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>View discussions about this entry Country: United States
Organization: YourHealthAdvocate.org
Focus of activity - Technology
Year the initiative began (yyyy) - 2007
Positioning in the Mosaic of solutions
Define the innovation - What is the main focus (product, services, etc) of your innovation? Who are the primary beneficiaries? How does it make health and/or health care more affordable, accessible, and simpler to achieve/use? How does it differ from what currently exists in the market? The web is bursting with health information, but patients do not benefit from this information. If the web were a great source of accurate health information, patients would be better informed and physicians would be answering fewer questions. Neither is the case -- ask any physician or provider. Patients are told to read web articles or to watch didactic videos loaded with information; this is how health information is presented on the web. The result is information overload. Moreover, specific patient questions are not answered, and this represents a failure to complement patient-provider communication. In the exam room of any physician's office, the doctor provides answers to questions asked either by the patient herself or by her advocates. Doctors do not lecture patients; why lecture patients outside the exam room? YourHealthAdvocate.org [YHA] brings the exam room process to the web with video answers to patient FAQs, available 24/7. Video answers are compelling, as opposed to text-based answers, and simulates the one-on-one nature of the patient-provider interaction. YHA disrupts the way in which medical information from the provider to the patient is communicated and transferred. Granular question and video answers can streamline the patient visit, even for patients with complex and multiple medical problems. Patient-provider communication, which is the essence of health care, is transmogrified, allowing providers to communicate with many patients in a highly cost-effective manner. The economics of the patient-provider interaction (an expensive and inefficient core activity of our health care system) can be favorably altered to help address the conundrum of caring for more patients -- both insured and uninsured -- with fewer resources. Equally important, with validated and standardized question and answer sets, YHA can help address the issue of variations in quality of care across the US. YHA is cost-efficient, accessible, and of uniform quality.
Context for Disruption: - Describe how your innovation is transforming traditional health or related systems in the short and long term. YourHealthAdvocate.org -- hereafter referred to as YHA -- aims to transform the way providers communicate with patients, while improving provider productivity.
YHA offers web-based video answers to frequently asked patient questions. When patients visit their physicians, they often accurately remember only a fraction of what their physicians said. After an office visit, patients frequently have more questions -- typically when they get home. Later, at the end of the day, patients often forget the original fraction of what their physician advised -- or, worse, remember the advice incorrectly. Finally, their loved ones may have additional questions about what the doctor said. This tenuous transfer of medical guidance from the doctor to the patient is a source of poorer patient outcomes (from an incomplete understanding by patients of their condition(s) and how best to manage them); increased health resource utilization (from poor outcomes); doctor frustration (from having to repeat herself multiple times to individual patients -- and also having to repeat the same advice over and over to patients with similar conditions); patient dissatisfaction (from not fully understanding why the doctor has advised a particular treatment); and lower doctor productivity (from having to spend the time answering the same questions multiple times). By video recording answers to commonly and frequently asked patient questions, and by having these answers to FAQs available 24/7 on the web, health care becomes more widely available and highly accessible. YHA offers better communication, which is a pillar of better care, and patients benefit. Doctors benefit from improved productivity from not having to spend as much time repeating themselves. This benefit is critical because many IT initiatives in health care have failed precisely because they provide little financial upside to physicians. There is nothing on the web like this. Delivery Model - How does your innovation reach its target populations? What mechanism(s) (e.g., communications, distribution channels, etc.) do you have in place? What is your current market penetration? How do you measure this? Our delivery model is based on physician referral and patient awareness.
One of YHA's core values is that it saves physicians time. By answering patient FAQs, physicians can be more productive. Physicians will refer patients to YHA content (video answers to FAQs) in order to be more productive. Patients will go to YHA because their doctor has referred them. We are partnering with hospital systems to generate credible video content. Hospital systems market their services to consumers; for any hospital system, those services are based on the physicians who perform those services. The hospital systems showcase their physicians answering frequently asked patient questions on YHA; patients connect a human face to the service offered by the hospital (a cardiac surgeon, for example, answers the top 60 questions about bypass surgery). This bonds patients to the doctor in the video affiliated with the hospital and attracts more patients. Also, hospitals' business development strategies revolve around winning the hearts and minds of referring physicians. Referring physicians are given brochures (branded by hospitals) that direct patients to YHA so that they, the physicians, can be more productive. We are currently implementing this strategy for a hospital system in New Jersey; we are in similar discussions with two academic medical centers and with a national blood testing laboratory company (to have FAQs answered about blood tests). Entities that provide patient services will each create video content to market and brand their services (patient care services for hospitals, blood testing services for laboratories); this will simultaneously build YHA content and disseminate awareness of YHA. Metrics for adoption are to be tracked with registration codes. Our current implementation was a proof of concept with a cardiology practice in New Jersey. Of patients referred to YHA, 70% have registered. The average age of the sample is 57 Key Operational Partnerships - What key partnerships have you established to make your disruptive innovation model possible? Who are your partners (business, social, government, other) and what are their roles? How central are these partnerships for your initiative. Our current partner is a hospital system in New Jersey. We are in discussions with several other medical centers in Manhattan. Their roles are to generate valid content for YHA, which they can then use to help educate their patients. These entities will also use this content as part of their marketing strategies to attract patients and referring doctors to use their services. In this latter function, these partnerships are critical to the dissemination and awareness-building of YHA content.
