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Hoff\u003c/br>STAT","isLoading":false},"byline_futureofyou_250136":{"type":"authors","id":"byline_futureofyou_250136","meta":{"override":true},"slug":"byline_futureofyou_250136","name":"Rachel D'Oro \u003c/Br> Associated Press","isLoading":false},"byline_futureofyou_4462":{"type":"authors","id":"byline_futureofyou_4462","meta":{"override":true},"slug":"byline_futureofyou_4462","name":"Unity Stoakes","isLoading":false},"cfarr":{"type":"authors","id":"3252","meta":{"index":"authors_1591205172","id":"3252","found":true},"name":"Christina Farr","firstName":"Christina","lastName":"Farr","slug":"cfarr","email":"cfarr@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Christina Farr (\u003ca href=\"https://twitter.com/chrissyfarr\">@chrissyfarr\u003c/a>) is the former editor and host of Future of You. She was previously with Reuters, covering digital health and Apple and before that, she reported for Venture Beat. 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Or $400.\u003c/p>\n\u003cp>It just depends where you live.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657832/table/pntd-0000402-t002/\">4 cents is in Tanzania\u003c/a>. That'll cover the two pills it takes to knock out the intestinal parasite. But in the United States, where hookworm has re-emerged, the price for two 200 mg tablets of albendazole can cost \u003ca href=\"https://www.goodrx.com/albendazole?drug-name=albendazole\">as much as $400\u003c/a>.\u003c/p>\n\u003cp>The pill will put an end to the problems hookworm can cause, such as anemia and protein deficiency as well as stunting growth in children.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want.'\u003ccite>Dr. Jonathan Alpern, HealthPartners Institute\u003c/cite>\u003c/aside>\n\u003cp>It's not just a problem with the anti-hookworm pill. Drugs for diseases of the developing world, in particular what are known as \"neglected tropical diseases\" like hookworm and \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/06/29/483721076/the-aleppo-evil-is-making-a-comeback\">leishmaniasis\u003c/a>, are enormously more expensive in the United States than in the developing world.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There really is no good reason for this price,\" \u003ca href=\"https://www.healthpartners.com/hprf/investigators/ENTRY_194022\">Dr. Jonathan Alpern\u003c/a> says of the albendazole price tag. Alpern works for the HealthPartners Institute, the research division of a health care organization in Minnesota.\u003c/p>\n\u003cp>[contextly_sidebar id=\"WWHZxql76AEWQSa0dS4fXrjLNFG8AVIY\"]Impax Laboratories is the only pharmaceutical company that offers the drug in the U.S. Impax did not wish to comment on product pricing for this story but stated in an email to NPR: \"Given the very different regulatory regimes in the U.S. versus outside the U.S., pricing is a very awkward comparison.\"\u003c/p>\n\u003cp>Because the drug's patent expired decades ago, other companies can sell the generic version. But for medications that fight neglected tropical diseases, pharmaceutical companies have been slow to jump in and manufacture the medicine.\u003c/p>\n\u003cp>As for those that do: \"[Impax] fits into a category of companies that have taken drugs that have been around for many years, acquired the rights and jacked up the price [for the Western market],\" says Alpern.\u003c/p>\n\u003cp>Indeed, prices for generic drugs that treat neglected tropical diseases \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005794\">are skyrocketing in the U.S.\u003c/a>\u003c/p>\n\u003cp>When a disease affects only a small number of patients in the U.S., \"there's less incentive for generic companies to enter the market,\" Alpern explains. That's because there's less potential for profit.\u003c/p>\n\u003cp>Hookworm, which was recently \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2017/09/12/550387650/the-u-s-thought-it-was-rid-of-hookworm-wrong\">discovered in a small community\u003c/a> in the U.S., is just one example of this trend.\u003c/p>\n\u003cp>[contextly_sidebar id=\"COtXc62j0KNxw4adAUKowpuaCpnf5tLX\"]Neurocysticercosis, a parasitic disease that causes seizures and epilepsy, is another example. The disease is rare in the U.S. with an estimated \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005108/\">1,000 to 5,000 new cases\u003c/a> every year. Either albendazole or praziquantel are used to treat the disease. Praziquantel is also pricey: \u003ca href=\"https://www.goodrx.com/biltricide?drug-name=biltricide\">about $525\u003c/a> for six 600 mg tablets.\u003c/p>\n\u003cp>Leishmaniasis, which affects 700,000 to a million people annually throughout the world, is more expensive to treat in the U.S., too. Though rare in the U.S. — only \u003ca href=\"http://phenomena.nationalgeographic.com/2015/10/19/leishmaniasis-tx/\">13 cases\u003c/a> were uncovered between 2000 and 2007 — the disease can cause disfiguring skin sores or swelling of the spleen or liver depending on the form of the disease that's contracted. Two 50 mg tablets of miltefosine for 28 days can treat the infection; the price of each pill wholesale is $685, according to Alpern's research.\u003c/p>\n\u003cp>\"When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want,\" Alpern says. \"In these cases, we often see companies taking advantage of their market position.\"\u003c/p>\n\u003cp>And some of these disease aren't all that rare. \u003ca href=\"https://www.bcm.edu/people/view/peter-hotez-m-d-ph-d/b1846a47-ffed-11e2-be68-080027880ca6\">Dr. Peter Hotez\u003c/a>, dean of the National School of Tropical Medicine at the Baylor College of Medicine, says certain neglected tropical diseases in the U.S. are surprisingly widespread, especially among those who may not be able to afford treatment.\u003c/p>\n\u003cp>For example, he estimates that \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003012\">1.1 million Americans\u003c/a> are annually diagnosed with a parasitic infection called toxoplasmosis. The treatment is Daraprim; four 25 mg tablets currently cost between \u003ca href=\"https://www.goodrx.com/daraprim?drug-name=daraprim&form=tablet&dosage=25mg&quantity=4&days_supply=&label_override=Daraprim\">$3,000 and $3,400\u003c/a> on the U.S. market.\u003c/p>\n\u003cp>\"We have now identified nearly half-a-dozen neglected tropical diseases that are widespread in the U.S. among the poor, especially in the American South,\" says Hotez, who last year published \u003ca href=\"https://jhupbooks.press.jhu.edu/content/blue-marble-health\">\u003cem>Blue Marble Health\u003c/em>\u003c/a>, a book evaluating neglected diseases in America. \"In all, I estimate that 12 million Americans now live in extreme poverty with a neglected tropical disease.\"\u003c/p>\n\u003cp>Some of them are in Lowndes County, Ala., where a community of individuals was recently \u003ca href=\"http://www.ajtmh.org/content/journals/10.4269/ajtmh.17-0396\">discovered to have hookworm\u003c/a>. The average income in the county is just $18,036.\u003c/p>\n\u003cp>If patients don't have health insurance, they must pay the full price for prescriptions or skip treatment altogether.\u003c/p>\n\u003cp>[contextly_sidebar id=\"0rRNuKIWq50sVJE9FBqR0zIOBeqefU8E\"]\"Some of the people in Lowndes County are living off $600 or $700 a month,\" says Catherine Flowers, founder of \u003ca href=\"https://www.acrecdc.com/\">Alabama Center for Rural Enterprise\u003c/a>, a nonprofit that addresses poverty. \"People have told me they sometimes have to choose between buying medication and eating.\"\u003c/p>\n\u003cp>In cases where patients have Medicaid, taxpayers bear the burden.\u003c/p>\n\u003cp>In the years following albendazole's price hike in 2011, Medicaid spending on the drug went from under $100,000 in 2008 to more than \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408376#t=article\">$7.5 million in 2013\u003c/a>. Medicaid spending on Daraprim, another tropical disease drug that just experienced a price hike, went from \u003ca href=\"https://www.washingtonpost.com/news/wonk/wp/2016/11/14/the-drugs-driving-up-medicare-spending/?utm_term=.1c130be6c3e1\">$2.2 million in 2014 to $15.7 million in 2015\u003c/a>.\u003c/p>\n\u003cp>Other times, U.S. patients bypass the system, Alpern says, by asking relatives in other countries to bring them the drug they need. In the United Kingdom, for example, 400 mg of albendazole costs just $2.\u003c/p>\n\u003cp>Why are prices so different in the U.S.?\u003c/p>\n\u003cp>\"In other countries, there are price control methods. The government steps in to ensure drug prices do not increase by a certain amount,\" Alpern says. \"There are no price control mechanisms in the U.S.\"\u003c/p>\n\u003cp>For patients with hookworm, there are few treatment alternatives in the U.S.\u003c/p>\n\u003cp>Mebendazole, which is less than half as effective than albendazole, according to hookworm expert Dr. David Diemert, is considered the second generic line of treatment for hookworm. Impax Laboratories also owns the rights to the drug. Between 2011 and 2016, mebendazole's price jumped more than 8,000 percent, \u003ca href=\"http://www.npr.org/sections/health-shots/2017/01/30/512400204/a-pinworm-medication-is-being-tested-as-a-potential-anti-cancer-drug\">from $4.50 to $369\u003c/a>.\u003c/p>\n\u003cp>Hotez agrees with Alpern's theory that pharmaceutical companies have a profit motive.\u003c/p>\n\u003cp>\"Presumably, small companies see a niche to make some quick cash,\" Hotez says. Meanwhile, in low-income countries, he says, \"many of these drugs are being donated for free [by pharmaceutical companies]. As an example, albendazole is \u003ca href=\"http://www.who.int/mediacentre/news/statements/2011/deworming_tabs_201109_09/en/\">donated by GlaxoSmithKline\u003c/a>.\"\u003c/p>\n\u003cp>According to its website, Impax is \"committed to making ENVERM [mebendazole] more affordable.\" The pharmaceutical company shared an \u003ca href=\"http://www.emverm.com/savings-program/\">online coupon\u003c/a> that can save patients up to $60 for a prescription that would cost more than $369.\u003c/p>\n\u003cp>Alpern hopes to see more companies start manufacturing the generic version of the drug. In his eyes, that's the ultimate solution.\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://nadiawhitehead.com\">\u003cem>Nadia Whitehead\u003c/em>\u003c/a>\u003cem> is a freelance journalist and a science writer at Texas Tech University Health Sciences Center El Paso. Her work has appeared in \u003c/em>Science\u003cem>, \u003c/em>The Washington Post\u003cem> and NPR. Find her on Twitter \u003c/em>\u003ca href=\"https://twitter.com/nadiamacias\">\u003cem>@NadiaMacias\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+A+Pill+That%27s+4+Cents+In+Tanzania+Costs+Up+To+%24400+In+The+U.S.