The Patient-Centered Medical Hom

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					    The Patient-Centered Medical Home and Health 2.0
                   Beyond the Bricks


                 Jane Sarasohn-Kahn, MA, MHSA
               THINK-Health and Health Populi blog

               AHRQ 2009 Conference, Bethesda, MD
                      September 15, 2009
                   Roadmap – PCMH & Health 2.0
                       Beyond the Bricks

      • Setting the context: What are PCMH and H2.0? What‟s
        driving them? Where are we „today?‟

      • A view from Dr. Jason Mitchell, AAFP

      • A view from Dr. Michael Barr, ACP

      • Reactions from the panelists

      • Questions, answers, prospects for moving Beyond the Bricks

               Total U.S. Health Spending in 2007
                          = $2.2 trillion

               Source: Chronic Disease Overview, Centers for Disease Control and Prevention.
               Available at: accessed July 21, 2009.
        “In our country, patients are the most under-
      utilized resource, and they have the most at stake.
      They want to be involved and they can be involved.
      Their participation will lead to better medical
      outcomes at lower costs with dramatically higher
      patient/customer satisfaction.”

                    Charles Safran, M.D., President, American Medical Informatics
               From his testimony before the Subcommittee on Health of the House
                                                  Committee on Ways and Means

                 “It Stresses Me Out Too Much To Think About
                            Health Care and Costs”
     % of Americans

                       Source: CIGNA, learn4yourhealth survey, conducted July 2009, published September 2009

               Why We Don’t Get Preventive Care in the U.S.

                     Source: Fixing Health Care: What Women Want, AAFP survey, May 2008

               Americans’ Health-Responses to the Economic Downturn
                                    August 2009

               In the past 12 months, have you or another family member living in your
                                 household…because of the COST?

                            Source: Kaiser Family Foundation Health Tracking Poll, August 2009   7
                 The Patient-Centered Medical Home
      • “An approach to providing comprehensive primary care
        that facilitates partnerships between individual patients,
        their personal physicians, and the patient‟s family”

      • It started with kids in 1967: first introduced by American
        Academy of Pediatrics in 1967, expanded in 1992 and

               Source: American Academy of Family Physicians, American Academy of Pediatrics, American College of
               Physicians, and American Osteopathic Association. Joint principles of the patient-centered medical home,

               The Patient-Centered Medical Home

      • Enhance access
      • Build on consumer-driven health and patient
      • Activate patient engagement and whole-person care
      • Rationalize and coordinate health care processes
        and utilization
      • Improve outcomes.

                                                Health 2.0

      • "The use of social software and IT-based tools to promote
        collaboration between patients, their caregivers, medical
        professionals, and other stakeholders in health.”1
      • "New concept of health care wherein all the constituents
        (patients, physicians, providers, and payers) focus on health care
        value (outcomes/price) and use competition at the medical
        condition level over the full cycle of care as the catalyst for
        improving the safety, efficiency, and quality of health care.” 2

               Source: 1Wisdom of Patients, Jane Sarasohn-Kahn, California HealthCare Foundation, 2009.
               2Scott Shreeve, The Enabling Technologies and Reform Initiatives for Next Generation Health Care, 2007.

                            Health 2.0
      • Ubiquitous Internet connectivity among health citizens
      • Universal adoption of mobile phones and  use of
        smart phones
      • > access to health information online
      • > social networking online overall; health has followed
        other consumer verticals
      • > consumer-directed care: >OOP costs drive
      • > “DIY” care (esp. in recession – remember KFF
        tracking poll data).

     Patients See Conversations with Docs Will Become More Important
              Along with Personal and Health Expert Channels

                                                      Health companies’ Web sites
                                                      TV News coverage
                                                      Articles in magazines
                                                      Web sites for specific brands of medication
                                                      Films or documentaries
                                                      Online message boards, forums or newsgroups
                                                      Articles in newspapers
                                                      Radio news coverage
                                                      Personal blogs                                Net becoming
                                                                                                    more important
                                                      Social networking websites
                                                      Web-based video sharing sites                  Net becoming
                                                      Corporate and product advertising             less important

               Source: Edelman Health Engagement Barometer, October 2008.
               Accessed at
         The promise of moving beyond the institution
                        for health care
         • Achieving optimal health outcomes is a team sport;
           patient as engaged player
         • Enabling technologies are in place: broadband, mobile
           (mHealth), Internet
         • Local markets forging ahead…pioneers…
            – Innovating payment: Kaiser, Geisinger, etc.
            – Innovating care delivery: Center for Connected Health
              Cleveland Clinic
         • The emergence of participatory health care…
         • Let’s listen…

Jane Sarasohn-Kahn, MA (Econ.), MHSA
Health Economist and Management Consultant
THINK-Health Blog