1. 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
THINK-Health

2. 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

3. 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, 2009.

4. “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

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

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

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

8. 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 2002.
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.

9. 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.

10. 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: 1Wisdom of Patients, Jane Sarasohn-Kahn, California HealthCare Foundation, 2009.
2Scott Shreeve, The Enabling Technologies and Reform Initiatives for Next Generation Health Care, 2007.

11. 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).

12. 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
Net becoming more important
Net becoming less important
Personal blogs
Social networking websites
Web-based video sharing sites
Corporate and product advertising
Source: Edelman Health Engagement Barometer, October 2008.
Accessed at
THINK-Health

13. 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…

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