Health care’s user interface

For the past 12 years we have worked on web site development projects designing online applications and tools that make complex information easy to understand. No where is that more needed today than in healthcare.

The complexity of individual data alone is staggering. Claims information, deductibles, in-network vs. out-of-pocket, prescription vs. generic, health savings accounts and flexible spending accounts all confuse the average consumer.

The dollars and cents part of the equation is maybe even harder to fathom. Costs are rising at rates 2-5 times the cost of living. Small business can’t afford to face 20+% increases each year for their health care. U.S. health care costs have risen from 4.4 percent of Gross Domestic Product (GDP) in 1950, to 9 percent in 1980, to 12.4 percent in 1990 and to 15.4 in 2005.

In this country we spend more money on health care than any other in the world and yet the result is many are forced into bankruptcy (Health Affairs article) We have a much higher obesity rate that any other of the 30 countries in the Organization for Economic Cooperation and Development and rank in the lowest third in life expectancy and per capita number of physicians (2006 OECD Health Data) in that group. Are we getting what we pay for?

Fortune 1000 companies are removing the lifetime health care benefits that our parents assumed because it is bankrupting them. The Ford Motor Company unbelievable announcement of early retirement packages for 75,000 employees is now being criticized as maybe not enough. In a Detroit Free Press editorial one of the concerns raised of the cuts is that unless the company gets major concessions from the unions largely on health care and retirement costs, Ford may need to make even deeper cuts in 3 years. (Free Press Editiorial article)

Demand is the third leg of the stool. With the first of the baby boomer generation turning 60, their tremendous numbers will stretch health care in the US for the next few decades. Even now the industry has become perhaps the most influential one in our economy. Michael Mandel quotes in a recent BusinessWeek article “Healthcare Economy” that 1.7 million jobs have been created in the health care industry since 2001. The rest of the private sector have created none in comparison (BusinessWeek article).

So its easy to agree that it is a big problem. What better way to make a big problem smaller than to make it easier to understand?

Many more Americans are opting to work on their own and will face the task of insuring themselves. Health care needs to become like retirement plans – something we all take charge of.

Enter – Consumer Driven health care and the chance to all of us to more firmly understand that each trip to the doctor’s office doesn’t just cost the $20 copay.

Consumer driven plans and tools are giving consumers more information and the chance to shop for services. Quality care, risk assessment, personalized health info like claims data and rx prescriptions gives average user the chance to save money by making intelligent health care choices. In a PricewaterhouseCoopers (press) release, the summary is that the “Current health plan trends to promote provider pay-for-performance, transparency, consumer engagement, and healthy lifestyles have the potential to mitigate future cost increases and address some root cost drivers.” In other words, if consumers treat health care like they treat every other major purchase they make maybe the costs can be managed to a more acceptable curve. And the only logical choice for making that “research” function really rich is online.

Empowered Central

Consumers for health care information come from all walks of life. In user tests that we conducted for hospital systems, we found at least 11 different types of online user for health care information. They range from people nervous about delivering their first child to those who need nutritional information (ie diabetes) to folks worried about a loved one going into surgery. They have various levels of internet savvy. They all have a need to find the information that will lesson their anxiety.

A collection of links to third parties doesn’t do that. It is more confusing. An entry screen designed by the back-end data base team probably doesn’t get it either. An enterprise solution has far too little customization in most cases. What we have found it boils down to is design that is simple to use – for everyone – and easily understandable.

Consumers want choice in everything else they purchase. And the internet has been a boom to informational gathering on consumer products from books to music to automobiles to homes. It is about time we all think about health care the same way.

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