&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The medication fights hookworm. It's one of several drugs for \"neglected tropical diseases\" that are priced differently in the United States than they are in the developing world.","status":"publish","parent":0,"modified":1513209938,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1200},"headData":{"title":"Why a Pill That's $400 in the U.S. Costs 4 Cents in Tanzania | KQED","description":"The medication fights hookworm. It's one of several drugs for "neglected tropical diseases" that are priced differently in the United States than they are in the developing world.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"437690 https://ww2.kqed.org/futureofyou/?p=437690","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/14/why-a-pill-thats-400-in-the-u-s-costs-4-cents-in-tanzania/","disqusTitle":"Why a Pill That's $400 in the U.S. Costs 4 Cents in Tanzania","nprImageCredit":"Kuni Takahashi","nprByline":"Nadia Whitehead\u003c/br>NPR Goats and Soda","nprImageAgency":"Bloomberg via Getty Images","nprStoryId":"567753423","nprApiLink":"http://api.npr.org/query?id=567753423&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/goatsandsoda/2017/12/11/567753423/why-a-pill-thats-4-cents-in-tanzania-costs-up-to-400-in-the-u-s?ft=nprml&f=567753423","nprRetrievedStory":"1","nprPubDate":"Tue, 12 Dec 2017 08:46:00 -0500","nprStoryDate":"Mon, 11 Dec 2017 11:06:00 -0500","nprLastModifiedDate":"Tue, 12 Dec 2017 14:33:15 -0500","path":"/futureofyou/437690/why-a-pill-thats-400-in-the-u-s-costs-4-cents-in-tanzania","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two pills to wipe out hookworm could cost you 4 cents. Or $400.\u003c/p>\n\u003cp>It just depends where you live.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657832/table/pntd-0000402-t002/\">4 cents is in Tanzania\u003c/a>. That'll cover the two pills it takes to knock out the intestinal parasite. But in the United States, where hookworm has re-emerged, the price for two 200 mg tablets of albendazole can cost \u003ca href=\"https://www.goodrx.com/albendazole?drug-name=albendazole\">as much as $400\u003c/a>.\u003c/p>\n\u003cp>The pill will put an end to the problems hookworm can cause, such as anemia and protein deficiency as well as stunting growth in children.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want.'\u003ccite>Dr. Jonathan Alpern, HealthPartners Institute\u003c/cite>\u003c/aside>\n\u003cp>It's not just a problem with the anti-hookworm pill. Drugs for diseases of the developing world, in particular what are known as \"neglected tropical diseases\" like hookworm and \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/06/29/483721076/the-aleppo-evil-is-making-a-comeback\">leishmaniasis\u003c/a>, are enormously more expensive in the United States than in the developing world.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There really is no good reason for this price,\" \u003ca href=\"https://www.healthpartners.com/hprf/investigators/ENTRY_194022\">Dr. Jonathan Alpern\u003c/a> says of the albendazole price tag. Alpern works for the HealthPartners Institute, the research division of a health care organization in Minnesota.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Impax Laboratories is the only pharmaceutical company that offers the drug in the U.S. Impax did not wish to comment on product pricing for this story but stated in an email to NPR: \"Given the very different regulatory regimes in the U.S. versus outside the U.S., pricing is a very awkward comparison.\"\u003c/p>\n\u003cp>Because the drug's patent expired decades ago, other companies can sell the generic version. But for medications that fight neglected tropical diseases, pharmaceutical companies have been slow to jump in and manufacture the medicine.\u003c/p>\n\u003cp>As for those that do: \"[Impax] fits into a category of companies that have taken drugs that have been around for many years, acquired the rights and jacked up the price [for the Western market],\" says Alpern.\u003c/p>\n\u003cp>Indeed, prices for generic drugs that treat neglected tropical diseases \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005794\">are skyrocketing in the U.S.\u003c/a>\u003c/p>\n\u003cp>When a disease affects only a small number of patients in the U.S., \"there's less incentive for generic companies to enter the market,\" Alpern explains. That's because there's less potential for profit.\u003c/p>\n\u003cp>Hookworm, which was recently \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2017/09/12/550387650/the-u-s-thought-it-was-rid-of-hookworm-wrong\">discovered in a small community\u003c/a> in the U.S., is just one example of this trend.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Neurocysticercosis, a parasitic disease that causes seizures and epilepsy, is another example. The disease is rare in the U.S. with an estimated \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005108/\">1,000 to 5,000 new cases\u003c/a> every year. Either albendazole or praziquantel are used to treat the disease. Praziquantel is also pricey: \u003ca href=\"https://www.goodrx.com/biltricide?drug-name=biltricide\">about $525\u003c/a> for six 600 mg tablets.\u003c/p>\n\u003cp>Leishmaniasis, which affects 700,000 to a million people annually throughout the world, is more expensive to treat in the U.S., too. Though rare in the U.S. — only \u003ca href=\"http://phenomena.nationalgeographic.com/2015/10/19/leishmaniasis-tx/\">13 cases\u003c/a> were uncovered between 2000 and 2007 — the disease can cause disfiguring skin sores or swelling of the spleen or liver depending on the form of the disease that's contracted. Two 50 mg tablets of miltefosine for 28 days can treat the infection; the price of each pill wholesale is $685, according to Alpern's research.\u003c/p>\n\u003cp>\"When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want,\" Alpern says. \"In these cases, we often see companies taking advantage of their market position.\"\u003c/p>\n\u003cp>And some of these disease aren't all that rare. \u003ca href=\"https://www.bcm.edu/people/view/peter-hotez-m-d-ph-d/b1846a47-ffed-11e2-be68-080027880ca6\">Dr. Peter Hotez\u003c/a>, dean of the National School of Tropical Medicine at the Baylor College of Medicine, says certain neglected tropical diseases in the U.S. are surprisingly widespread, especially among those who may not be able to afford treatment.\u003c/p>\n\u003cp>For example, he estimates that \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003012\">1.1 million Americans\u003c/a> are annually diagnosed with a parasitic infection called toxoplasmosis. The treatment is Daraprim; four 25 mg tablets currently cost between \u003ca href=\"https://www.goodrx.com/daraprim?drug-name=daraprim&form=tablet&dosage=25mg&quantity=4&days_supply=&label_override=Daraprim\">$3,000 and $3,400\u003c/a> on the U.S. market.\u003c/p>\n\u003cp>\"We have now identified nearly half-a-dozen neglected tropical diseases that are widespread in the U.S. among the poor, especially in the American South,\" says Hotez, who last year published \u003ca href=\"https://jhupbooks.press.jhu.edu/content/blue-marble-health\">\u003cem>Blue Marble Health\u003c/em>\u003c/a>, a book evaluating neglected diseases in America. \"In all, I estimate that 12 million Americans now live in extreme poverty with a neglected tropical disease.\"\u003c/p>\n\u003cp>Some of them are in Lowndes County, Ala., where a community of individuals was recently \u003ca href=\"http://www.ajtmh.org/content/journals/10.4269/ajtmh.17-0396\">discovered to have hookworm\u003c/a>. The average income in the county is just $18,036.\u003c/p>\n\u003cp>If patients don't have health insurance, they must pay the full price for prescriptions or skip treatment altogether.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"Some of the people in Lowndes County are living off $600 or $700 a month,\" says Catherine Flowers, founder of \u003ca href=\"https://www.acrecdc.com/\">Alabama Center for Rural Enterprise\u003c/a>, a nonprofit that addresses poverty. \"People have told me they sometimes have to choose between buying medication and eating.\"\u003c/p>\n\u003cp>In cases where patients have Medicaid, taxpayers bear the burden.\u003c/p>\n\u003cp>In the years following albendazole's price hike in 2011, Medicaid spending on the drug went from under $100,000 in 2008 to more than \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408376#t=article\">$7.5 million in 2013\u003c/a>. Medicaid spending on Daraprim, another tropical disease drug that just experienced a price hike, went from \u003ca href=\"https://www.washingtonpost.com/news/wonk/wp/2016/11/14/the-drugs-driving-up-medicare-spending/?utm_term=.1c130be6c3e1\">$2.2 million in 2014 to $15.7 million in 2015\u003c/a>.\u003c/p>\n\u003cp>Other times, U.S. patients bypass the system, Alpern says, by asking relatives in other countries to bring them the drug they need. In the United Kingdom, for example, 400 mg of albendazole costs just $2.\u003c/p>\n\u003cp>Why are prices so different in the U.S.?\u003c/p>\n\u003cp>\"In other countries, there are price control methods. The government steps in to ensure drug prices do not increase by a certain amount,\" Alpern says. \"There are no price control mechanisms in the U.S.\"\u003c/p>\n\u003cp>For patients with hookworm, there are few treatment alternatives in the U.S.\u003c/p>\n\u003cp>Mebendazole, which is less than half as effective than albendazole, according to hookworm expert Dr. David Diemert, is considered the second generic line of treatment for hookworm. Impax Laboratories also owns the rights to the drug. Between 2011 and 2016, mebendazole's price jumped more than 8,000 percent, \u003ca href=\"http://www.npr.org/sections/health-shots/2017/01/30/512400204/a-pinworm-medication-is-being-tested-as-a-potential-anti-cancer-drug\">from $4.50 to $369\u003c/a>.\u003c/p>\n\u003cp>Hotez agrees with Alpern's theory that pharmaceutical companies have a profit motive.\u003c/p>\n\u003cp>\"Presumably, small companies see a niche to make some quick cash,\" Hotez says. Meanwhile, in low-income countries, he says, \"many of these drugs are being donated for free [by pharmaceutical companies]. As an example, albendazole is \u003ca href=\"http://www.who.int/mediacentre/news/statements/2011/deworming_tabs_201109_09/en/\">donated by GlaxoSmithKline\u003c/a>.\"\u003c/p>\n\u003cp>According to its website, Impax is \"committed to making ENVERM [mebendazole] more affordable.\" The pharmaceutical company shared an \u003ca href=\"http://www.emverm.com/savings-program/\">online coupon\u003c/a> that can save patients up to $60 for a prescription that would cost more than $369.\u003c/p>\n\u003cp>Alpern hopes to see more companies start manufacturing the generic version of the drug. In his eyes, that's the ultimate solution.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://nadiawhitehead.com\">\u003cem>Nadia Whitehead\u003c/em>\u003c/a>\u003cem> is a freelance journalist and a science writer at Texas Tech University Health Sciences Center El Paso. Her work has appeared in \u003c/em>Science\u003cem>, \u003c/em>The Washington Post\u003cem> and NPR. Find her on Twitter \u003c/em>\u003ca href=\"https://twitter.com/nadiamacias\">\u003cem>@NadiaMacias\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+A+Pill+That%27s+4+Cents+In+Tanzania+Costs+Up+To+%24400+In+The+U.S.