The Rand organization puts out a number of interesting health research pieces every year. A recent one looked at how changes in benefit plans are creating a market for better information and decision support tools for health consumers. (Rand Report) The authors first note the growing prevalence of health plan benefits that include wellness programs, value-based insurance design and high-deductible health plans, all of which are intended to engage consumers more in health care decisions and which therefore create a need for better tools to help consumers with those decisions. Despite the changes in benefit design, many consumers remain unengaged and perhaps access to better sources of information and decision aids may improve engagement rates.
The report then identifies a set of capabilities that could be used to create what Rand refers to as a consumer-controlled personal health management system. Rand identifies three key categories of functionality: health information management, promotion of wellness and decision support. The actual data and applications could reside on a server somewhere, perhaps supplied by a payer or provider or by an independent vendor, but the collection of and use of the data on the server would be controlled by the individual. To some extent this would be an enhanced version of the personal health record idea. Perhaps the most important component is decision support; helping to supply access to cost and quality information about providers, information on potential treatments and information on benefit packages that may be best for the consumer.
As the research notes, there is little clear evidence in the literature about the beneficial effects on health or costs of the various components of the proposed personal health management system, but what evidence there is does suggest that consumer engagement can be increased, with improvements in health status and a lowering of cost. A big problem to date has been getting consumers to accept and use the tools, especially those consumers who are in poor health and use a large number of health services. Many of these patients actually need surrogate decision-makers. But the trend toward placing more health costs on patients will undoubtedly continue, so helping them with tools to better make decisions will be very valuable.