Disclaimer:

When it comes to discussions about nationalized healthcare, cost reductions, and other major political issues – I generally don’t feel qualified to comment. With this post I’m stepping out on a limb – and my qualifications(1) for doing so are probably still [...]]]>

Disclaimer:

When it comes to discussions about nationalized healthcare, cost reductions, and other major political issues – I generally don’t feel qualified to comment. With this post I’m stepping out on a limb – and my qualifications(1) for doing so are probably still lacking. I welcome your feedback. I’m more than happy to be proved wrong – this is just want seems logical (and obvious?) to me.

Delimiters:

In this post I am not going to argue for or against nationalized healthcare, rather I am going to discuss alternative methods of reducing costs/improving treatment. This is not because I disagree with nationalized healthcare(2) but rather because I see these steps as being a natural first step in any attempts at cost reduction/treatment improvement.

Automation:

Each year I (try to) go for a physical with my doctor. I don’t enjoy it – but it allows me to find out if there is something major and obvious wrong with me. It takes a lot of time to see a doctor. After setting up the appointment one generally has to leave work and travel to the doctor. Being the anti-travel person that I am, that isn’t too big of a hazard – my doctor is five minutes drive from my house, ten from my work. Still – its a nuisance.

Once I arrive, no matter how early or late, I always end up waiting and waiting (and waiting and waiting). Generally I am surrounded by others like me who are healthy and present for routine maintenance as well as those who are ill. Unfortunately, this means I am in a closed air enclosure with several individuals who are hacking and sneezing – throwing contagious germs around the room. I don’t harbor any hard feelings – I do the same when I am ill and I go to the same place to get treatment…but still, the risk is that I will leave with more wrong with me than when I entered.

The doctor’s examination includes fairly routine processes. He checks my height and weight. Checks my blood pressure, listens to my heart beat, pays attention for any abnormalities in my breathing, checks my mouth, ears, and nose – amongst other questions and proddings. Much of this process is actually carried out by one or more nurses (including the occasional bleeding for blood tests).

Now, my suggestion is simple, why not work on devices like the Zeo which can perform most of this sort of monitoring automatically? Granted, the Zeo is only for sleep – but why can we not make multifunctional devices that can monitor our blood pressure, heart beat, breathing, and any of dozens of other health factors? It seems that both the Apple iPhone and the Verizon/Motorola/Google Droid would be able to serve as perfect multifunctional devices for such a purpose (in addition to their many current uses). I’m not a big fan of having something implanted in me (call it Revelation/666 syndrome if you must) but I see no reason why such devices could not be used once a day/week in a few moments or with a small wireless bandaid type patch to monitor our health.

This automation would provide us with numerous benefits such as:

• Reduced visits to doctors for regular physicals, increasing our work productivity/time off for recreation.
• Increased monitoring of our vitals – alerting us to health issues in days instead of weeks or months.
• Reduced exposure to environments with significant amounts of communicable health issues.
• Advanced analysis of our health vitals to determine patterns of health that are disconcerting and need review.

Let me give a few examples of how a device like this might function:

• Jane is fairly healthy. She uses her multifunction device once a week. It gives her peace of mind that her main vitals continue to operate within normal bounds. She doesn’t spend as much time worrying about whether this or that minor issue might be part of a bigger dilemma.
• John uses his device daily. The device notes over a months time that John has significant blood sugar spikes around noon every Friday and this is accompanied by extreme bouts with sleepiness throughout the day. The device alerts John and John is able to change his dieting habits to reduce the sugar intake reducing his sleepiness.
• Mary has chronic heart problems. While family bought her one of those devices that calls 911 if pressed they still worry about her constantly…until she received a multifunction device. She keeps a wireless patch on her all the time – which covers her vitals. It lets her know when she is working too hard and in danger of bringing on a heart incident and will even call 911 if she keels over – without her interaction.

Analysis:

I know some people are afraid of having their records kept electronically. I could explain why I don’t think this is a major concern but perhaps another time(3). The keeping of electronic records instead of traditional paper records would offer several significant benefits:

• Medical offices could (with permission) share information instantaneously. No more waiting days or weeks to get paperwork transferred from one office to another.
• Medical offices could communicate with one another electronically and share results to coordinate better treatment plans.
• A significant reduction in the amount of paperwork could be made. Individuals could give HIPAA consent via an e-sign form rather than through the useless bundles one receives at each doctor.
• The data could be analyzed anonymously to garner important health information and to look for patterns invisible to the naked human eye. Think about it – we could find that individuals who now live in every state in the union and are suffering from stomach cancer all originally lived in the small town of (put name here). While this might not solve their health problems it could launch an investigation to discover that (name toxin) is present in (name location – e.g. elementary school).
• Further, the efficiency of treatments, the possibility of causes, the analysis of diseases could all be significantly expedited by such a process. The data could be anonymized and then made available for legitimate researchers to utilize in performing research (e.g. such as World Community Grid projects).

Pre-Treatment:

A lot of expense and time is caused by the inability to discover issues before they occur. What if we could monitor our health? What if we could be alerted (and allow our medical professionals to be alerted) before a major issue arises? If our spiking cholesterol levels were managed before they became a crisis? If our hearts failing functionality was noted before it resulted in a heart attack? If our liver and kidney function could be monitored?