&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437690/why-a-pill-thats-400-in-the-u-s-costs-4-cents-in-tanzania","authors":["byline_futureofyou_437690"],"categories":["futureofyou_1"],"tags":["futureofyou_948","futureofyou_232"],"featImg":"futureofyou_437691","label":"futureofyou"},"futureofyou_437450":{"type":"posts","id":"futureofyou_437450","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437450","score":null,"sort":[1512633706000]},"guestAuthors":[],"slug":"retail-health-care-lacks-the-personal-connections-that-patients-want-and-need","title":"Retail Health Care Less Effective, Lacks Personal Connection Patients Need (Commentary)","publishDate":1512633706,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Retail thinking is spreading quickly in health care. It promises greater convenience and speed for delivering basic health care services — but it isn’t what patients really want.\u003c/p>\n\u003cp>Retail thinking views patients as consumers: faceless targets for buying services and products that aren’t always health-related. It’s the thinking behind technology-assisted health care services, like ZocDoc, Amwell, and One Medical, which quickly triage symptoms or serve up medical advice. It’s the thinking that makes it possible for me to walk in, no appointment needed, to my local CVS or Target to have a cough or sore throat examined.\u003c/p>\n\u003cp>At the same time, it gives web-based apps \u003ca href=\"https://www.reuters.com/article/us-health-apps-privacy/health-apps-often-lack-privacy-policies-and-share-our-data-idUSKCN0WA2KE\" target=\"_blank\" rel=\"noopener\">opportunities to sell\u003c/a> some of your information to advertisers, who want to sell you other things. It gives brick-and-mortar organizations cross-selling opportunities for everything from allergy medications to Halloween candy as I walk down the store aisle to get my flu shot from the pharmacist or have the nurse practitioner apply guideline-driven diagnosis and treatment. The providers I see during these interactions know nothing about me, offer little tailored advice, and the services they provide will be both limited and standardized in how they are delivered.\u003c/p>\n\u003caside class=\"pullquote alignright\">What patients want most in health care is something human and intimate, maintained through regular one-on-one interactions with experts they knew and trusted who were compassionate, empathetic, friendly, and respectful.\u003c/aside>\n\u003cp>Being viewed through the retail lens also means that I am asked to consume other offerings pitched to me by whoever provides me with health care, be it my insurance company or my employer. They try to get me interested in legal and babysitting services, gym memberships, pedometers, mail-order pharmacies, round-the-clock nurse help lines, life insurance, and more. They do this to help them earn more of my loyalty, generate more revenue for themselves, or reduce their costs.\u003c/p>\n\u003cp>The hospitals and medical offices I visit seek to keep me within their system of care delivery, make me a long-term customer, and refer me only to their providers and services, both of which they control. By using retail tactics like offering one-stop shopping — where I can get primary, specialty, and other types of care all without leaving the same building — and marketing their brand to me with simplified rating systems that show their high quality, they want me to trust that they have my interests at heart and can deliver any type of health care transaction I require.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Retail thinking has its place in health care today because there are some services and products that people need quickly and which do not require a personal touch or someone who understands them as unique individuals. Such services might be low-level acute care (think strep throat), flu shots and immunizations, and some forms of simple chronic disease management, such as blood sugar checks or foot and eye exams for people with diabetes, especially if they are guideline driven. There’s no question that retail thinking can also create purchasing opportunities for things patients find useful, if not always essential, and perhaps do so in ways that are cost-effective or convenient for us.\u003c/p>\n\u003cp>[contextly_sidebar id=\"qGlMknrKeKf4bI1E46uTCBwN0fHZychq\"]But retail health care is impersonal, lacks relational warmth, and isn’t what patients really want.\u003c/p>\n\u003cp>I interviewed 80 patients and doctors for a \u003ca href=\"https://global.oup.com/academic/product/next-in-line-9780190626341?cc=us&lang=en&\" target=\"_blank\" rel=\"noopener\">new book\u003c/a> on the doctor-patient relationship in the era of efficiency-driven innovation, corporate care, and retail medicine. What I heard from patients is that the impersonal nature of retail thinking is frustrating them and lowering their expectations about the levels of emotional support and customized help they can get from any doctor, or from others in the health care system.\u003c/p>\n\u003cp>No patient with whom I spoke wanted transactional care at the expense of relational care. No one prioritized \u003ca href=\"https://www.statnews.com/2016/10/04/fitbit-wont-improve-health/\">Fitbits\u003c/a>, web-based assessments of symptoms, or seeing a stranger about a sore throat in a big-box store over a long-term personal connection with a doctor. What these individuals wanted most in health care was something human and more intimate, maintained through regular one-on-one interactions with experts they knew and trusted who were compassionate, empathetic, friendly, and respectful.\u003c/p>\n\u003cp>The physicians with whom I spoke wanted the same things.\u003c/p>\n\u003cp>This type of sustained personal experience between two people who know something about each other, and who are motivated to really talk and listen as care partners, is something retail thinking does not do well. It is not concerned with the emotional aspects of care, building interpersonal trust between doctor and patient, or getting to know people as individuals with their own relevant life stories.\u003c/p>\n\u003cp>Yet existing research demonstrates that these are the very features that are good for patients. For example, \u003ca href=\"http://www.hpm.org/Downloads/Bellagio/Articles/Continuity/Cabana_MD_-_2004_-_Does_continuity_of_care_improve_patient_outcomes.pdf\" target=\"_blank\" rel=\"noopener\">care continuity\u003c/a> through a stable doctor-patient relationship improves health care quality and patient satisfaction. \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1468-0009.00223/full\" target=\"_blank\" rel=\"noopener\">Doctor-patient trust\u003c/a>, established through extended interpersonal contact, helps patients become more engaged in their care; creates a positive patient experience; and increases perceived effectiveness of care. \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0738399108006319\" target=\"_blank\" rel=\"noopener\">Extended dialogue\u003c/a> between patient and doctor positively affects health outcomes ranging from high blood pressure to mental health problems. \u003ca href=\"http://bjgp.org/content/63/606/e76.full\" target=\"_blank\" rel=\"noopener\">Physician empathy\u003c/a> is linked to more accurate diagnoses, better health outcomes, and an enhanced patient experience.\u003c/p>\n\u003cp>[contextly_sidebar id=\"DXDu9yVu5UXGAwIZHglW19AkCubz5xhW\"]If you don’t believe the literature, just ask the patients I interviewed. Teddy, a healthy man in his 30s, believed that without feeling trust towards a specific doctor — which for him was forged over time through regular face time and conversations with that doctor — little could be uncovered of the more intimate, life story information that he felt was most important for keeping him healthy. He said he had never been completely honest with clinicians he didn’t know.\u003c/p>\n\u003cp>Hallie, a 50-year-old woman with several chronic diseases, talked confidently about better understanding how to manage her many conditions, and how they affected her everyday life — the result of having a doctor who knew something about her personally, who spent time not reading off a care guideline but instead asking her real-time questions about how she felt, and then showing genuine compassion with her daily struggles. Hallie felt better able to self-manage her care, which kept her from using the system unnecessarily.\u003c/p>\n\u003cp>Cliff, a stressed-out dad in his 50s, talked excitedly about finally having the same physician he could see on a consistent basis; a doctor who in their first visit had spent time just listening to him, nothing more; then taking that information and asking him questions about his own life; and finally tailoring therapeutic advice based on the entire dialogue. Janell, a career-minded mom in her 40s, recalled with joy the memory of a past primary care physician who remembered conversations they had during previous visits and who used that knowledge to give Janell tailored guidance about how to manage her life stressors more effectively.\u003c/p>\n\u003cp>Can an industry that wants to use retail tactics also deliver on the relational excellence that patients and research say is important? It’s not easy, given retail thinking’s focus on speed and efficiency. Here are four ways that might meld these two approaches.\u003c/p>\n\u003cp>First, put more thought into where \u003cem>not\u003c/em> to use retail thinking in health care. It may make sense for care delivery that is routine, care that can be standardized in a straightforward way, and in situations where the patient wants convenience above all else. But that actually amounts to a limited menu of services, and even routine care can often reveal deeper problems in patients, requiring the kinds of relational features I’ve described.\u003c/p>\n\u003cp>Second, better measure and monetize the components of relational excellence, making it matter to health care organizations and third-party payers. That means carefully assessing dynamics like interpersonal trust between doctor and patient; analyzing those data to see how they positively affect health outcomes; and then giving this metric the same relative importance in high-quality care delivery compared to other things like prescribing a particular drug for a particular condition.\u003c/p>\n\u003cp>Third, look for innovative ways to \u003cem>strengthen\u003c/em> the doctor-patient relationship, not undermine it. For example, the industry should experiment with using technology as a tool to give doctors more face time and direct contact with their patients. Right now, both doctors and patients perceive technology, primarily the electronic health record, as interfering with their relationship.