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Power to the people - EY - Global

Progressions 2012

Power to the people

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As patients are becoming more empowered, access to information has grown.
   
  Diego Miralles, MD
  Janssen Healthcare Innovation,
Head



Today's health systems need to move from disease care to health care to reduce the tremendous waste that is endemic in our health systems. This will involve empowering patients to manage their own health — to choose preventive actions, engage in real-time monitoring and more.

Yet, many professionals in the health care business often think patients cannot handle their health information. Providers, for example, have typically guarded how much information they give a patient and discouraged over-the-counter diagnostic tests — the belief has been that patients would not have enough information or expertise to make good decisions with the information, or they would simply be overwhelmed. The result has been a tremendously asymmetrical relationship between the providers of health care and the consumers of health care.

In scores of other industries, consumers have been empowered in ways that we now take for granted but which were unimaginable at the outset. Fifty years ago, if you told anybody in the banking industry that people could responsibly use a machine on any street corner to gain access to their money and conduct banking transactions, they would have been very skeptical. They would have worried about consumers making mistakes and falling victim to fraud.

At around the same time, if you had predicted that consumers at gas stations would one day actually pump their own gasoline, you would have been told that that would be incredibly dangerous and unlikely. After all, gasoline is highly flammable and potentially explosive.

And who would have envisioned just 20 years ago that travelers would be able to book a trip around the world on their own — leaving as soon as the next day — without ever needing to talk to or meet with a travel agent? Most people would have thought that travel arrangements are too complicated and that travelers could not manage the information and make reservations themselves without making mistakes, or would simply not be able to identify the highest-quality arrangements for a given budget.

There's a recurring theme here: when there are opportunities to give more power to consumers, the established players often resist on the basis that the consumer lacks the expertise and resources to handle it. This same conflict now exists in health care. Empowering and trusting patients with their own information could unleash huge efficiencies in health care.

There has been a lot of discussion about consumers having access to their own genomic data. The first thing to note here is that the portals that have been set up are excellent — the data is displayed in a way that is very understandable, probably more so than the average physician's explanation to a patient.

Also, we must remember that today, HIV and pregnancy testing — perhaps two of the most life-changing diagnoses — are available throughout the world over the counter, and the medical community resisted these, as well. The evidence suggests that consumers are much wiser and more capable of managing their own health than is believed.

Another important way to inform patients is to bring transparency to the health care system; this will introduce a real marketplace. Consider what a new company, Castlight Health, is doing to help consumers "find better quality at a lower price."

Similar to the way shoppers can search Amazon for best buys on consumer products, patients can use Castlight to search and find a list of providers for a specific medical treatment, including information on co-pays and out-of-pocket costs, as well as quality assessments. Imagine how health care-related behaviors will change if we enable transparency within the cost and quality of health care — if it became easy to see that one hospital charged $4,000 more for a procedure than another one, without any difference in quality.

As patients are becoming more empowered, access to information has grown. Just think about the changes we've seen in the last several years — the volume of information available on the internet and, more recently, new technologies and mobile apps that are giving more control and information to patients.

Can the transition to this world of transparency and big data seem overwhelming? Will patients need decision-support tools to make sense of all this information? Absolutely. We need to help patients navigate this new world.

But first, we need to trust them with control over their own information and some degree of medical autonomy. This way, they can better manage their own health and bring value to the system.

This article was featured in our report Progressions 2012 - the third place: health care everywhere.

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Progressions 2012: health care everywhere
Progressions 2012: health care everywhere
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