1997 Partnerships for Networked Consumer Health Information Conference

Summaries of Plenary Sessions and Breakout Sessions

Closing Plenary, Telehealth 2000

Wednesday, April 16, 1997
3:30 - 5:00 PM

Moderator: Tom Kalil, Senior Director, National Economic Council, The White House

Speaker: Michael S. Brown, President and Principal Consultant, MSB Associates, "Telehealth in the Year 2000: Is it Deja Vu All Over Again?"

Speaker: David J. Lansky, Phd, President, Foundation for Accountability (FACCT), "Information: The ‘Missing Link' of Health Care Reform?"

Speaker: Des Cummings, Jr., PhD, Executive Vice President, Florida Hospital, "Launching the Health Culture of the 21st Century"

This session will focus on the various aspects of Telehealth, which is an inclusive term that embraces all of the activities that combine telecommunications and health, such as: Internet relay chats; bulletin boards; World Wide Web self-help sites; community-based networks; health work stations; decision-support interactive software; telemedicine; programs linking home and clinic; and provider-patient e-mail. The ultimate goal of Telehealth activities is to improve the health and well-being and to prevent disease for all individuals and communities.

The panelists will bring to the discussion broad-based, but diverse, perspectives. Issues that will be discussed include: (1) The technocontrarian perspective of how use of networked consumer health information must be maintained to ensure that the medium does not become the message; (2) A description of a partnership with Walt Disney that may be become a leading model for health care delivery in the 21^st century; and (3) a rationale for why networked information may be the a missing link for health care reform in general.

"Telehealth In The Year 2000: "Is It Deja Vu All Over Again?"

The rapid advances in health care and medical communications technology have created many opportunities for improving Americans’ health status. However, for every opportunity, there is a significant challenge or barrier to successfully adopting a particular technology. More importantly, many health education strategies actually benefit from using "low tech" media. The "technocontrarian" perspective of challenging each use of networked consumer health information must be maintained to ensure that the medium does not become the message.

Among the key issues facing those who now use or plan to use these technologies in distribution of consumer health and medical information are the following:

1. Only 15 percent of U.S. households have access to the Internet or commercial online services. The costs of owning PC’s and getting online are a significant barrier. Initiatives to provide more public access sites will only alleviate the problem.
2. The profile of the average online consumer who seeks health care and medical information (the so-called, "HealthMed Retriever") is not that of the average American. Those who most need online health care information are not able to access it.
3. The Internet and commercial online services provide consumers with unprecedented access to heretofore "private" medical journals and discussions among health care professionals. However, even the sophisticated HealthMed Retrievers may not be able to evaluate the accuracy, timeliness, objectivity, and relevance of this information.
4. The HealthMed Retrievers are most interested in receiving online information from their own physicians and caregivers. A conflict arises because physicians see themselves as the sole source of online information for their patients, but don’t have the time or techno-savvy to do so. Further, they are often threatened by HealthMed Retrievers’ proactive information gathering behaviors.
5. The promise of the online technologies is giving way to the realities that they cannot always deliver the quantifiable benefits and outcomes that were expected. The result will be a significant shakeout and major restructuring of online health care and medical resource providers over the next few years.
6. Even the remaining online providers will have to re-think the way that content is packaged and distributed; focusing more on the learning abilities, demographics, and cultural backgrounds of target audiences.
7. The economic "driver" of lowering the cost of health care while maintaining quality will ultimately determine who pays for online health care information and telemedical services.

Ultimately, the ability of health care organizations and providers to successfully use online and interactive technologies is determined solely by how effectively they develop and execute a strategic plan. Ten key "planning paradigms" exist that will help ensure this success and avoid the mistakes of the past.

"Information: The Missing Link of Health Care Reform?"

National health care reform is still widely seen as necessary, yet no one expects national policymakers to undertake comprehensive reform as a governmental initiative. Instead, there is a growing expectation that purchasers will drive system changes by the ways they collect and disseminate information about health care choices and health system performance.

Key Issues

Readiness of consumers and patients to use information about health care quality; relevance of available information about health care choices and health system performance.

Roles, Responsibilities

There is widespread agreement that the U.S. health system needs to become more responsive to the people it serves. And it is clear that the health system has many legitimate stakeholders, each of whom has much to gain or lose as the reform process continues. The kinds of changes that are needed are not themselves controversial: an emphasis on chronic disease management; on risk factor reduction and prevention; on serving populations as well as presenting patients; on practicing from evidence; on integrating psychosocial and community services with medical services; on the patient’s acceptance of responsibility for health-related behaviors and choices; and on building partnerships that cut across the stakeholder boundaries.

These changes all share a dependence on the availability of information and a recasting of traditional roles. Health care purchasers - both public and private - are embracing these two strategies.

Leading purchasers are committed to measuring health outcomes for plans and provider systems, and distributing such information to employees and public program beneficiaries. They are quickly learning that "data" is not effective in supporting consumer behavior change or the larger goal of health system reform, so are turning increasing attention to understanding how consumers interpret and use information and how best to put performance data into a richer context. They are moving quickly to assess new media and technologies to support a context-rich information strategy.

But they are also moving beyond a "1^st generation" belief in raw market power as the device to shape system change towards a more complex partnership between plans.

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