How Information Therapy can heal a sick healthcare system

Slide 1: Today’s Health Care System Media Self-Care Physician Information Overload Health Insurance The Patient

Slide 2: 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

Slide 3: What’s wrong with healthcare today?  Remember your last visit to your doctor ?

Slide 5:  Poorly organised patients + rushed doctors = badly performed consultation = poor medical care  How can we improve this ?

Slide 6: 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 !

Slide 7: 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.

Slide 10: 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

Slide 12: 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

Slide 14: Solution  Need to reform the healthcare ecosystem !  Put patients at the center – “ patients are the largest untapped healthcare resource “ !

Slide 15: 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.

Slide 16: Patient centered healthcare  Self-care  Personalization  Transparency  Quality  Control

Slide 17: 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

Slide 18: Blended model  Click and mortar  Provide information in the real world  Provide information on the web

Slide 19: Patient information centers  At every point of clinical contact  Clinics  Labs  Diagnostic centers  Chemists  Hospitals

Slide 20: 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

Slide 21:  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 !

Slide 22: 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.

Slide 23: 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 .

Slide 29: 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

Slide 30: 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

Slide 31: 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 !

Slide 32: Patient Information Center  Core collection of books  DVDs  PC with internet connection  Printer  Staff member  “Corner” centers – need just about 100 sq ft

Slide 34: New locations  Mini-libraries in pharmacies  Mini-libraries in medical laboratories  Mini-libraries in clinics

Slide 35: Online Information Therapy  Free  24/7  Easily accessible  Increased internet penetration  Answer questions free by email !

Slide 38: 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

Slide 39: 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 .

Slide 40: 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)

Slide 42: 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

Slide 45: Why will patients use the PHR ?  Three players  Patients  Doctors  Health insurance companies

Slide 46: 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.

Slide 47: 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

Slide 48: 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).

Slide 49: 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

Slide 50: 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 .

Slide 51: 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

Slide 54: 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

Slide 55: 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

Slide 56: 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)

Slide 57: White-labelled PHRs

Slide 58: 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

Slide 59: 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

Slide 60: 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 !

Slide 61: Risks  Need a critical mass of patients to adopt this  Privacy issues  Legal liability issues

Slide 62: Today’s Health Care System Media Self-Care Physician Information Overload Health Insurance The Patient

Slide 63: The Patient as Integrator Information Care & Feedback The Empowered Patient – with the help of Information Therapy Choice