Another solution to the health care crisis

by francine Hardaway on February 2, 2007

Finally, a group of corporate leaders has stepped up to the plate to solve the problem of health care information. Chairman Craig Barrett of Intel, the former CIO of Walmart, a vice president of Applied Materials, and the CEO of Pitney Bowes have gotten together and to develop a web-based platform for personal health records. I think they are now on a road show trying to sell the idea to payers, providers, and policymakers.

I listened to them launch it in Arizona at a panel moderated by, of all people, Esther Dyson.

These corporate giants hired Mercer to do a study first, and found out what they expected to find — that there would be a 6.7% aggregate savings to health care, and the savings will come from things like:
* elimination of suboptimal treatment
* collectection of patient data before the visit
* use of self care instead of provider assisted care
* subsitution of lower cost drugs for higher costs, etc.

So in their mind, although some in the audience argued this point, the ROI for the employer is there. Not to mention the fact that, as Dyson pointed out, it’s the moral thing to do.

Okay, so what’s the difference between these guys and everyone else who is trying to fix the system? Simple. These guys have resources, technology, supply chain expertise, and lots of other things to throw at the problem. The will probably get the product to market and deployed to their own employees.

So will it be the big corporations that fix this — the private sector?

The actual developer and the site of the data will be a non profit organization: Dossia. The record will belong to the patient, who will control what’s in Dossia and what he/she chooses to share. In the beginning, only employees of large corporations will have access to the Dossia service, but they hope it will spread virally through the migration of employees from company to company.

Dossia hopes to make the individual a partner with the provider and the employer in self-managing health. The Dossia PHR should give the individual a tool to self-manage. Basically, these corporations are wanting to shift accountability for health back to the individual whose health it is. This involves preventive medicine, adherance to treatment plans, and employee engagement to in the company.

Pitney Bowes has already done this by starting a Health Care University and a culture of health. It aso has company clinics. There’s major trust in the company, between employer and employees, who know there is a thick wall between the company and the employee health records. PB has brought costs of care down, even as it has increased cost-sharing with its employees, because the services are not used as much. AMAT, on the other hand, has only recently started empowering its employees to monitor their own health. They don’t have a real tool yet to gather accurate data and keep it for the employee.

Craig Barrett says that Dossia started because the average cost of health care to an employer per person in the US is $7000. This makes us non competitive with other countries. We pay more for health care and get worse results than many other countries. The debate in Washington, however, is not about how to fix the system, but about who should pay for it (the dual payer vs. single payer system).

Craig wants to wring excess costs from the system by eliminating duplication of effort.

What will make this attractive to employees? Why will they use it? In the long term, Dossia proponents feel that this is a product for the public good. In the short term, it’s good for disease management, portability, family medical management and a variety of other messages.

I got up and asked the question of where the data would come from, and I was assured that existing data streams that were only available heretofore in industrial applications would be made accessible to Dossia to allow the PHRs autopopulate with pre-existing electronic records (lab tests, claims data, etc). The obstacles to his accessibility, as of now, are political and legal–not technological — and it is assumed that the the country’s aggregated large employers can drive public policy to make the existing accommodations.

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