Insights from the Care Continuum Alliance Meeting: Federal Planning, Small Low-Overhead Practices, Full Risk Contracting and Social Networking

A number of insights from attending today's Forum10 in Washington DC:

It seems that once D.C. policymakers get armed with Federal health legislation, they like nothing better than to talk-circuit with bubbled, arrowed, jargon-filled and notion-addled PowerPoints. The Disease Management Care Blog witnessed this first hand today, when it learned from a plenary session speaker that our government is developing a national health agenda that will drive measurement and change quality for the better. All well and good, says the DMCB, but the fact is that it's locally developed programs that have always been the source of real innovation, and that they only use the Feds' resources only when they add real value. The conceit was astonishing.

If physician income is no object, it's possible to set up a small, low-overhead, limited panel clinical practice and still take good care of patients. It may mean that the docs escort the patients back to the single examining room themselves, draw up and administer their own immunizations, carry a cell-phone 24-7 and create their own primitive records on desktop PC's. That was not surprising to the DMCB - what was interesting was the physician-speaker's assertion that doing all that gives that clinic a head start on getting NCQA recognition as a medical home. Will "concierge practices" add claims of also being a medical home to their other supposed virtues?

Conduct one big study of a disease management/telephonic care management program that shows a big return on investment. Check. Get it past peer review to make sure that what you think you've found is correct. Check. Conduct a bunch of similar in-house studies involving other clients that show the same thing. Check. Then, and only then, can you be confident enough to go to market with that program with a guaranteed, full-risk contract option. To do otherwise would be foolish.

Did you know there are 105 million Twitter users? 400 million on Facebook? That there have been 6.5 billion views on YouTube? Yet, while the telecommunications, computer, specialty retailers and the food industry have all tapped into this "social networking" phenomenon to great effect, the health care industry is still looking at it as an answer that's in search of a question. While there are some health care examples of social networking like hospitals (that use it to market and get patient feedback), patient communities (an example is PatientsLikeMe) and the Centers for Disease Control and Prevention (podcasts and videos are out there extolling the virtues of influenza immunization), this has yet to truly fill it's potential. Consumers are worrying about privacy and they'll only use social networking if it yields better information than a simple Google search. As you ponder this for your company, think about issues involving 1) identity (how much personal information must users share?), 2) authenticity (is this really good from the users' points of view?), 3) accessibility (you cannot afford to have your site go down), 4) reputation (users may not trust managed care-run networking, no matter how well-meaning) and 5) reciprocity (this is two way). These and other insights are courtesy of Deloitte. You can read more here.