How Information Therapy can heal a sick healthcare system

Today’s Health Care System Physician Health Insurance Self-Care Information Overload Media The Patient

How to heal a sick healthcare system
Dr Aniruddha Malpani, MD
Medical Director, HELP
Health Education Library for People
World’s largest free health library
www.healthlibrary.com

What’s wrong with healthcare today?
Remember your last visit to your doctor ?

Poorly organised patients + rushed doctors = badly performed consultation = poor medical care
How can we improve this ?

The commonest complaints patients have today are:
Doctors are too busy – they make me wait too long
I don’t understand what they say – they don’t have time to explain their jargon. They don’t share information or respect my preferences
Care is fragmented amongst specialists
Doctors are not transparent or accountable. How do I know his advise is reliable and trustworthy ?
Too expensive !

Doctors are unhappy too !
They are stressed out, because of the large number of patients they need to see, and feel that patients expect too much from them. The feel that patients unfairly blame doctors for all bad outcomes.
They also feel that many patients waste their valuable time by asking stupid and irrelevant questions; because they are too disorganized; and don’t bother to educate themselves or do their homework.

Result? Breakdown in Doctor-Patient Communication
Patients don’t trust doctors as much as they used to in the past
Doctors are getting burnt out
They practice defensive medicine to protect themselves from malpractise suits
Overspecialisation – specialists have tunnel vision
No one to look after the “whole” patient
Doctors have become technicians – lost the human touch

Major reason for a sick healthcare system
Everything is doctor-centric - the doctor is the center of the medical care system
Healthcare is therefore fragmented and disorganised
Too many specialists , most of whom have tunnel vision

Solution
Need to reform the healthcare ecosystem !
Put patients at the center – “ patients are the largest untapped healthcare resource “ !

Assumption
Patients ( or their relatives and friends) are : intelligent and capable; and because they have a lot at stake , they are motivated to get good health care, and will be willing to invest time and energy if given the right tools to ensure a good outcome.

Patient centered healthcare
Self-care
Personalization
Transparency
Quality
Control

Information Therapy
“ The right information to the right person at the right time to help make better health decisions”
What information do patients want ?
To choose doctors and treatments with good outcomes
To communicate effectively with doctors
To know what the doctor should do

Blended model
Click and mortar
Provide information in the real world
Provide information on the web

Patient information centers
At every point of clinical contact
Clinics
Labs
Diagnostic centers
Chemists
Hospitals

Patients have questions !
We need to answer these proactively
Win-win situation !
Helps to improve patient satisfaction
Helps to improve patient compliance
Can be answered by all healthcare professionals
Great way of marketing

Patient education is an untapped area in India today !
Anyone who provides this will create a USP
Improve brand recognition and market share !
Works very well in the USA !

Our experience with Information Therapy in the real-world
HELP – world’s largest free health library
Established in 1998
Mission - to empower people by providing them with the information they need to promote their health , and prevent and treat medical problems in the family in partnership with their doctor.
We are a registered charitable trust and a non-profit organisation.

We help patients save money on medical care
1. Promote SelfCare . Help them to do as much for themselves as they can
2. Provide Evidence-Based Guidelines , so they can ask for the right medical treatment that they need - no more and no less
3. Help them with Veto Power, so they can say No to medical care they don’t need, thus preventing overtesting and unnecessary surgery .

What we provide
Easy to read materials – for patients and by patients
Wide variety of styles – from single page pamphlet to books
Comprehensive – from stress management, exercise, diet, all illnesses, alternative medicine
Over 300 DVDs

Our focus areas now are:
1. encouraging health insurance companies to invest in patient education
2. advocating information therapy
3. setting up a national network of patient education centers
4. developing patient educational materials in Indian languages for the web

HELP is growing ! National Network
Every hospital should have a Patient Education Resource Center
Win-win situation
Great tool to empower patients
Helps doctors and hospitals too !

Patient Information Center
Core collection of books
DVDs
PC with internet connection
Printer
Staff member
“ Corner” centers – need just about 100 sq ft

New locations
Mini-libraries in pharmacies
Mini-libraries in medical laboratories
Mini-libraries in clinics

Online Information Therapy
Free
24/7
Easily accessible
Increased internet penetration
Answer questions free by email !