\u003c/p>\n\u003cp>Fourth, and most important, the patient voice must be heard. This could include adopting greater transparency with respect to assessing patient satisfaction with retail tactics, say through \u003ca href=\"https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2015.1030\" target=\"_blank\" rel=\"noopener\">Yelp-type accountability mechanisms\u003c/a>, and conducting market research that goes beyond simple binary questions of “would you use this” or “would you like greater convenience in accessing your care” and instead delves deeper into discovering what patients really value.\u003c/p>\n\u003cp>In thinking about my discussions with patients, there is one other important thing they want. They want to decide when their health care should work like the drive-through at McDonald’s or buying with one click at Amazon and when it should be more personal than that, involving extended human-to-human interaction, highly trained experts who know their patients, and an abundance of the time, trust, and soft skills required to make us healthier long-term and see health care as the important part of our lives that it really is.\u003c/p>\n\u003cp>\u003cem>Timothy J. Hoff, Ph.D., is professor of management, health care systems, and health policy at the D’Amore-McKim School of Business and the School of Public Affairs and Policy at Northeastern University in Boston; a visiting associate fellow at Green-Templeton College and visiting scholar at Said Business School, both at the University of Oxford; and the author of \u003ca href=\"https://global.oup.com/academic/product/next-in-line-9780190626341?cc=us&lang=en&\" target=\"_blank\" rel=\"noopener\">“Next in Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health”\u003c/a> (Oxford University Press, September 2017).\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This \u003ca href=\"https://www.statnews.com/2017/12/04/retail-health-care-patients/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/p>\n\n","blocks":[],"excerpt":"Retail thinking promises greater convenience for delivering basic health care services but doesn't offer the doctor-patient connection that improves health.","status":"publish","parent":0,"modified":1512673832,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1698},"headData":{"title":"Retail Health Care Less Effective, Lacks Personal Connection Patients Need (Commentary) | KQED","description":"Retail thinking promises greater convenience for delivering basic health care services but doesn't offer the doctor-patient connection that improves health.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"437450 https://ww2.kqed.org/futureofyou/?p=437450","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/07/retail-health-care-lacks-the-personal-connections-that-patients-want-and-need/","disqusTitle":"Retail Health Care Less Effective, Lacks Personal Connection Patients Need (Commentary)","nprByline":"Timothy J. Hoff\u003c/br>STAT","path":"/futureofyou/437450/retail-health-care-lacks-the-personal-connections-that-patients-want-and-need","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Retail thinking is spreading quickly in health care. It promises greater convenience and speed for delivering basic health care services — but it isn’t what patients really want.\u003c/p>\n\u003cp>Retail thinking views patients as consumers: faceless targets for buying services and products that aren’t always health-related. It’s the thinking behind technology-assisted health care services, like ZocDoc, Amwell, and One Medical, which quickly triage symptoms or serve up medical advice. It’s the thinking that makes it possible for me to walk in, no appointment needed, to my local CVS or Target to have a cough or sore throat examined.\u003c/p>\n\u003cp>At the same time, it gives web-based apps \u003ca href=\"https://www.reuters.com/article/us-health-apps-privacy/health-apps-often-lack-privacy-policies-and-share-our-data-idUSKCN0WA2KE\" target=\"_blank\" rel=\"noopener\">opportunities to sell\u003c/a> some of your information to advertisers, who want to sell you other things. It gives brick-and-mortar organizations cross-selling opportunities for everything from allergy medications to Halloween candy as I walk down the store aisle to get my flu shot from the pharmacist or have the nurse practitioner apply guideline-driven diagnosis and treatment. The providers I see during these interactions know nothing about me, offer little tailored advice, and the services they provide will be both limited and standardized in how they are delivered.\u003c/p>\n\u003caside class=\"pullquote alignright\">What patients want most in health care is something human and intimate, maintained through regular one-on-one interactions with experts they knew and trusted who were compassionate, empathetic, friendly, and respectful.\u003c/aside>\n\u003cp>Being viewed through the retail lens also means that I am asked to consume other offerings pitched to me by whoever provides me with health care, be it my insurance company or my employer. They try to get me interested in legal and babysitting services, gym memberships, pedometers, mail-order pharmacies, round-the-clock nurse help lines, life insurance, and more. They do this to help them earn more of my loyalty, generate more revenue for themselves, or reduce their costs.\u003c/p>\n\u003cp>The hospitals and medical offices I visit seek to keep me within their system of care delivery, make me a long-term customer, and refer me only to their providers and services, both of which they control. By using retail tactics like offering one-stop shopping — where I can get primary, specialty, and other types of care all without leaving the same building — and marketing their brand to me with simplified rating systems that show their high quality, they want me to trust that they have my interests at heart and can deliver any type of health care transaction I require.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Retail thinking has its place in health care today because there are some services and products that people need quickly and which do not require a personal touch or someone who understands them as unique individuals. Such services might be low-level acute care (think strep throat), flu shots and immunizations, and some forms of simple chronic disease management, such as blood sugar checks or foot and eye exams for people with diabetes, especially if they are guideline driven. There’s no question that retail thinking can also create purchasing opportunities for things patients find useful, if not always essential, and perhaps do so in ways that are cost-effective or convenient for us.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But retail health care is impersonal, lacks relational warmth, and isn’t what patients really want.\u003c/p>\n\u003cp>I interviewed 80 patients and doctors for a \u003ca href=\"https://global.oup.com/academic/product/next-in-line-9780190626341?cc=us&lang=en&\" target=\"_blank\" rel=\"noopener\">new book\u003c/a> on the doctor-patient relationship in the era of efficiency-driven innovation, corporate care, and retail medicine. What I heard from patients is that the impersonal nature of retail thinking is frustrating them and lowering their expectations about the levels of emotional support and customized help they can get from any doctor, or from others in the health care system.\u003c/p>\n\u003cp>No patient with whom I spoke wanted transactional care at the expense of relational care. No one prioritized \u003ca href=\"https://www.statnews.com/2016/10/04/fitbit-wont-improve-health/\">Fitbits\u003c/a>, web-based assessments of symptoms, or seeing a stranger about a sore throat in a big-box store over a long-term personal connection with a doctor. What these individuals wanted most in health care was something human and more intimate, maintained through regular one-on-one interactions with experts they knew and trusted who were compassionate, empathetic, friendly, and respectful.\u003c/p>\n\u003cp>The physicians with whom I spoke wanted the same things.\u003c/p>\n\u003cp>This type of sustained personal experience between two people who know something about each other, and who are motivated to really talk and listen as care partners, is something retail thinking does not do well. It is not concerned with the emotional aspects of care, building interpersonal trust between doctor and patient, or getting to know people as individuals with their own relevant life stories.\u003c/p>\n\u003cp>Yet existing research demonstrates that these are the very features that are good for patients. For example, \u003ca href=\"http://www.hpm.org/Downloads/Bellagio/Articles/Continuity/Cabana_MD_-_2004_-_Does_continuity_of_care_improve_patient_outcomes.pdf\" target=\"_blank\" rel=\"noopener\">care continuity\u003c/a> through a stable doctor-patient relationship improves health care quality and patient satisfaction. \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1468-0009.00223/full\" target=\"_blank\" rel=\"noopener\">Doctor-patient trust\u003c/a>, established through extended interpersonal contact, helps patients become more engaged in their care; creates a positive patient experience; and increases perceived effectiveness of care. \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0738399108006319\" target=\"_blank\" rel=\"noopener\">Extended dialogue\u003c/a> between patient and doctor positively affects health outcomes ranging from high blood pressure to mental health problems. \u003ca href=\"http://bjgp.org/content/63/606/e76.full\" target=\"_blank\" rel=\"noopener\">Physician empathy\u003c/a> is linked to more accurate diagnoses, better health outcomes, and an enhanced patient experience.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>If you don’t believe the literature, just ask the patients I interviewed. Teddy, a healthy man in his 30s, believed that without feeling trust towards a specific doctor — which for him was forged over time through regular face time and conversations with that doctor — little could be uncovered of the more intimate, life story information that he felt was most important for keeping him healthy. He said he had never been completely honest with clinicians he didn’t know.\u003c/p>\n\u003cp>Hallie, a 50-year-old woman with several chronic diseases, talked confidently about better understanding how to manage her many conditions, and how they affected her everyday life — the result of having a doctor who knew something about her personally, who spent time not reading off a care guideline but instead asking her real-time questions about how she felt, and then showing genuine compassion with her daily struggles. Hallie felt better able to self-manage her care, which kept her from using the system unnecessarily.