperability of so many competing platforms and apps. The first is a red herring, the other two have some validity but I think there’s a deeper reason, captured by Alexandra Drane’s comment. The traditional healthcare system is not yet ready to give up on its old role as a sick care system that fixes problems, to transform to one whose defining purpose is keeping people well.

Even with the vastly increased amounts of data, greater use of clinical technologies and the rise of risk-sharing and value based care, the culture – the mindset – of much of healthcare is still in the “we fix problems” state. This is reflected in the reluctance of providers to truly involve patients in decision-making or share all the information necessary for the patient to make an informed decision. It’s embodied in payment regimes that still attach value to the provider’s work and little to that done by the patient herself, even as we move to outcomes-based care. And most of all, in the traditional healthcare systems reluctance to embrace those actions that help us live well, to Alexandra Drane’s point.

There are, of course, many exceptions to this, organizations truly searching for a new relationship with patients and using these new tools in collaboration with patients to help with life, not just sickness. Bernard Tyson, CEO of Kaiser Permanente, spoke about his company’s involvement in “irrigating” the food deserts in so many urban areas. Nick Macchione, Director of the Health and Human Services Agency of San Diego County, had amazing stories of tackling childhood health through everything from school lunch programs to transformed policing. There is a commendable number of other organizations and providers taking similar paths.

But the culture of traditional healthcare mostly looks askance at the tracking, digital therapy and communication tools that form such a big part of Health 2.0. Ultimately, our relationship to our own health and our understanding of how we can live better have to evolve dramatically to achieve the costs and outcomes changes in healthcare that are imperatives. The ideas we see at Health 2.0 will form a large part of that evolution. But, as long as the healthcare system sees these as superficial or part of a lesser, consumer-driven parallel system, the gap will remain and the change so much harder to achieve. In other words, as long as their view of health does not include life.

Peter Heywood wrote this on October 01, 2014 / no comments

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