My Thoughts from the 2007 Information Therapy Conference

I’ll be honest. I was sort of conferenced out when I was heading to Park City, UT for the next Information Therapy Conference. I figure these conferences are only as valuable as the people I meet and the extent to which the information I learn impacts current or future behavior. “Conference Burn Out” is generally not a great foundation for conference-inspired behavior change!

Well, I’m actually really glad I went. This conference is sort of like the little gem in the industry in my opinion: it draws a lot of very forward-thinking people from some very well-known institutions and some very cutting-edge ideas are discussed.
For the uninitiated, here’s the definition of Information Therapy:

Information Therapy (n.)
Prescribing the right information at the right time to a patient so that the patient is elevated from “passive receipient of care” to ” educated and empowered active self-monitor of the care being received.”

Basically, it just means that a diabetic patient 30 years ago may have blindly gotten their A1C Test just because their doctor told them to. But his modern-day counterpart was educated by his doctor about what the A1C Test really is, why it’s so important, and what the different ranges mean. In other words, the patient is now empowered to monitor what’s happening to him in his healthcare experience.

I wasn’t too sold on the concept when I first started going to this conference a few years ago but today I take a long, savory drink of this particular Kool-Aid. It’s really game-changing stuff.

I think what’s most interesting is that it’s something very concrete, so people have used it to launch other ideas about what it means to be a patient in the “new” healthcare paradigm. Basically, there’s a growing trend toward people seeing the patient as a partner in the care process, someone who has a proactive care plan and works in partnership with his doctor to achieve his personal goals. It means the patients is educated enough to know at least generally why he’s getting the tests or treatments that he is.

It means that it’s actually possible that the patient might know more than the doctor does about her particular illness because she obsessively researched it prior to her visit. Dr. Paul Wallace, Chief Medical Officer at Kaiser Permanente and a former practicing oncologist, humbly admitted that one his more enterprising patients frankly knew more about her ovarian cancer than he did.

This isn’t a failure on his part; there’s simply too much information on every different type of cancer for him to be the world’s expert. Rather, it’s an indicator that we live in a world overflowing with more information than anyone can reasonably process. That means that the days of the doctors as the untouchable lecturer of all relevant knowledge are sort of gone, and the days of the doctor as highly-educated consultant who works together with the patient to make the best decisions are beginning to come here.

It’s funny because I sat next to a girl who was developing a wellness program for her Care Management company (for the uninitiated, Care Management Companies are hired by insurance companies to proactively call members who suffer from chronic conditions and help increase compliance to keep costs down). Anyways, I cynically told her that by the end of the conference we would have yet another “we know the healthcare system is broken and if we just close our eyes and squeeze our fists we can all change it.”

I was actually proven wrong, though. The seeds of change are already afoot. Here are a few examples from the conference:

This is a paradigm-changing practice started by Dr. Rushika Fernandopulle, who had possibly the most difficult-to-spell name at the entire conference. Dr. Fernandopulle studied healthcare policy at Harvard and utlimately decided the current system delivers systematically “crappy” care (his word; I like it). So he created a new model of primary care, which is supported by a different kind of labor setup and a different kind of business model.

Renaissance Health charges its patients $20 – $40/month and in exchange the patient goes from “episodic care” (i.e. visit doctor when I get sick) to having a proactive medical partner who works together to manage your current health and prevent future illness.

The sense of realism is what struck me most. Dr. F talked about a patient that had 5 co-morbidities. They determined that for her to do everything that was “optimal” for each condition would have required around 3 hours per day. So instead of unrealistically saying “go do these things” and then forgetting about her, they worked together to create a “care strategy”, they prioritized the list, and then they focused on the 1 or 2 issues that mattered most to her.

Dr. F also talked about how he wanted to change the paradigm of “protect the doctor from the patient at all costs” to “strategically avail the doctor to the patient in conjunction with supporting resources.” He introduced positions in his practice like “health educator” that simply don’t exist in most other practices. Sadly, Dr. F complained, the IT they wanted was more optimized to help the doctor code for the highest possible reimbursement rather than communicate proactively with the patient.

I thought it was a phenomenal model, and I have so much respect for Dr. F for “doing” instead of just talking. I hope we’ll get the chance to work together.

These guys actually presented at last year’s conference, but I ran into their CEO, Jeffrey Greene and we chatted a bit. I obviously can’t share the details of our conversation, but just based off their public demo last year and other “winds” I’ve heard since, here’s another potential game-changer.

MedEnctive is a pay-for-performance company (for the uninitiated, that means they help setup incentive programs so that doctors who provide higher quality care are rewarded by earning more money), except that they set up a very clever incentive scheme: the patient is incentivized financially to engage the doctor (the patient gets 30 bucks if he can get the doctor to give him an information prescription) and the doctor can earn up to 10% – 15% more income per year if he gives the patient an information prescription and gets high satisfaction ratings from the patient.

The results from their first pilot were IMPRESSIVE. Like, I’m talking 30% overall cost savings in the system. That’s crazy! Crazy good, that is.

Finally, we have another game changer. This was the first conference I’d been to since Microsoft announced their HealthVault product last week, and their was a palpable excitement in the air. Essentially, MS has setup a Personal Health Record (that’s a medical record that patients can access and update) and set up an open, free interface for accessing it.

That’s huge. It means that Omedix systems can talk with some random EMR company we’ve never even heard of as long as both of us talk with Microsoft Healthvault. Here again we have the seeds of change being sowed.

Overall, I guess you could say I’m almost kind of euphoric. I feel like American Healthcare — in all its big, clumsy, excessively wasteful and inefficient glory — is finally beginning to lumber around to a better system. For the first time, I actually feel like there are things I can do as an entreprneur that are simultaneously fun, good for America, and profitable. Finally, capitalism works the way it’s supposed to.

It’s an exciting time in our industry…as much as I’m suffering from conference burnout, I can’t wait to go to the next one!

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