Disease Management, Opting In and Social Media



Health care isn't immune

Anyone working in population health and disease management is undoubtedly familiar with the terms "opt-in" (for example) and "opt-out" (for example).  In the former, the sponsor builds the program and has to recruit patients. In other words, those with the condition have to agree to formally  enroll.  In the latter, all patients with the condition are automatically    entered into the programs, but each person is given the option of disenrolling.

"Opt-in" has the advantage of only recruiting interested volunteers who are highly likely to be engaged. Its disadvantage is that only small numbers of eligible persons typically join.  "Opt-out" has the advantage of a "head start" that exposes many more individuals to an intervention.  Its disadvantage is that only a fraction are likely to fully participate.  While opt-out, compared to opt-in, is more expensive, it's generally favored by buyers and insurers because of a belief that high initial enrollment levels will ultimately lead to better outcomes. That's why the DMCB guesses more of today's commercial disease management programs are "opt out." If you are recently discharged from the hospital with heart failure, you will be telephoned.  If you use a glucose meter, you can expect to receive a letter. Lather rinse repeat. 

Vendor familiarity with the strengths and weaknesses of "opt-in" vs "out" and knowing how to deal with them is why the Disease Management Care Blog suspects population health and disease management (DM)  companies will lead the way with the use of social media, such as texting, blogs, Facebook and Twitter, to improve care and reduce costs.  That's because "subscribers," "friends" and "followers" are earned one person at a time.  Social media is intensely "opt-in."

The DMCB has been learning about this first hand.  For example, it currently has 307 followers on Twitter, and it's growing day by day.  Each discovered the DMCB on their own.  Each voluntarily opted in.  Each has been highly valued by the DMCB.  There are "engines" that assess Twitter impact (here and here) and given its narrow slice of health care vs. Lady Gaga or Oprah, the DMCB's 8th percentile score "influence" score doesn't seem too bad.  Things are going well.

While skeptics and the DMCB spouse legitimately continue to wonder about the impact of social media on health care and consultant income, the DMCB responds

1) persons are increasingly relying on social networks as the primary portal for news updates and Internet searches,

2) persons are coming to trust sources in their networks more than institutions or governments for information,

3) it can even threaten government control, be it strong arm Middle East dictators or the smooth functioning of representative democracy

4) it is really cool.

If you, your boss or your associates doubt social media could have a huge impact on health care, you need to reconsider. As this phenomenon continues to burrow deeper into human society, provider organizations that learn to gain followers and harness it will win. 

In a future post, the DMCB will discuss potential organizational approaches to maximizing the "opt-in" social media uptake for its health care consumers.