medtalk: patient psychology of health it

Paschane, DM (c) 2006

MEDTALK

The essence of consumer-driven healthcare

The necessary linkage between Health Savings Accounts and Individual Health Records


Business Opportunity

• Consumer-driven healthcare

– Economizes decision-making

– Reinforces self-management of consumption

• Patient control opportunities:

– Spending, e.g., health savings accounts

– Information, e.g., individual health records

• Missing a system that makes these useable by patients, and:

– Improves patient-provider communications

– Establishes patient ownership of information

– Overcomes barriers due to disabilities or language

– Accommodates differences in patients’ understanding

– Enhances healthcare services and experiences


MEDTALK Solution• A patient-controlled health assessment software

– Translates patient to provider language/understanding

– Integrates physical and psychological elements

– Provides patient ownership/gate-keeping of information

– Reinforces patient’s role in clinical/non-clinical settings

– Provides comprehensive/convenient assessments

– Increases time for individualized attentive care

– Focuses treatment through communication accuracy

– Reduces costs through early and integrated care

– Responds to care-seeking behavior in a timely matter

– Engages patients in managing disease processes

– Provides early identification of patients’ complications

– Minimizes likelihood of errors and noncompliance


Overlooked Key: Patient Psychology

• Patient psychology affects

– Sense of control and self-care

– Motivation and self-determination

– Expectations and compliance

• Reinforced patient control can

– Enhance the immune system and physical responses

– Reduce negative stress responses and reactance

– Improve patient participation and effectiveness


Solution Concept• The patient

– Answers a series of directed questions

– Selects prioritization of concerns

– Controls storage and delivery of information

• The software

– Provides associated questions through a rules engine

– Updates questions to provide comprehensive information

– Translates from user-specific non-clinical language

– Organizes chief and related complaints, and system factors

– Organizes psychological factors in complaints and processes

– Organizes medical and treatment histories

– Produces a one-page pre-clinical summary

– Leads patient through a post-clinical assessment


Solution Structure

Patient Personal Computing Device

Patient’s Home

Kiosk

Doctor’s Office

`

Doctor’s Computer

Database Servers(Patient Data)

Front End Web Servers

(Patient Access)

Application Servers(Rules Engine)

Security Certificate Servers(Authentication and Authorization)

Secure Hosting Facility

Internet

Patient chooses to send the inventory via fax, email, or hard copy.

The growth of on-site Kiosk services is another MEDTALK point-of-entry.

MEDTALK makes the timing of communication effective, and more valuable in treatment.


Solution Operations

• The user receives a self-launching CD that explains

– Accessing and operating MEDTALK

– Benefits for the patient and provider

• Access will be secured through

– Digital certificates

– External security mechanisms

• All servers will be located in a secure hosting facility


Marketing Conditions

• Potential buyers of MEDTALK

– The individual or family consumer

– Private financiers, such as employers

– Health plans carrying economic risks

– Government financiers, such as Medicaid/Medicare/Tri-Care

• Motivations for buying MEDTALK

– Patients seeking greater control and personalization

– Health plans wanting to control costs without losing patients

– Employers instituting consumer-controls to limit risks

– Governments wanting to solve barriers for vulnerable groups


Internal Rate of Return Example

Total people in Health Plan 500,000 Percent non-capitated 15% Percent not using Medtalk due to accessibility 15% Percent not using Medtalk due to compliance 20% People using Medtalk 250,000 Efficiency factor, for improper usage 90% Very High Users (10+ visits per year) 10% Average number of visits per year 12 Percent of decrease in visits via Medtalk 15% High Users (4-9 visits per year) 20% Average number of visits per year 6 Percent of decrease in visits via Medtalk 10% Average Users (1-3 visits per year) 70% Average number of visits per year 2 Percent of decrease in visits via Medtalk 5%Potential cost to Health Plan per ambulatory visit $85Cost of Medtalk Price of Medtalk, per patient $12.00 Total Cost of Medtalk to insurance company $3,000,000Benefit of Medtalk Cost savings in very high user group $3,442,500 Cost savings in high user group $2,550,000 Cost savings in average user group $1,487,500 Total benefit in prevented visits $7,480,000PROJ ECT IRR 149%

A health system targeting excessive utilization


Development Assumptions

• Funding to support development and research

• No major legal problems

• Appropriate security of system

• Beta partner with internal security

• Initial user incentives provided by beta partner

• Successful pilot with demonstrated benefits


Success Criteria• Improves patient care

– Less clinical time spent on history

– Greater comprehension in patient-provider communication

– Reduction in number of non-specific visits

– Provider and patient satisfaction with clinical encounter

• Improves cost management

– Increase in total number of patients seen per provider

– Diagnosis-specific reduction in number of visits

– Reduction in total non-specific acute diagnoses

– Early detection and treatment of psychological needs

– High rates of retention per provider

medtalk: patient psychology of health it

Health & Medicine