Monday, April 23, 2007

Informing and empowering the modern consumer

My previous three posts discussed the daunting challenges facing today's "modern consumer." This post focuses on what is needed to inform and empower consumers, so they make good decisions and act responsibly when it comes to selecting the best treatments and adhering to them.

It's obvious that consumers need valid, understandable information about the risks, benefits and costs of different treatment options. But often that's not enough. Consumers also need the motivation, resources and skill to comply with chosen plans of care. In other words, they must be mentally, emotionally and physically able and willing to carry out their healthy living strategies, and do it effectively and efficiently.

Obtaining the needed information can be difficult because information found on different web sites, instructional pamphlets and expert opinions often offer conflicting, inadequate, irrelevant, unclear, and/or invalid information. Only 16% of online consumers searching for health information find what they were looking for. Although general search engines perform satisfactorily for generic searches, they may not do well for health queries. [1]

For example, much available information focuses only on conventional treatment options and ignores CAM (complementary and alternative medicine) interventions. Some information sources lack objectivity because they are influenced by advertisers sponsoring them. Some offer general information that is not adequately personalized for an individual's particular situation. And it's tough to find clear-cut information that lays out all reasonable options in terms of cost; risks (e.g., adverse side-effects, mortality rates, quality of life impairment, etc.); likely benefits; patient responsibilities; and so on. In addition, an individual's personal preferences tend to be overlooked.

Another problem is that the mind-body connection is often ignored, even though up to 50% of all visits to a primary care physician are for conditions with affected by psychological factors, and the relationship between emotional stress and physical disease is well established.[2] So, if a person is diagnosed with a physical problem, related emotional/psychological issues are rarely addressed, and visa versa.

Furthermore, consumers can be overwhelmed by having to navigate through web sites with hundreds of links, or read search engine returns that can easily total in the tens of thousands to hundreds of thousands.

And one more thing, consumers often need to have conversations with subject matter experts-including knowledable peers and professionals-in order to have their questions answered and to receive hands-on guidance and encouragement. Sometime reading written materials, listening to tapes, or watching videos isn't enough.

I suggest, therefore, that the best way to give consumers what they need is to implement a consumer-focused strategy with the following tactics-and do it in an easy, secure way that protects personal privacy:
  • Perform comprehensive, lifetime health status and risk assessments that examine the "whole-person," including psychological and biological factors, environmental influences, and personal preferences and abilities.
  • Use the results of the assessment to provide personalized "information therapy" that gives a clear explanation of people's existing conditions and risks, offers a risk-benefit analysis of both conventional and CAM treatment options, and gives instructions for adhering to healthy living strategies.
  • Offer targeted, interactive, decision-support and problem-solving tools that assist people in making good choices and dealing with troubling issues likely to prevent treatment compliance, in order to replace stress, denial, depression, anxiety, etc. with effective coping skills and proactive behaviors.
  • Focus on well-care (illness prevention, health optimization, recovery from health problems, and health self-maintenance).
  • Connect people with vetted peers and professionals who share experiences and ideas, ask and answer questions, and give emotional support.
  • Take the time to examine motivational issues and offer meaningful support and incentives.
  • Offer alerts and reminders to increase awareness of what to do and when to do it.
  • Make sure care is coordinated when multiple providers are involved (e.g., primary care and specialists).
What we need, then, are collaborating networks of peers and professionals who use a next-generation Personal Health Application (PHA), which differs considerably from today's personal health records (PHRs) and health information web sites. My colleagues and I are developing such networks and prototypes of such technologies; I'll have more to say about this in future posts.

[1] "Health Information Search Engines Emerge; Growing Consumer Demand for Health Information Increases Need for Better Quality, More Personalized Searches, Says Expert at 11th World Congress on Internet in Medicine." Internet Wire (Oct 18, 2006).

[2] WellnessWiki
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