The Patient-Centered Medical Home and Health 2.0 Beyond the Bricks Jane Sarasohn-Kahn, MA, MHSA THINK-Health and Health Populi blog AHRQ 2009 Conference, Bethesda, MD September 15, 2009 MEDICAL THINK-Health

Roadmap – PCMH & Health 2.0 Beyond the Bricks Setting the context: What are PCMH and H2.0? What’s driving them? Where are we ‘today?’ A view from Dr. Jason Mitchell, AAFP A view from Dr. Michael Barr, ACP Reactions from the panelists Questions, answers, prospects for moving Beyond the Bricks

THINK-Health Total U.S. Health Spending in 2007 = $2.2 trillion Source: Chronic Disease Overview, Centers for Disease Control and Prevention. Available at: accessed July 21,

“In our country, patients are the most under- utilized resource, and they have the most at stake. They want to be involved and they can be involved. Their participation will lead to better medical outcomes at lower costs with dramatically higher patient/customer satisfaction.” Charles Safran, M.D., President, American Medical Informatics Association From his testimony before the Subcommittee on Health of the House Committee on Ways and Means THINK-Health

“It Stresses Me Out Too Much To Think About Health Care and Costs” Source: CIGNA, learn4yourhealth survey, conducted July 2009, published September 2009 % of Americans

THINK-Health Why We Don’t Get Preventive Care in the U.S. Source: Fixing Health Care: What Women Want, AAFP survey, May 2008

THINK-Health Americans’ Health-Responses to the Economic Downturn August 2009 In the past 12 months, have you or another family member living in your household…because of the COST? 7 Source: Kaiser Family Foundation Health Tracking Poll, August 2009

THINK-Health The Patient-Centered Medical Home Definitions “An approach to providing comprehensive primary care that facilitates partnerships between individual patients, their personal physicians, and the patient’s family” It started with kids in 1967: first introduced by American Academy of Pediatrics in 1967, expanded in 1992 and Source: American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association. Joint principles of the patient-centered medical home, 2007.

THINK-Health The Patient-Centered Medical Home Drivers Enhance access Build on consumer-driven health and patient satisfaction Activate patient engagement and whole-person care Rationalize and coordinate health care processes and utilization Improve outcomes.

THINK-Health Health 2.0 Definitions "The use of social software and IT-based tools to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health.” 1 "New concept of health care wherein all the constituents (patients, physicians, providers, and payers) focus on health care value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.” 2 Source: 1 Wisdom of Patients, Jane Sarasohn-Kahn, California HealthCare Foundation, Scott Shreeve, The Enabling Technologies and Reform Initiatives for Next Generation Health Care, 2007.

THINK-Health Health 2.0 Drivers Ubiquitous Internet connectivity among health citizens Universal adoption of mobile phones and  use of smart phones > access to health information online > social networking online overall; health has followed other consumer verticals > consumer-directed care: >OOP costs drive engagement > “DIY” care (esp. in recession – remember KFF tracking poll data).

Patients See Conversations with Docs Will Become More Important Along with Personal and Health Expert Channels Health companies’ Web sites TV News coverage Articles in magazines Web sites for specific brands of medication Films or documentaries Online message boards, forums or newsgroups Articles in newspapers Radio news coverage Personal blogs Social networking websites Corporate and product advertising Web-based video sharing sites Net becoming more important Net becoming less important Source: Edelman Health Engagement Barometer, October Accessed at THINK-Health

The promise of moving beyond the institution for health care Achieving optimal health outcomes is a team sport; patient as engaged player Enabling technologies are in place: broadband, mobile (mHealth), Internet Local markets forging ahead…pioneers… –Innovating payment: Kaiser, Geisinger, etc. –Innovating care delivery: Center for Connected Health Cleveland Clinic The emergence of participatory health care… Let’s listen…

Jane Sarasohn-Kahn, MA (Econ.), MHSA Health Economist and Management Consultant THINK-Health Blog