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[…] I interest you in a 2 minute summary of DM in Medicare?  Please read my posting Medicare Chronic Disease Management Direction? It’s Anybody’s Guess on the World Health Care […]

Thanks Vince, always wonderfully concise and fascinating.

As an observation, it seems that the problem lies in the nature of the innovation. Is it in the gadgets created? or is it in the programs around them? Is it in the payment system? or is it all of the above? I think that sometimes we all tend to put the cart before the horse. In some cases I have seen wonderfuI and innovative management systems in search of patients, in other cases I have seen great business models but not product. It seems clear that Medicare is interested but they want to see savings to justify the expense and if the way to do that is to get patients to manage their healthcare better, than the key would be to finding tools, application, gadgets that would be as user friendly as possible. In this instance I would define such ‘user friendliness’ as finding ways to integrate into patients existing lifestyles as easyily and seemlessly as possible. Don Jones (SVP, Qualcomm) describes the 7 ‘C’s that are required to satisfy User needs, one of them being Confidentiality; being where a user can manage their healthcare wherever, whenever they wanted and anyone around would not be aware of any health issue. And on the other side of the coin, such approach should also be designed to involve the physician side on an ‘as need’ basis as aopposed to many existing approaches which are more of the ‘always on’ mode. This is where I think the Holy Grail may lie.

Using Vince’s examples above, there certainly seems to be interest on the Medicare side, but they want savings. The law of averages shows that the more people involved, the greater the number using it, resulting in greater gross savings to the ’system’. So the it can easily integrate into a patients life, the greater the useability and acceptance.

Anyway, that’s my 2 minute thought on a 2 minute summary

Howard Rosen
CEO
Life:WIRE
hrosen@lifewire-us.com
www.lifewire-us.com
www.lifewire.ca

Howard,

Thanks so much for your perspectives. I’ll offer 3 follow up thoughts:

1) It’s not about the technology itself, it’s about the information provided from the technology and the actions that can be taken by patients, clinicians, and other caregivers. The technology is the means, not the end.
2) The current DM model is not scaleable. Nurses and other people in call centers and counseling patients one-on-one is very expensive. This is cost effective for the sickest patients where evidence clearly shows short-term cost avoidance of ER visits and hospitalizations, but will not diffuse to longer term DM opportunities, prevention, wellness, and productivity enhancement applications.
3) However, many DM technologies will bring us days back to the early days of Internet economics. The cost will be in up front development, and the marginal costs of deploying the applications (once developed) will be close to zero — how much does a “hit” on a website or an outgoing reminder SMS message cost?

Vince

[…] that Medicare’s future direction for chronic care management has become murky,  I’ve started to pay more attention to the many other demonstration/pilot projects […]

[…] Medicare Chronic Disease Management Direction? It’s Anybody’s Guess […]

[…] Medicare Chronic Disease Management Direction? It’s Anybody’s Guess […]

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