\u003c/p>\n\u003cp>Cliff, a stressed-out dad in his 50s, talked excitedly about finally having the same physician he could see on a consistent basis; a doctor who in their first visit had spent time just listening to him, nothing more; then taking that information and asking him questions about his own life; and finally tailoring therapeutic advice based on the entire dialogue. Janell, a career-minded mom in her 40s, recalled with joy the memory of a past primary care physician who remembered conversations they had during previous visits and who used that knowledge to give Janell tailored guidance about how to manage her life stressors more effectively.\u003c/p>\n\u003cp>Can an industry that wants to use retail tactics also deliver on the relational excellence that patients and research say is important? It’s not easy, given retail thinking’s focus on speed and efficiency. Here are four ways that might meld these two approaches.\u003c/p>\n\u003cp>First, put more thought into where \u003cem>not\u003c/em> to use retail thinking in health care. It may make sense for care delivery that is routine, care that can be standardized in a straightforward way, and in situations where the patient wants convenience above all else. But that actually amounts to a limited menu of services, and even routine care can often reveal deeper problems in patients, requiring the kinds of relational features I’ve described.\u003c/p>\n\u003cp>Second, better measure and monetize the components of relational excellence, making it matter to health care organizations and third-party payers. That means carefully assessing dynamics like interpersonal trust between doctor and patient; analyzing those data to see how they positively affect health outcomes; and then giving this metric the same relative importance in high-quality care delivery compared to other things like prescribing a particular drug for a particular condition.\u003c/p>\n\u003cp>Third, look for innovative ways to \u003cem>strengthen\u003c/em> the doctor-patient relationship, not undermine it. For example, the industry should experiment with using technology as a tool to give doctors more face time and direct contact with their patients. Right now, both doctors and patients perceive technology, primarily the electronic health record, as interfering with their relationship.\u003c/p>\n\u003cp>Fourth, and most important, the patient voice must be heard. This could include adopting greater transparency with respect to assessing patient satisfaction with retail tactics, say through \u003ca href=\"https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2015.1030\" target=\"_blank\" rel=\"noopener\">Yelp-type accountability mechanisms\u003c/a>, and conducting market research that goes beyond simple binary questions of “would you use this” or “would you like greater convenience in accessing your care” and instead delves deeper into discovering what patients really value.\u003c/p>\n\u003cp>In thinking about my discussions with patients, there is one other important thing they want. They want to decide when their health care should work like the drive-through at McDonald’s or buying with one click at Amazon and when it should be more personal than that, involving extended human-to-human interaction, highly trained experts who know their patients, and an abundance of the time, trust, and soft skills required to make us healthier long-term and see health care as the important part of our lives that it really is.\u003c/p>\n\u003cp>\u003cem>Timothy J. Hoff, Ph.D., is professor of management, health care systems, and health policy at the D’Amore-McKim School of Business and the School of Public Affairs and Policy at Northeastern University in Boston; a visiting associate fellow at Green-Templeton College and visiting scholar at Said Business School, both at the University of Oxford; and the author of \u003ca href=\"https://global.oup.com/academic/product/next-in-line-9780190626341?cc=us&lang=en&\" target=\"_blank\" rel=\"noopener\">“Next in Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health”\u003c/a> (Oxford University Press, September 2017).\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This \u003ca href=\"https://www.statnews.com/2017/12/04/retail-health-care-patients/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437450/retail-health-care-lacks-the-personal-connections-that-patients-want-and-need","authors":["byline_futureofyou_437450"],"categories":["futureofyou_452","futureofyou_1"],"tags":["futureofyou_794","futureofyou_232","futureofyou_177","futureofyou_487"],"featImg":"futureofyou_437452","label":"futureofyou"},"futureofyou_250136":{"type":"posts","id":"futureofyou_250136","meta":{"index":"posts_1591205157","site":"futureofyou","id":"250136","score":null,"sort":[1474579084000]},"guestAuthors":[],"slug":"health-care-800-miles-away-satellite-connection-changes-lives-in-alaska","title":"Health Care, 800 Miles Away: Satellite Connection Changes Lives in Alaska","publishDate":1474579084,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>The only clinic in one of the nation's busiest commercial fishing ports is so remote that even conventional telemedicine for emergencies has been impossible for its limited staff — until this week.\u003c/p>\n\u003cp>Starting Thursday, a new partnership with an Anchorage hospital will virtually beam critical care doctors 800 miles (1,287 kilometers) away to the emergency room on the island that holds Dutch Harbor, the operations base for the Bering Sea crabbing fleet made famous by the Discovery Channel show \"Deadliest Catch.\"\u003c/p>\n\u003cp>But instead of transmissions with fiber-optics, which are nowhere near the isolated Unalaska Island, the team putting together the system is relying on satellite technology in what is believed to be a first in the country for telemedicine.\u003c/p>\n\u003cp>The clinic, Iliuliuk Family and Health Services, brings to nine the number of providers served by the electronic intensive care unit at Providence Alaska Medical Center in Anchorage.\u003c/p>\n\u003cp>\"We are kind of mix-mashing everything together to try to make this work,\" Sharon Compton, services manager of Providence's eICU office, said after a recent demonstration of the Dutch Harbor link.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new system will provide real-time camera links between emergency doctors and clinic staffers during medical emergencies, such as fishing industry injuries.\u003c/p>\n\u003cfigure id=\"attachment_250140\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250140\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Remote-AK-medicine2-800x450.jpg\" alt=\"Intensive care unit nurse Deborah Springer in Anchorage, Alaska, demonstrates the focusing ability of a telemedicine camera that is part of a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center.\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2.jpg 876w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Intensive care unit nurse Deborah Springer in Anchorage, Alaska, demonstrates the focusing ability of a telemedicine camera that is part of a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center. \u003ccite>(Rachel D'Oro/AP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The idea is to help stabilize patients before transporting them out of town and to help with triage during major events like a ship sinking.\u003c/p>\n\u003cp>From afar, doctors will be able to view X-rays and patient charts and talk directly with patients on camera instead of consulting with medics by phone and email.\u003c/p>\n\u003cp>There are some unknowns about how the system will work, with likely slowdowns in satellite reception because of the region's notoriously bad weather.\u003c/p>\n\u003cp>During the recent demonstration, pre-launch kinks prevented the rolling-cart-mounted camera in Dutch Harbor from being pivoted remotely. But the camera otherwise performed impressively, sending back crystal-clear video of clinic staffers as they chatted with a critical care doctor.\u003c/p>\n\u003cp>The new service was lauded by Seattle-based crabbing boat owner Lance Farr, who has been badly hurt twice in his decades of working in the Bering Sea.\u003c/p>\n\u003cp>Several years ago, he almost severed a finger in a dockside engine accident. He was stabilized at the clinic before being flown to Anchorage for further treatment. In 1996, Farr broke his foot at Dutch Harbor after dropping an engine on it. He spent the night at the clinic under the care of nurses before being flown out the next day.\u003c/p>\n\u003cp>In hindsight, having his care visually monitored by emergency room specialists would have provided a morale boost, as well as invaluable expertise, Farr said.\u003c/p>\n\u003cfigure id=\"attachment_250142\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250142\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Remote-AK-medicine3-800x600.jpg\" alt=\"ICU office services manager Sharon Compton in Anchorage, Alaska, talks about a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3.jpg 1067w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">ICU office services manager Sharon Compton in Anchorage, Alaska, talks about a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center. \u003ccite>(Rachel D'Oro/AP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"It would be a good thing, I would think, to have a real physician being able to advise the people out there,\" he said.\u003c/p>\n\u003cp>The city of Unalaska has just 4,600 year-round residents, but the population swells to 16,000 or more during the region's two main fishing seasons, when boat crews and processing workers flood the town with dozens of languages and cultures. That means more potential for patients, including people who don't speak English.\u003c/p>\n\u003cp>The clinic averages more than 300 after-hours emergency room visits a year, with about a third of those patients flown elsewhere, often to Anchorage, for more complete treatment.\u003c/p>\n\u003cp>Fishing-industry emergencies at sea can mean significant delays to appropriate medical treatments when the injured must first be carried by rescue helicopter to Dutch Harbor. Injuries can range from deep cuts and broken bones to back injuries and amputations.\u003c/p>\n\u003cp>\"These guys are pretty tough out here, and they will, you know, continue to fish until they can't get out of bed anymore,\" said James Novotny, nurse practitioner at the clinic.\u003c/p>\n\u003cp>The drastically shifting population can put a strain on clinic staffing in this rural setting. So can the inability to afford emergency specialists or much in the way of diagnostic equipment.\u003c/p>\n\u003cp>Then there's the challenge of living in such a far-flung spot, which makes finding and keeping medical staff difficult, according to clinic medical director Ann Nora Ehret, an osteopathic doctor who has wanted to tap into telemedicine since joining the staff in 2013. Only recently did the clinic hire a second doctor after the position was vacant for nearly a year.\u003c/p>\n\u003cp>Adding the long-distance help will be invaluable, Ehret said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think it could be a game changer for recruiting, retention and for the care of the patients,\" she said. \"We are getting the support we need in an austere environment.