So much of what is done in the eHealth space has a fuzzy value proposition attached to it. One of the recurring themes that I hear for healthcare providers and many healthcare vendors is that they are trying to empower health consumers (or patients). It’s a theme that’s receiving attention from a great many sources – the government, insurers and employers.
But what does empower really mean? As so many different groups take up an empowerment rallying cry, each of them brings a different set of goals to the party, and the result is a definition of empowerment that becomes less and less concrete.
For those entities paying for healthcare (and I include the federal and state governments in this category), consumer empowerment equates to greater fiduciary responsibility. By sharing the financial burdens of the cost of care, they hope that patients make less expensive choices and thereby rein in the exploding costs of the healthcare system.
Employers have some similar motives relating to managing costs, but they’re also hoping that patients take greater responsibility for making good decisions as opposed to simply being cost conscious. If their employees take responsibility for maintaining their health, they belive insurance costs would come into line and time lost from work due to health issues would be reduced significantly.
The voice lost in all of this is that of the patient. Here’s a thought from the recent report on e-Health for Patient Empowerment in Europe that sums up the problem quite clearly:
“…most e-Health applications have been developed primarily to support organizations and professionals, not for consumers.”
eHealth technologies have the potential to transform and revitalize a healthcare system that, today, has some fundamental problems. That level of change will be nearly impossible to achieve through forces working strictly outside of the healthcare system. At the same time, current industry players cannot start from where they are and make incremental changes to get to the place they need to be.
The first step, fundamentally, is to center the process of change around the health consumer. If the things we do are not focused on solving their problems — even at the expense of solving the problems of providers, payers, employers or government — then consumers will not use them. If health consumers fail to adopt the tools presented, then the net value they provide is negligible.
Once you begin to define the problem around the health consumer, empowerment takes on an entirely new meaning. There are many different roles that one might take during a lifetime of health-related successes and challenges. An individual health consumer does not take the same role at all times. Nor do they want to. Nor is that in their best interest.
There are many factors impacting the appropriate and desired level of empowerment for a health consumer:
- Demographic factors such as age, gender, socioeconomic status or faith tradition
- Familiarity with the decisions to be made such as those for a chronic disease rather than an acute, one-time health incident
- The gravity of the decision to be made
- The person for whom the decision is to be made –- the consumer themselves, a friend they are advising or a loved one for whom they are responsible
In other words, the long-term diabetic can and should be empowered in a different manner than that same person experiencing sudden and very unexpected chest pain. We must introduce eHealth tools that truly help consumers across these scenarios before we can expect motivational inducements — such as shifting costs onto those consumers — to have any real opportunity beyond incremental improvements.