A recent article described an innovative approach to speeding innovation and sharing results of research more widely among people and organizations in the medical treatment business. [A. Marcus “Sharing Ideas Advance Cancer Research?” Wall Street Journal Sep 18, 2007, sub required]  One effort involved the development of programs that offer million-dollar awards for the best ideas in cancer treatment, regardless of whether there have even been clinical trials.  The intent is to promote the sharing of such ideas across researchers, rather than jealously guard them through the research, clinical testing and patenting period, merely in order to protect their economic value and publications potential for “publish or perish” faculty.

The other idea is being practiced by Oncology, a cancer journal, which is aimed at overcoming a long-established practice of researchers who fail never sharing that information with anyone.  While it is perhaps understandable that researchers are reluctant to share such information, it can help others.  For one thing, it can prevent others from duplicating efforts on treatments that don’t work.  And for another, the basic concept in a treatment that failed may still be worth testing in some other way.

The reticence of organizations to share information about what they have found that does or does not work, or ideas that merely might work, is at least as common in the health management (HM) arena as it is in sickness treatment.  And while we are constantly bombarded with studies by the federal government or university faculty showing that HM, or more often DM (disease management) does not work consistently, what we don’t know is precisely how successful and unsuccessful HM or DM providers went about shooting for success.

I have hundreds of articles in my files, for example, recounting the successes of particular HM and DM providers, clients, and organizations that do it themselves, often with what look to be exaggerated success.  The exaggerations often arise from failure to account for regression to the mean and self-selection bias effects, but given the tendency for people to share good news much more than they share bad, the bias in published studies toward success is enormous.

While it is always easier for causes related to finding successful treatment for disease, particularly deadly ones, to raise money, there are good reasons for governments, large businesses, and private foundations to emulate examples such as the Value Investors Club, the Gotham Prize for Cancer Research, and Prize4Life by promoting the sharing of HM and DM “treatments”. Whether they work or not, the information would be valuable.  Knowing that DM methods as a whole have yielded widely varying results is of little use, unless we also know how those with good results as well as those with bad went about it.

Were the problems related to the disease, for example, since DM programs aimed at congestive heart failure and diabetes often seem to save money, while those aimed at asthma and depression may not.  One thing we do know is that programs aimed at employee populations can yield far greater savings, simply because the costs of health-related worker absence and presenteeism are usually much greater than healthcare costs alone, so savings from employee health improvement are far greater. [“Presenteeism Dwarfs Absenteeism as Cause of Employee Productivity Loss” HealthMedia.com Sep 17, 2007]

Moreover, there are surely a lot of people out there who have some ideas about how to make HM and DM more effective, but lack a forum for sharing the ideas or testing them in practice.  I, myself, recently figured out a way to determine the participation rates needed for any particular return-on-investment (ROI) amount or ratio, but since I am retired, I have no way of testing it in practice, except with hypothetical numbers.  HM and DM providers, once clearly separated, are becoming closer if not totally overlapped, as the market for proactive approaches to reducing the healthcare cost crisis expands dramatically.

The models that are emerging to promote sharing of information on HM and DM will clearly face the same hurdles as prevail in the search for sickness cures.  But the value of earlier and more widespread sharing of information, insights and ideas about HM and DM could ultimately have far more value.  The sooner we master the art and science of changing consumers’ health behaviors, and thereby reducing the incidence, prevalence and treatment costs of sickness, the better off all of us will be, with the possible exception of those dependent on sickness for their livelihoods.