How do we provide the right information to the right patient ?
Free floating information is useless
Information Therapy needs to be prescribed to them, tailored to their needs, based on their medical problems
How can we do this ?
PHR

PHR – Personal Health Record
For the Tax Department, you are your tax return
For the Bank, you are your bank statement
For the healthcare system, you are your medical record .

PHR
Technology to help patients to store their medical records on their personal website. Interactive forms and templates so they can fill in the details online. Images, ECGs can be scanned in
This is NOT an EMR !
Using CCR information standards , the PHR can exchange data with other databases so that the PHR can be automagically updated ( for example, with lab test results ; with the chemist’s prescription; with the hospital EMR; with health insurance company data)

Yos Technologies
Yos Technologies ( www.yostechnologies.com) is based in Bangarore and provides a comprehensive "Personal Healthcare System" which includes PHRs, Healthcare tools and applications for Preventive and Continuous Care
I am an angel investor

Why will patients use the PHR ?
Three players
Patients
Doctors
Health insurance companies

PHR = organised medical information = improved medical care
Patients have a lot at stake !
Keeping this record will help them to get better medical care.
Patients need to manage their own health record.

Patient benefits
Instantly available on your mobile, wherever you are
Information is shared amongst all the specialists who participate in your care
Available during emergencies
Always updated
Ensures you don’t forget allergies and drug reactions
Automated reminders ( for example, for checkups ) using SMS

Patients own this information.
Part can be secure, private, and confidential; part can be public
Patients can add a lot of value to the healthcare system using Patient to Patient ( P2P) networking.
Social networking – an online community , in which patients share information
“ Wisdom of the crowds”
“ Expert patients “ can act as mentors and email buddies.
Patients can grade their doctors and hospitals ( using the amazon.com review model ) and compare treatments ( www.askapatient.com ).

How do we get patients to sign up ?
Reach out to patients directly
Highly motivated patient groups
Patients with chronic illness, such as cancer, infertility, HIV
Pregnant women
Mothers ( for their children)
Corporates
Employee wellness

PRM – Patient Relationship Management !
PHR can help doctors improve their practise
Because patients are better organized; and the doctor has easy access to all the relevant medical records, the doctor’s productivity will improve
Good medical records reduce medical errors. Important in risk management , thus reducing the doctor’s medicolegal liability .

More doctors now have their own websites
Websites are effective marketing tools for doctors which can help them to promote their practice
As doctors move online, they will want their patients to move with them !
Email is a much more effective form of communication than a phone call !
Can also integrate with the doctor’s EMR

Major player – health insurance companies
Initially, health insurance companies can offer the PHR as a value-added service to their clients
Later, the health insurance company could make this compulsory for all their clients

How the PHR helps health insurance companies
They could use this for providing health education to their clients, which would help to reduce their medical bills.
It would reduce their transaction costs, because the data processing ( collecting premiums, authorizing payments, issuing payments) could all be done electronically, and much more efficiently

How the PHR helps health insurance companies
They could mine the data these records warehouse, to improve the quality of their services and obtain more accurate actuarial data .
Online disease management ( based on the PHR) would help them reduce costs for patients with chronic illnesses ( http://www.lifemasters.com/index.asp )

White-labelled PHRs

Applications being developed
1. Google Earth – to map the nearest doctor; nearest chemist; nearest hospital
2. Databases of doctors, hospitals, medicines and their prices
Changing the healthcare ecosystem using Web 2.0

Why haven’t more hospitals adopted IT ?
Bugs in software
Difficult to get skilled IT manpower to run the systems
Difficult to scale up
Connectivity issues

Better model
Software as a Service !
All the technology is outsourced to Yos
Webware ( Web 2.0)
No installation or maintenance needed
Always updated
Can be easily scaled
Always available – from anywhere !

Risks
Need a critical mass of patients to adopt this
Privacy issues
Legal liability issues

Today’s Health Care System Physician Health Insurance Self-Care Information Overload Media The Patient

The Patient as Integrator Care Choice Information & Feedback The Empowered Patient – with the help of Information Therapy

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How Information Therapy can heal a sick healthcare system

by Aniruddha Malpani on May 14, 2008

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