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The future of collaborative health tools

One of the many topics one hears about during discussions on the future for health IT is the concept of “improved collaboration tools to improve outcomes”.   There’s a lot of potential for technology to increase the collaborative effectiveness between the various players that a healthcare consumer (e.g. patient) must interact with in order to navigate the healthcare continuum.

Let’s look at the example of rehabilitative therapy.  I’ve had two surgeries on the same knee, with two different surgeons in two different states.  I’ve been to a number of physical therapists across a number of states – some of these therapists I picked myself, and some I was referred to by the surgeon who performed the operation.  The results of all of this have been mixed.   My knee is okay (but not great) and the experience was okay, but not great.  So who is responsible for my good (but not great) experience?

One of the things that I learned through my experience is that the process is very fragmented, with no consistent thread from start to finish other than myself.  I’ve heard various conflicting ideas regarding which of the current players should be filling this role, but I’m not sure any of the current players should be filling that role.  Think about it:  if you want the best surgeon to work on your knee, then you want the surgeon who has a) done that operation many times, and b) has the lowest rate of complications.  That means that you’d likely rather not have a surgeon who spends 30% of his/her time focused on things other than purely perfecting the art of replacing that ligament.  For me, based upon my experience I want the surgeon who has done the operation so many times that they can do it in their sleep.  Same goes with a physical therapist – I want someone who is plugged into the latest and greatest thinking on how to rehabilitate my injury/my surgery.  Someone who has the most innovative ways to rehabilitate my leg.   I don’t necessarily want someone who is spending their valuable time managing the administrative aspects of their case load, filling out paperwork or conducting some other task not related to being the best physical therapist I can get.

So right now, there’s a vacancy in terms of a patient like me having someone who is the overall coordinator of my care.  The beauty of proposed online collaboration tools is that they can be a conduit of information and communication that can therefore enable the only proper overall owner of my care to play that role effectively – me.  For too long, we patients have expected someone else to care more about our overall health than we do, and that just doesn’t make sense to me.  Don’t get me wrong.  I want my surgeon to care as much as I do (if not more) about making the replacement ligament strong, viable and lasting.  I want my physical therapist to care as much as I do about rebuilding my strength in my leg to make that new ligament last.  But let’s face it – in the current health model, there’s no one who cares about the entire value chain – from injury to being able to say “I’m healed” – other than me.  So I think these new collaborative tools are a great way to enable me as the patient to live up to that role.

That said, one key question remains:  who will pay for the collaborative tools?  As much as I want great care and as much as I want to recover from my injury and the subsequent operation, I’m loath to pay N dollars per month for access to a collaborative tool that I feel should already exist in the marketplace, particularly when I already think my healthcare premiums are too high.  I don’t see the surgeons paying for the availability of these tools either.   That leaves either the physical therapists or the health plans to pick up the tab for these collaborative tools.  The trick is going to be able to demonstrate the return on investment to them by higher marketshare or increased member retention.  I think the case can be made – particularly to those innovative thinkers out there.

© 2009 medullan | blog.