Can Digital Health Technologies make People Better Health Care Consumers?

By now, many have either heard Dr. Jon Cohen’s talk firsthand or read articles referring to it. Dr. Cohen, CMO of Quest Diagnostics was a speaker at the recent TEDMed conference where he commented on how poorly educated and motivated people were as consumers of health care compared to other goods and services. I will not review the talk itself, but will refer you to a couple of other pieces which do: http://mhealthinsight.com/2012/04/14/do-patients-make-poor-health-care-consumers-or-does-a-lack-of-documentation-just-make-choices-too-difficult/ and http://healthbeat.areavoices.com/2012/04/16/undermining-the-patient/. What I would like to do is to discuss how digital health technologies may improve consumer education when it comes to health care. As a matter of disclosure I have no financial interest in any of the companies mentioned below.
There are apps which assist in informing people of the price of care. LowestMed is designed to allow consumers to locate the cheapest price of a medication within ten miles utilizing their smart phone’s GPS feature, or expand the search by inserting a zip code. GoodRX is another comparative drug price shopping app. Canopy Financial has an iPhone app, available May 18, which is aimed at people with high deductible health insurance plans. It claims to provide an average price of a medical procedure in their local area or searchable via zip code. Prices are estimated from Medicare prices and the company’s own health insurance clients, so they are estimates at best, but do provide both ballpark figures and comparative data. Various health insurers have apps which allow people to shop for personalized health plans.
There are thousands of fitness and patient education apps. These apps, by providing disease awareness, help people seek appropriate providers, ask more targeted questions, and ultimately participate in more high level shared decision-making. Some of the more elaborate and focused education tools are Emmi Solutions (which are specifically provider-prescribed, and Orca Health. The British National Health Service has an app called NHS Direct which allows the user to check symptoms and get advice on how to relieve them, often without seeing a provider. Without having access to the app and evaluating it, I won’t comment on the merits or pitfalls of such an app.
Not all apps need to be focused on the patient. Caregivers are important health care consumers and the efforts they put forth on behalf of their patients and loved ones may be very dependent upon their consumer education. One reference for 12 handy apps for caregivers may be found at: http://www.care2.com/greenliving/12-handy-apps-for-caregivers.html.
Patient portals are portions of the electronic health record to which patients themselves have direct access to and can contribute to and amend. The utilization of these portals (albeit only by 10% of patients initially) is mandated in Stage 2 of Meaningful Use EHR mandates. There has been substantial pushback by physicians over this requirement, because of their lack of confidence in consumer motivation, healthcare literacy level, and compliance. Consumer and patient advocates are pushing hard for maintaining this standard because of its importance in the participatory medicine movement. I believe that patients will become more educated consumers of health care by being more knowledgeable about their diagnoses, medications, and medical history. They are the most invested in the success of this portion of the EHR mandate.
I am confident that people will become better consumers of health care. They simply must. Health care institutions and providers likewise need to become better consumers of goods and services, and most of all need to realize that patients should be the focus and beneficiaries first and foremost of the economic decisions which they make.