Severity Monitoring:

I get sick somewhat often with minor bugs – a stomach bug, a cold, a virus. Annoying but not life threatening. In my line of work (IT) sometimes its really important to get a project done and while I personally am of the opinion that it is better to stay home and heal before returning to work many others in my field (and the American culture in general) are not. Sometimes even I succumb to the pressure to be present when feeling under the weather. What if I could cough into a small device attached to my multifunction and receive feedback on what sort of cold or virus I have? If its just the common cold I take some dayquil and am good to go – but if its strep, bronchitis, or the flu – well I stay home and see a doctor. How many epidemics could be prevented or reduced?

Conclusion:

I am not arguing for or against nationalized healthcare. I do wonder why there is not more effort in the areas I have outlined above – by governmental and private agencies – to utilize technology to solve these issues. I recognize that these solutions will have minimal effect on what some are especially concerned about (I am concerned as well) – the masses who are unable to receive affordable healthcare coverage. I suppose my thought is that if we can reduce the burden on the overall system, reduce our costs overall, this would provide more time and finances to direct towards those who have a need (whether that is on a governmental, religious, local, or personal level) while creating a sustainable system for future generations.

I eagerly await your thoughts and feedback. Thanks for your time and consideration of my ramblings!

Notes:

(1)In this instance my qualifications consist in their entirety of (a) reading Newsweek weekly, (b) keeping current on major headlines [including healthcare] via Yahoo, and (c) reading/skimming a wide variety of rss feeds covering a gamut of tech/health topics.

(2)I disagree with those who utilize (Christian) Scripture as a argument against socialized medicine. I see no such impetus in Scripture. On the other hand, I find myself less optimistic about the effectiveness of governmental organizations than many more liberal minds (in Christian circles, Jim Wallis comes to mind).

(3)In brief, (a) privacy is an illusion – our information is already available, perhaps just not centralized and (b) I have nothing to hide – so why hide it? You want to know I struggle with Obsessive-Compulsive Disorder? Now you know. Finally, as outlined above I think the benefits are huge (and outweigh the negatives).

Requests for Comment:

Here are a few people who I’d like to hear their thoughts on this post: Dana Blankenhorn (ZDNet), Jim Wallis (Sojourners), Ed Dobson, Tosca Lee (Demon: A Memoir), Michael Arrington (TechCrunch), Jason Calacanis (Mahalo), the folks over at Zeo.

Well, I don’t plan to blog too often about products or services I don’t like, but for the sake of humanity I think it is worthwhile to talk for a few minutes about eHealthInsurance. Choosing a health insurance provider is like [...]]]> Image via Wikipedia

Well, I don’t plan to blog too often about products or services I don’t like, but for the sake of humanity I think it is worthwhile to talk for a few minutes about eHealthInsurance. Choosing a health insurance provider is like pulling teeth – there are dozens of them and they all use confusing terms and have dozens of plans with prices that can outrun your income. eHealthInsurance seeks to make your life easier by compiling a number of health care providers at one spot – honing in on the plans that are best for you – and allowing you to apply right then and there online.

What did I like about the service? Well, the initial pages of the website where straightforward – enter my name, age, height and weight as well as that of my wife Charity. I also entered my zip code, then a large number of plans were made available to choose from and I could look at them by popularity, company, price, etc. Okay, all well and good.

I was a bit overwhelmed even with all this streamlining so I decided to call in. The phone menu was a little longer than necessary – but not bad comparatively (e.g. Verizon). I talked to a representative named Keith. Now I was impressed. This guy knew what he was talking about, walked me through the process, recommended the best plan for my needs, and was genuinely polite and friendly – I thought I would love eHealthInsurance.

He told me to get back on the site and fill out the online application and this is where things when downhill. While the main site has a nice design and UI, the form is a nightmare. Part of this is the insurance companies‘ fault. They ask questions out the wazoo. But still, the UI design is pretty bad, so I’m going to highlight the issues here and hope eHealthInsurance stumbles upon this page and hears my concerns. They have a great nebulous idea, but until these issues are resolved I can’t recommend the service wholeheartedly:

• When asked to select a doctor they allow you to perform a lookup of physicians. This is great, except for the fact that once you find the physician there is no way to automatically import that physician’s information into your application. You have to type it in by hand!
• There form validation fields are all messed up. For example, even though we hadn’t taken medications for certain ailments the validation made us select a treatment begin and end date! And this was even so after we checked the “none” box to note we hadn’t taken any medications.
• After asking about our ailments and treatment they proceeded to have another entire form that asked just for all our prescription medication treatments – again. This information should have been imported from earlier in the document.
• Just these changes could make a huge difference in the user friendliness of the form. For a few thousand (dollars) more they could throw in a nice web 2.0 ajax enabled ui that would allow for streamlined forms that could be half the length (e.g. the page asking what ailments you have and the page allowing you to enter details about ailments/treatment could be made into one single page).

Well that is about it. I’m not saying eHealthInsurance isn’t a good company. In fact, if I had to say, “go here to get a health insurance quote.” I would probably still send people to eHealthInsurance…But not before warning those I tell about the site to be prepared for some tears and anguish before the job is completed.