Financial Model - Describe the financial model for your innovation. What percentage, if any, of the total operating costs does earned income (from products, services, or other fees) represent? Our initial financial model is based on the revenue from producing the web video content for our partners. This will scale linearly with the number of partners we acquire. Later, the goal will be to document improved patient compliance and outcomes in chronic diseases as a consequence of the doctor-recommended YHA intervention. This will require longitudinal follow-up; this is one of the proposed metrics to be tracked with our current partner in the disease vertical of diabetes. We then plan to approach payors, who have a large stake in managing chronic conditions, to generate additional revenue.
We have found that patients and providers of direct patient care services -- doctors, hospitals, ancillary service entities (such as laboratories) -- immediately understand and see value in the YHA innovation; pharma and payors, however, don't immediately see value. What is considered valuable by patients and providers is not considered so by the entities with large amounts of capital in the health care system in the US. There appears to be little alignment between the interests of pharma and payors and those of patients and providers. The YHA innovation appears to highlight this disconnect. This incongruity may be a synecdoche of the larger problem of rapidly increasing health costs without better quality of care or increased insurance coverage in the US. The improvement in physician productivity, made feasible by the YHA innovation of detailed information transfer from the provider to the patient, is unique and should drive adoption and sustain the innovation. Subsequent improvements in disease management metrics -- from better patient education and understanding and from greater patient attention to her health using automated reminders -- will drive the business model.
Effectiveness - What has been the measurable impact of your project to date? How many people have benefited from your program in total? What policies, communities, or institutions have been influenced to make fundamental changes because of your work? In our proof of concept, we have piloted YHA in a community setting with a cardiology practice using the disease verticals hypertension and hypercholesterolemia. A YHA website has been created (www.yourhealthadvocate.org) to which patients are referred to have commonly asked questions about both disease states answered in video format. Additionally, patients are prompted with a once-weekly email reminder to log in to the YHA website (password protected) to enter the "YHA Weekly Monitor" to record basic, healthful behaviours, such as: Are you taking all prescribed medicines? What is your weight? Have you stopped smoking? Are you exercising three to four times per week, at least 30 minutes each? Are you reducing fat in your diet to a minimum? What is your blood pressure? Patient answers to these queries are currently not stored; the Weekly Monitor only serves to remind patients about staying healthful (we plan on allowing patients to graph their progress over time in the future). Currently, patients print out the Weekly Monitor form and bring them to their next doctor's appointment.
Of the patients referred (n=110), we have a 70% registration rate; the high registration rate is expected, given that patients are referred on the advice of their doctor. Patient feedback is highly positive, as this is perceived as an additional service that the doctor's office provides. They enjoy the videos, and they feel that they learn a great deal about their condition. Atlantic Health Systems (AHS) has evaluated YHA, and we are in the initial stages of implementation for AHS in the disease verticals of cardiology (hypertension, hypercholesterolemia, bypass surgery, arrhythmias, heart failure) and diabetes.
Scaling up Strategy - What is your priority for the next 3 years and please describe why. Our priority is to garner as many partnerships with leading medical centers and hospital systems to create deep content across a wide variety of disease states. Virtually every hospital we've contacted has expressed interest in creating web-video of their physicians answering patient FAQs. Much of the content will be repetitive -- for example, multiple diabetologists from different hospital systems and academic centers will answer patient FAQs about various diabetes drugs available. This will provide patients multiple video answers to each specific question, offering them multiple doctor's opinions about their condition(s) -- multiple free consultations, as it were, from doctors of the best medical institutions in the US.
We are also attempting to partner with other health services providers such as laboratories, home care services, visiting nurse services, nursing homes and long-term care companies, hospice companies, rehabilitation institutions, and imaging facilities. Each of these entities can offer video content to YHA to help educate patients (and physicians) about the wide spectrum of health services provided in the US. As an example, having video answers to FAQs about terminal care is important and can educate patients, family, and physicians (many physicians have antiquated ideas of hospice care) about this growing and important service.
Origin of the Initiative - Tell the personal story that will help people connect to your work. How did the initiative start? Was there a particular individual or event driving the idea? Tell the reader the story behind the innovation. I was struck with how much I repeat myself in my day-to-day care of patients. This made my job less enjoyable, and I was wasting time. I realized that I could memorialize my answers -- all of which were nearly the same, irrespective of the patient, because their conditions were the same -- in video format. The web is available 24/7 and this was the perfect tool to capture what I (and most physicians) do: answer questions and explain conditions to patients.
My 10-year old son said that he wished he had a YHA-like solution for his assignments in reading comprehension. He dislikes reading 3-paragraph topics followed by three or four questions, testing his comprehension of those paragraphs. Patients are currently faced with the same task of comprehending reams of health information on the web in order to have their questions answered. YHA provides the answer key. > Contact Information:
John Whang
Co-Founder YourHealthAdvocate.org (Individual) Discussions about this entry |