\"\u003c/p>\n\n","blocks":[],"excerpt":"Doctors in Anchorage are using remote satellite technology to treat patients 800 miles away on remote Unalaska Island. ","status":"publish","parent":0,"modified":1474580778,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":839},"headData":{"title":"Health Care, 800 Miles Away: Satellite Connection Changes Lives in Alaska | KQED","description":"Doctors in Anchorage are using remote satellite technology to treat patients 800 miles away on remote Unalaska Island. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"250136 http://ww2.kqed.org/futureofyou/?p=250136","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/09/22/health-care-800-miles-away-satellite-connection-changes-lives-in-alaska/","disqusTitle":"Health Care, 800 Miles Away: Satellite Connection Changes Lives in Alaska","nprByline":"Rachel D'Oro \u003c/Br> Associated Press","path":"/futureofyou/250136/health-care-800-miles-away-satellite-connection-changes-lives-in-alaska","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The only clinic in one of the nation's busiest commercial fishing ports is so remote that even conventional telemedicine for emergencies has been impossible for its limited staff — until this week.\u003c/p>\n\u003cp>Starting Thursday, a new partnership with an Anchorage hospital will virtually beam critical care doctors 800 miles (1,287 kilometers) away to the emergency room on the island that holds Dutch Harbor, the operations base for the Bering Sea crabbing fleet made famous by the Discovery Channel show \"Deadliest Catch.\"\u003c/p>\n\u003cp>But instead of transmissions with fiber-optics, which are nowhere near the isolated Unalaska Island, the team putting together the system is relying on satellite technology in what is believed to be a first in the country for telemedicine.\u003c/p>\n\u003cp>The clinic, Iliuliuk Family and Health Services, brings to nine the number of providers served by the electronic intensive care unit at Providence Alaska Medical Center in Anchorage.\u003c/p>\n\u003cp>\"We are kind of mix-mashing everything together to try to make this work,\" Sharon Compton, services manager of Providence's eICU office, said after a recent demonstration of the Dutch Harbor link.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new system will provide real-time camera links between emergency doctors and clinic staffers during medical emergencies, such as fishing industry injuries.\u003c/p>\n\u003cfigure id=\"attachment_250140\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250140\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Remote-AK-medicine2-800x450.jpg\" alt=\"Intensive care unit nurse Deborah Springer in Anchorage, Alaska, demonstrates the focusing ability of a telemedicine camera that is part of a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center.\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine2.jpg 876w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Intensive care unit nurse Deborah Springer in Anchorage, Alaska, demonstrates the focusing ability of a telemedicine camera that is part of a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center. \u003ccite>(Rachel D'Oro/AP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The idea is to help stabilize patients before transporting them out of town and to help with triage during major events like a ship sinking.\u003c/p>\n\u003cp>From afar, doctors will be able to view X-rays and patient charts and talk directly with patients on camera instead of consulting with medics by phone and email.\u003c/p>\n\u003cp>There are some unknowns about how the system will work, with likely slowdowns in satellite reception because of the region's notoriously bad weather.\u003c/p>\n\u003cp>During the recent demonstration, pre-launch kinks prevented the rolling-cart-mounted camera in Dutch Harbor from being pivoted remotely. But the camera otherwise performed impressively, sending back crystal-clear video of clinic staffers as they chatted with a critical care doctor.\u003c/p>\n\u003cp>The new service was lauded by Seattle-based crabbing boat owner Lance Farr, who has been badly hurt twice in his decades of working in the Bering Sea.\u003c/p>\n\u003cp>Several years ago, he almost severed a finger in a dockside engine accident. He was stabilized at the clinic before being flown to Anchorage for further treatment. In 1996, Farr broke his foot at Dutch Harbor after dropping an engine on it. He spent the night at the clinic under the care of nurses before being flown out the next day.\u003c/p>\n\u003cp>In hindsight, having his care visually monitored by emergency room specialists would have provided a morale boost, as well as invaluable expertise, Farr said.\u003c/p>\n\u003cfigure id=\"attachment_250142\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250142\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Remote-AK-medicine3-800x600.jpg\" alt=\"ICU office services manager Sharon Compton in Anchorage, Alaska, talks about a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Remote-AK-medicine3.jpg 1067w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">ICU office services manager Sharon Compton in Anchorage, Alaska, talks about a new telemedicine partnership between the Iliuliuk Family and Health Services on Unalaska Island and Providence Alaska Medical Center. \u003ccite>(Rachel D'Oro/AP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"It would be a good thing, I would think, to have a real physician being able to advise the people out there,\" he said.\u003c/p>\n\u003cp>The city of Unalaska has just 4,600 year-round residents, but the population swells to 16,000 or more during the region's two main fishing seasons, when boat crews and processing workers flood the town with dozens of languages and cultures. That means more potential for patients, including people who don't speak English.\u003c/p>\n\u003cp>The clinic averages more than 300 after-hours emergency room visits a year, with about a third of those patients flown elsewhere, often to Anchorage, for more complete treatment.\u003c/p>\n\u003cp>Fishing-industry emergencies at sea can mean significant delays to appropriate medical treatments when the injured must first be carried by rescue helicopter to Dutch Harbor. Injuries can range from deep cuts and broken bones to back injuries and amputations.\u003c/p>\n\u003cp>\"These guys are pretty tough out here, and they will, you know, continue to fish until they can't get out of bed anymore,\" said James Novotny, nurse practitioner at the clinic.\u003c/p>\n\u003cp>The drastically shifting population can put a strain on clinic staffing in this rural setting. So can the inability to afford emergency specialists or much in the way of diagnostic equipment.\u003c/p>\n\u003cp>Then there's the challenge of living in such a far-flung spot, which makes finding and keeping medical staff difficult, according to clinic medical director Ann Nora Ehret, an osteopathic doctor who has wanted to tap into telemedicine since joining the staff in 2013. Only recently did the clinic hire a second doctor after the position was vacant for nearly a year.\u003c/p>\n\u003cp>Adding the long-distance help will be invaluable, Ehret said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think it could be a game changer for recruiting, retention and for the care of the patients,\" she said. \"We are getting the support we need in an austere environment.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/250136/health-care-800-miles-away-satellite-connection-changes-lives-in-alaska","authors":["byline_futureofyou_250136"],"categories":["futureofyou_1"],"tags":["futureofyou_1055","futureofyou_190","futureofyou_232","futureofyou_1056","futureofyou_1057","futureofyou_1054"],"featImg":"futureofyou_250138","label":"futureofyou"},"futureofyou_4462":{"type":"posts","id":"futureofyou_4462","meta":{"index":"posts_1591205157","site":"futureofyou","id":"4462","score":null,"sort":[1434652374000]},"guestAuthors":[],"slug":"five-health-technologies-i-wish-i-could-invest-in-today","title":"Five Health Technologies I Wish I Could Invest In Today","publishDate":1434652374,"format":"standard","headTitle":"Startup Culture | KQED Future of You | KQED Science","labelTerm":{"term":110,"site":"futureofyou"},"content":"\u003cp>Far too often, radically transformative ideas get stuck on the starting block, never able to truly take off. These innovations languish because a series of roadblocks make success seem impossible. In the U.S. healthcare system, radical change is often held up by regulatory hurdles, lack of resources and inadequate funding. Sometimes, the new technology just seems too futuristic for the general public to embrace.\u003c/p>\n\u003cp>At \u003ca href=\"http://www.startuphealth.com\">StartUp Health\u003c/a>, I am often confronted by the tug-of-war between a brilliantly innovative solution, and the harsh reality of a system that isn’t ready for it. Hundreds of pioneering digital health companies are paving the way, but many find themselves tangled in bureaucracy, stalled by lack of funding and challenged by the fear of doing things differently.\u003c/p>\n\u003caside class=\"pullquote alignright\">There are dozens of digital health concepts I wish I could fund now, yet many of these would not be accepted by today’s market.\u003c/aside>\n\u003cp>Just look at consumer genomics company \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>, which was \u003ca href=\"http://ww2.kqed.org/science/2014/05/05/consumer-gene-tests-whats-the-future/\">soundly rebuffed by the FDA\u003c/a> over its personalized genomic health product. The company started off as a popular ancestry service, making use of a DNA spit test to map personal genomes.\u003c/p>\n\u003cp>Realizing potential, 23andMe moved swiftly into the medical arena, offering patients customized health reports that predicted risk of heritable diseases. The FDA’s 2013 order to pull the health product until 23andMe could prove it was interpreting the results correctly had a chilling effect on a burgeoning industry of consumer genomics offered by the private sector.\u003c/p>\n\u003cfigure id=\"attachment_4667\" class=\"wp-caption alignleft\" style=\"max-width: 323px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/SUH-2.jpg\">\u003cimg class=\" wp-image-4667\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/SUH-2-800x533.jpg\" alt=\"StartUp Health entrepreneurs at the company's quarterly summit in New York, in April 2015. (StartUp Health)\" width=\"323\" height=\"215\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-960x640.jpg 960w\" sizes=\"(max-width: 323px) 100vw, 323px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">StartUp Health entrepreneurs at the company's quarterly summit in New York, in April 2015. (StartUp Health)\u003c/figcaption>\u003c/figure>\n\u003cp>There are dozens of digital health concepts I wish I could fund now, yet many of these would not be accepted by today’s market. If regulators, more investors and the general public were willing to embrace these concepts, here are five technologies that could radically improve human health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Embeddable Consumer Devices \u003c/strong>\u003c/p>\n\u003cp>The concept of embeddable consumer devices moves way beyond wearable sensors. An embeddable in this context isn’t a traditional medical device like a pacemaker or a stent. It’s a tiny sensor swallowed or embedded to constantly monitor biometrics. Consumers would be able to track the effect of a new diet on blood pressure, or the effect of a new medication on sleep patterns.