The Patient-Centered Medical Home and Health 2.0Beyond the Bricks

Jane Sarasohn-Kahn, MA, MHSATHINK-Health and Health Populi blog

AHRQ 2009 Conference, Bethesda, MDSeptember 15, 2009

MEDICAL

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Roadmap – PCMH & Health 2.0Beyond the Bricks

• Setting the context: What are PCMH and H2.0? What’s driving them? Where are we ‘today?’

• A view from Dr. Jason Mitchell, AAFP

• A view from Dr. Michael Barr, ACP

• Reactions from the panelists

• Questions, answers, prospects for moving Beyond the Bricks

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Total U.S. Health Spending in 2007= $2.2 trillion

Source: Chronic Disease Overview, Centers for Disease Control and Prevention.Available at: http://www.cdc.gov/nccdphp/overview.htm accessed July 21, 2009.

“In our country, patients are the most under-

utilized resource, and they have the most at stake.

They want to be involved and they can be involved.

Their participation will lead to better medical

outcomes at lower costs with dramatically higher

patient/customer satisfaction.”

Charles Safran, M.D., President, American Medical Informatics Association

From his testimony before the Subcommittee on Health of the House Committee on Ways and Means

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“It Stresses Me Out Too Much To Think About Health Care and Costs”

Source: CIGNA, learn4yourhealth survey, conducted July 2009, published September 2009

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f Am

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ans

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Why We Don’t Get Preventive Care in the U.S.

Source: Fixing Health Care: What Women Want, AAFP survey, May 2008

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Americans’ Health-Responses to the Economic DownturnAugust 2009

In the past 12 months, have you or another family member living in your household…because of the COST?

7Source: Kaiser Family Foundation Health Tracking Poll, August 2009

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The Patient-Centered Medical HomeDefinitions

• “An approach to providing comprehensive primary care that facilitates partnerships between individual patients, their personal physicians, and the patient’s family”

• It started with kids in 1967: first introduced by American Academy of Pediatrics in 1967, expanded in 1992 and 2002.

Source: American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association. Joint principles of the patient-centered medical home, 2007.

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The Patient-Centered Medical HomeDrivers

• Enhance access

• Build on consumer-driven health and patient satisfaction

• Activate patient engagement and whole-person care

• Rationalize and coordinate health care processes and utilization

• Improve outcomes.

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Health 2.0Definitions

• "The use of social software and IT-based tools to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health.”1

• "New concept of health care wherein all the constituents (patients, physicians, providers, and payers) focus on health care value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.”2

Source: 1Wisdom of Patients, Jane Sarasohn-Kahn, California HealthCare Foundation, 2009. 2Scott Shreeve, The Enabling Technologies and Reform Initiatives for Next Generation Health Care, 2007.

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Health 2.0Drivers

• Ubiquitous Internet connectivity among health citizens• Universal adoption of mobile phones and use of

smart phones• > access to health information online• > social networking online overall; health has followed

other consumer verticals• > consumer-directed care: >OOP costs drive

engagement• > “DIY” care (esp. in recession – remember KFF

tracking poll data).

Patients See Conversations with Docs Will Become More ImportantAlong with Personal and Health Expert Channels

Health companies’ Web sites

TV News coverageArticles in magazines

Web sites for specific brands of medicationFilms or documentariesOnline message boards, forums or newsgroupsArticles in newspapersRadio news coveragePersonal blogsSocial networking websites

Corporate and product advertisingWeb-based video sharing sites

Net becoming more important

Net becoming less important

Source: Edelman Health Engagement Barometer, October 2008. Accessed at http://www.engageinhealth.com/docs/Edel_HealthBarometer_R13c.pdf

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The promise of moving beyond the institution for health care

• Achieving optimal health outcomes is a team sport; patient as engaged player

• Enabling technologies are in place: broadband, mobile (mHealth), Internet

• Local markets forging ahead…pioneers…– Innovating payment: Kaiser, Geisinger, etc.– Innovating care delivery: Center for Connected Health

Cleveland Clinic• The emergence of participatory health care…• Let’s listen…

Jane Sarasohn-Kahn, MA (Econ.), MHSAHealth Economist and Management ConsultantTHINK-Healthjane@think-health.comwww.think-health.comwww.healthpopuli.com Blog