Last week my wife, Kerry, helped host our school’s 2nd grade parent social. Located just outside Washington, DC, our school has families from all over the world. Not surprisingly, a big topic of conversation was the Ebola outbreak; the tragic consequences in Africa were (and still are) being felt at home. Along with diplomats who visit their home countries regularly, several parents in the group – including me – spend a good part of their time on airplanes. Others are health care workers at a nearby facility for the National Institutes of Health, a designated Ebola treatment center, and were just as concerned with their exposure risk as they were about reports of health care workers being discriminated against. The parents were wondering how to proactively manage this and other threats, and the entire conversation seemed reminiscent of prior concerns around SARS, H1N1, and even anthrax.
For years, the health care system has chalked many of its problems up to a lack of consumer engagement. The recent outbreak of Ebola in Africa and the US is yet another opportunity to engage consumers in a conversation about how the US health care system can become one that rapidly identifies, contains, and mitigates novel health threats—because this won’t be its last. While unrelenting media coverage has nearly guaranteed that potential Ebola cases will likely be detected, it has also fueled drastic responses from both individuals and organizations. The US health care system needs improvements to be one that can better deal with a broad range of issues across the population wherever they might be, and it needs more engaged and informed consumers in order to get there.
What is needed in the health care system to achieve this? How do those needs translate to the average consumer? In my opinion, the health care system needs to become an intelligent, responsive and adaptable one with certain critical capabilities:
Proactive monitoring of emerging threats: Sick patients arriving at hospitals are often a late indication that something is going on. Early warning signs of new or changing diseases often come from other sources: spikes in over-the-counter medication purchases, reduced public transit usage, Internet searches, weather events and more are early indicators that the system should be able to use. Analytics capabilities could encompass a broad range of data to give health officials a clearer sense of potential threats. Engaged and informed consumers will likely be those who understand the broader implications their actions and the actions of others have on these emerging threats. Even small actions like washing hands frequently and getting an annual flu shot help consumers remain engaged with the system before the threat becomes real and arrives at their doorstep.
Collaborative development of policies and update workflows: As threats are identified, public health and clinical officials alike should consider assessing protocols that are in place, and either reinforcing or modifying as necessary. However, these stakeholders might also take into account how changes will affect workflow and whether these changes will require new resources. Consumers need the tools and education to understand how to interact with the system—the best workflow and policies in the world will not necessarily help if consumers cannot find the information and care they need.
Optimization of the collection and sharing of health data: The country’s investment in health information technology is poised to improve the quality and safety of clinical care. Many institutions, however, lack the ability to rapidly align their electronic health records (EHRs) with evolving needs or updated decision-support tools so much of the data remains trapped within an organization. EHRs can be valuable tools in identifying and managing critical public health issues, especially in the absence of broad awareness or media coverage. Consumer engagement with health care data and information technology is on the rise, but could still be stronger. Deloitte’s survey of US health care consumers found that one-third of Millennials and only 18 percent of Baby Boomers have a personal EHR. Clearly the case has not been made to enough consumers that collection and sharing of data could strengthen the health care system and leave it better prepared to handle crises such as outbreaks, outweighing the potential privacy and security concerns (that should also be addressed).
Leadership and governance: Amid the fear and uncertainty of new public health threats, decisions should be made in a thoughtful manner that addresses the level of risk, individual freedoms, and public interest. Greater collaboration and communication among stakeholders is critical, and as with the others, consumers need transparency around these decisions.
As the world seeks to control the impact of this disease and others that continue to take precious lives and resources, I see this as a teachable moment. This situation could (and should) strengthen the rationale for broader stakeholder and consumer cooperation, data stewardship, and appropriate protection of privacy. Within health care, it should strengthen the business case for EHR adoption, interoperability, and expanded analytics capabilities for organizations and consumers alike.
This outbreak, like other issues we have confronted in the past, may get the public more engaged and educated as to the benefits of a modern, data-driven health care system. People want to be confident that the US health care system can see threats emerging, prepare for them adequately, identify cases quickly, treat them effectively, and prevent broader impacts. They should be able to trust that the health care industry, government and other stakeholders have the tools and capabilities to deal with a broad range of issues, and where they can help to fill gaps. According to the 2012 Deloitte survey of US health care consumers, trust in information provided by academic medical centers, teaching hospitals, and medical associations and societies is quite high. The opportunity before the industry now is either to reinforce trust and garner support for a more integrated and capable system or see that trust erode.