\u003c/p>\n\u003cp>A company called \u003ca href=\"http://www.proteus.com/\">Proteus Digital Health\u003c/a> is taking the first steps with its \u003ca href=\"http://mobihealthnews.com/39612/proteus-oracle-launch-integrated-software-ingestible-sensors-for-clinical-trials/\">ingestible sensor\u003c/a> that sends a signal to a battery-operated patch worn on the skin. At this stage, Proteus seems focused on improving medication compliance. If privacy and safety concerns can be appropriately addressed, embeddable consumer devices could be used outside the healthcare setting to focus more broadly on daily health and wellness.\u003c/p>\n\u003caside class=\"pullquote alignright\">What’s needed is a consumer-friendly dashboard that operates as simply as Google Analytics — with consolidated, easy-to-use visualization of data in real time.\u003c/aside>\n\u003cp>\u003cstrong>Consolidated Health Dashboard\u003c/strong>\u003c/p>\n\u003cp>Diagnostic tools are becoming more sophisticated and cloud storage of health data will soon be universal. With these developments, each patient should be able to access his or her own \u003ca href=\"https://www.tictrac.com/business/\">health dashboard\u003c/a> the same way we can for our Web sites or automobiles. And I’m not referring to what the medical industry refers to as an electronic health record. What’s needed is a consumer-friendly dashboard that operates as simply as Google Analytics -- with consolidated, easy-to-use visualization of data in real time.\u003c/p>\n\u003cp>A similar concept would be a dashboard for employers and businesses to track the wellness of their teams the same way we do their productivity metrics. An employer dashboard could track healthcare decisions of each employee, identifying preferences and trends over time.\u003c/p>\n\u003cp>One big roadblock to a health dashboard is data fragmentation. Many small companies already offer their own dashboards, but there is no one consolidated provider to streamline the experience across different datasets that impact our health and wellness on a real-time basis. In addition, the data we collect today is catalogued in different ways, making it difficult to synchronize.\u003c/p>\n\u003caside class=\"pullquote alignright\">Every patient has a unique medical history and physiology, so why shouldn’t treatments be personalized?\u003c/aside>\n\u003cp>\u003cstrong>Microbiome-Based Consumer Goods\u003c/strong>\u003c/p>\n\u003cp>The concept of personalized medicine is intuitive. Every patient has a unique medical history and physiology, so why shouldn’t treatments be personalized? In addition to personalized medicine, we should have personalized consumer products. Consumer goods like toothpaste, shampoo, lotion and cosmetics could be tailored to suit each person’s microbiome.\u003c/p>\n\u003cp>We are \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/06/15/in-future-fecal-transplants-the-tool-wont-be-stool/\">learning more about the essential role of the microbiome\u003c/a> - the billions of bacterial cells that comprise between one and three percent of our body mass. One person’s oral microbiome, for example, could be paired with a complimentary toothpaste, the ingredients designed just for that individual, potentially saving millions in healthcare spending for minor infections and other issues.\u003c/p>\n\u003cfigure id=\"attachment_4714\" class=\"wp-caption alignleft\" style=\"max-width: 368px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/8146322408_5312e9deb2_c.jpg\">\u003cimg class=\" wp-image-4714\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/8146322408_5312e9deb2_c-677x600.jpg\" alt=\"A colorized model composed of three-dimensional human intestinal cells cultured with specific gut bacteria. (Pacific Northwest National Laboratory/Flickr)\" width=\"368\" height=\"326\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/8146322408_5312e9deb2_c-677x600.jpg 677w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/8146322408_5312e9deb2_c-400x355.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/8146322408_5312e9deb2_c.jpg 800w\" sizes=\"(max-width: 368px) 100vw, 368px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A colorized model composed of three-dimensional human intestinal cells cultured with specific gut bacteria. (Pacific Northwest National Laboratory/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>For this concept to become a reality, consumer product companies and healthcare companies would have to collaborate in an unprecedented way. The medical community is also still in the early stages of microbiome research. The FDA is unlikely to support personalized consumer goods just yet, as they rely on a system of rigorous batch testing to guarantee products are safe for everyone. Personalized products might be perfect for one person but unsafe for another, presenting a unique challenge in the era of 3-D printing and personalized everything.\u003c/p>\n\u003cp>\u003cstrong>$100 \"RobotDoc\"\u003c/strong>\u003c/p>\n\u003cp>Today’s autonomous devices can perform many of the same tasks performed during a regular checkup. It’s unlikely that a robot will replace a family practitioner any time soon, but in some remote regions of the world, a machine equipped with the basic diagnostic technology could identify common medical ailments that would otherwise go undiagnosed. I call this concept \"RobotDoc.\"\u003c/p>\n\u003cp>Today, a \u003ca href=\"http://astounde.com/first-medical-tricorder-scans-analyzes-and-shares-all-your-core-vitals/\">tiny handheld device\u003c/a> made by a company called \u003ca href=\"https://www.scanadu.com/\">Scanadu\u003c/a> can check blood pressure, temperature and heart rate. The company is also developing a urine test kit. The technology exists today, but it’s too expensive to be practical around the globe.\u003c/p>\n\u003cp>Ethical and cultural considerations for RobotDoc would need to be navigated, as will the many regulatory hurdles, but the benefits could be astounding. For this concept to fly, the RobotDoc would have to be inexpensive, perhaps $100. That’s an attractive price point for agencies looking to fund healthcare solutions in developing nations.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The big challenge is creating an affordable solution that is not only accurate, but also fits seamlessly and unobtrusively into our everyday lives, so people will actually stick with it.\u003c/aside>\n\u003cp>\u003cstrong>Digital Nutritionist\u003c/strong>\u003c/p>\n\u003cp>Today, it’s often a mystery what you are ingesting. Food labels aren’t very helpful and chances are high if it requires a food label it’s not very good for you anyway. Some people hire nutritionists to evaluate their medical history and make personalized diet recommendations. That’s too expensive to be practical. There’s a bigger opportunity in leveraging wand-like sensors, or even a small portable assay, to take the guesswork out of the equation.\u003c/p>\n\u003cp>Armed with the patient’s complete medical history, a \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/06/11/6-technology-trends-that-are-changing-how-we-eat/\">food analysis technology\u003c/a> could help consumers determine the foods that are best for them to eat and understand the health value of each food item in real time. This would encourage smarter eating habits and more precise information about the stress felt when trying to make the “healthy” choice based on a nutrition label. In addition, this type of technology could immediately flag allergens, perhaps preventing hospitalizations.\u003c/p>\n\u003cp>The big challenge is creating an affordable solution that is not only accurate, but also fits seamlessly and unobtrusively into our everyday lives, so people will actually stick with it.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Unity Stoakes is cofounder and president of \u003ca href=\"http://www.startuphealth.com\">StartUp Health\u003c/a>, a health innovation company with more than 100 digital health and wellness companies in its portfolio. \u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Radically transformative ideas that could improve human health, if people were ready to embrace them. ","status":"publish","parent":0,"modified":1477281521,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1334},"headData":{"title":"Five Health Technologies I Wish I Could Invest In Today | KQED","description":"Radically transformative ideas that could improve human health, if people were ready to embrace them. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"4462 http://ww2.kqed.org/futureofyou/?p=4462","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/06/18/five-health-technologies-i-wish-i-could-invest-in-today/","disqusTitle":"Five Health Technologies I Wish I Could Invest In Today","nprByline":"Unity Stoakes","path":"/futureofyou/4462/five-health-technologies-i-wish-i-could-invest-in-today","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Far too often, radically transformative ideas get stuck on the starting block, never able to truly take off. These innovations languish because a series of roadblocks make success seem impossible. In the U.S. healthcare system, radical change is often held up by regulatory hurdles, lack of resources and inadequate funding. Sometimes, the new technology just seems too futuristic for the general public to embrace.\u003c/p>\n\u003cp>At \u003ca href=\"http://www.startuphealth.com\">StartUp Health\u003c/a>, I am often confronted by the tug-of-war between a brilliantly innovative solution, and the harsh reality of a system that isn’t ready for it. Hundreds of pioneering digital health companies are paving the way, but many find themselves tangled in bureaucracy, stalled by lack of funding and challenged by the fear of doing things differently.\u003c/p>\n\u003caside class=\"pullquote alignright\">There are dozens of digital health concepts I wish I could fund now, yet many of these would not be accepted by today’s market.\u003c/aside>\n\u003cp>Just look at consumer genomics company \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>, which was \u003ca href=\"http://ww2.kqed.org/science/2014/05/05/consumer-gene-tests-whats-the-future/\">soundly rebuffed by the FDA\u003c/a> over its personalized genomic health product. The company started off as a popular ancestry service, making use of a DNA spit test to map personal genomes.\u003c/p>\n\u003cp>Realizing potential, 23andMe moved swiftly into the medical arena, offering patients customized health reports that predicted risk of heritable diseases. The FDA’s 2013 order to pull the health product until 23andMe could prove it was interpreting the results correctly had a chilling effect on a burgeoning industry of consumer genomics offered by the private sector.\u003c/p>\n\u003cfigure id=\"attachment_4667\" class=\"wp-caption alignleft\" style=\"max-width: 323px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/SUH-2.jpg\">\u003cimg class=\" wp-image-4667\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/SUH-2-800x533.jpg\" alt=\"StartUp Health entrepreneurs at the company's quarterly summit in New York, in April 2015. (StartUp Health)\" width=\"323\" height=\"215\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/SUH-2-960x640.jpg 960w\" sizes=\"(max-width: 323px) 100vw, 323px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">StartUp Health entrepreneurs at the company's quarterly summit in New York, in April 2015. (StartUp Health)\u003c/figcaption>\u003c/figure>\n\u003cp>There are dozens of digital health concepts I wish I could fund now, yet many of these would not be accepted by today’s market. If regulators, more investors and the general public were willing to embrace these concepts, here are five technologies that could radically improve human health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Embeddable Consumer Devices \u003c/strong>\u003c/p>\n\u003cp>The concept of embeddable consumer devices moves way beyond wearable sensors. An embeddable in this context isn’t a traditional medical device like a pacemaker or a stent. It’s a tiny sensor swallowed or embedded to constantly monitor biometrics. Consumers would be able to track the effect of a new diet on blood pressure, or the effect of a new medication on sleep patterns.\u003c/p>\n\u003cp>A company called \u003ca href=\"http://www.proteus.com/\">Proteus Digital Health\u003c/a> is taking the first steps with its \u003ca href=\"http://mobihealthnews.com/39612/proteus-oracle-launch-integrated-software-ingestible-sensors-for-clinical-trials/\">ingestible sensor\u003c/a> that sends a signal to a battery-operated patch worn on the skin. At this stage, Proteus seems focused on improving medication compliance. If privacy and safety concerns can be appropriately addressed, embeddable consumer devices could be used outside the healthcare setting to focus more broadly on daily health and wellness.\u003c/p>\n\u003caside class=\"pullquote alignright\">What’s needed is a consumer-friendly dashboard that operates as simply as Google Analytics — with consolidated, easy-to-use visualization of data in real time.\u003c/aside>\n\u003cp>\u003cstrong>Consolidated Health Dashboard\u003c/strong>\u003c/p>\n\u003cp>Diagnostic tools are becoming more sophisticated and cloud storage of health data will soon be universal. With these developments, each patient should be able to access his or her own \u003ca href=\"https://www.tictrac.com/business/\">health dashboard\u003c/a> the same way we can for our Web sites or automobiles. And I’m not referring to what the medical industry refers to as an electronic health record. What’s needed is a consumer-friendly dashboard that operates as simply as Google Analytics -- with consolidated, easy-to-use visualization of data in real time.\u003c/p>\n\u003cp>A similar concept would be a dashboard for employers and businesses to track the wellness of their teams the same way we do their productivity metrics. An employer dashboard could track healthcare decisions of each employee, identifying preferences and trends over time.\u003c/p>\n\u003cp>One big roadblock to a health dashboard is data fragmentation. Many small companies already offer their own dashboards, but there is no one consolidated provider to streamline the experience across different datasets that impact our health and wellness on a real-time basis. In addition, the data we collect today is catalogued in different ways, making it difficult to synchronize.\u003c/p>\n\u003caside class=\"pullquote alignright\">Every patient has a unique medical history and physiology, so why shouldn’t treatments be personalized?\u003c/aside>\n\u003cp>\u003cstrong>Microbiome-Based Consumer Goods\u003c/strong>\u003c/p>\n\u003cp>The concept of personalized medicine is intuitive. Every patient has a unique medical history and physiology, so why shouldn’t treatments be personalized? In addition to personalized medicine, we should have personalized consumer products. Consumer goods like toothpaste, shampoo, lotion and cosmetics could be tailored to suit each person’s microbiome.\u003c/p>\n\u003cp>We are \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/06/15/in-future-fecal-transplants-the-tool-wont-be-stool/\">learning more about the essential role of the microbiome\u003c/a> - the billions of bacterial cells that comprise between one and three percent of our body mass. One person’s oral microbiome, for example, could be paired with a complimentary toothpaste, the ingredients designed just for that individual, potentially saving millions in healthcare spending for minor infections and other issues.\u003c/p>\n\u003cfigure id=\"attachment_4714\" class=\"wp-caption alignleft\" style=\"max-width: 368px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/8146322408_5312e9deb2_c.jpg\">\u003cimg class=\" wp-image-4714\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/8146322408_5312e9deb2_c-677x600.jpg\" alt=\"A colorized model composed of three-dimensional human intestinal cells cultured with specific gut bacteria. (Pacific Northwest National Laboratory/Flickr)\" width=\"368\" height=\"326\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/8146322408_5312e9deb2_c-677x600.jpg 677w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/8146322408_5312e9deb2_c-400x355.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/8146322408_5312e9deb2_c.jpg 800w\" sizes=\"(max-width: 368px) 100vw, 368px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A colorized model composed of three-dimensional human intestinal cells cultured with specific gut bacteria. (Pacific Northwest National Laboratory/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>For this concept to become a reality, consumer product companies and healthcare companies would have to collaborate in an unprecedented way. The medical community is also still in the early stages of microbiome research. The FDA is unlikely to support personalized consumer goods just yet, as they rely on a system of rigorous batch testing to guarantee products are safe for everyone. Personalized products might be perfect for one person but unsafe for another, presenting a unique challenge in the era of 3-D printing and personalized everything.\u003c/p>\n\u003cp>\u003cstrong>$100 \"RobotDoc\"\u003c/strong>\u003c/p>\n\u003cp>Today’s autonomous devices can perform many of the same tasks performed during a regular checkup. It’s unlikely that a robot will replace a family practitioner any time soon, but in some remote regions of the world, a machine equipped with the basic diagnostic technology could identify common medical ailments that would otherwise go undiagnosed. I call this concept \"RobotDoc.\"\u003c/p>\n\u003cp>Today, a \u003ca href=\"http://astounde.com/first-medical-tricorder-scans-analyzes-and-shares-all-your-core-vitals/\">tiny handheld device\u003c/a> made by a company called \u003ca href=\"https://www.scanadu.com/\">Scanadu\u003c/a> can check blood pressure, temperature and heart rate. The company is also developing a urine test kit. The technology exists today, but it’s too expensive to be practical around the globe.\u003c/p>\n\u003cp>Ethical and cultural considerations for RobotDoc would need to be navigated, as will the many regulatory hurdles, but the benefits could be astounding. For this concept to fly, the RobotDoc would have to be inexpensive, perhaps $100. That’s an attractive price point for agencies looking to fund healthcare solutions in developing nations.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The big challenge is creating an affordable solution that is not only accurate, but also fits seamlessly and unobtrusively into our everyday lives, so people will actually stick with it.\u003c/aside>\n\u003cp>\u003cstrong>Digital Nutritionist\u003c/strong>\u003c/p>\n\u003cp>Today, it’s often a mystery what you are ingesting. Food labels aren’t very helpful and chances are high if it requires a food label it’s not very good for you anyway. Some people hire nutritionists to evaluate their medical history and make personalized diet recommendations. That’s too expensive to be practical. There’s a bigger opportunity in leveraging wand-like sensors, or even a small portable assay, to take the guesswork out of the equation.\u003c/p>\n\u003cp>Armed with the patient’s complete medical history, a \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/06/11/6-technology-trends-that-are-changing-how-we-eat/\">food analysis technology\u003c/a> could help consumers determine the foods that are best for them to eat and understand the health value of each food item in real time. This would encourage smarter eating habits and more precise information about the stress felt when trying to make the “healthy” choice based on a nutrition label. In addition, this type of technology could immediately flag allergens, perhaps preventing hospitalizations.\u003c/p>\n\u003cp>The big challenge is creating an affordable solution that is not only accurate, but also fits seamlessly and unobtrusively into our everyday lives, so people will actually stick with it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Unity Stoakes is cofounder and president of \u003ca href=\"http://www.startuphealth.com\">StartUp Health\u003c/a>, a health innovation company with more than 100 digital health and wellness companies in its portfolio. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/4462/five-health-technologies-i-wish-i-could-invest-in-today","authors":["byline_futureofyou_4462"],"series":["futureofyou_110"],"categories":["futureofyou_1060"],"tags":["futureofyou_232","futureofyou_80","futureofyou_35","futureofyou_457"],"featImg":"futureofyou_4700","label":"futureofyou_110"},"futureofyou_2224":{"type":"posts","id":"futureofyou_2224","meta":{"index":"posts_1591205157","site":"futureofyou","id":"2224","score":null,"sort":[1429736621000]},"guestAuthors":[],"slug":"what-if-restaurants-like-hospitals-refused-to-share-their-prices","title":"What if restaurants, like hospitals, refused to share their prices?","publishDate":1429736621,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Imagine walking into a restaurant, and you're handed a menu with no prices.\u003c/p>\n\u003cp>At this hypothetical restaurant, you're told that the cost of the meal will fluctuate based on where you sit, and who happens to serve you. And you'll only receive a detailed copy of the bill four weeks later, when it arrives via fax machine.\u003c/p>\n\u003cp>Welcome to the U.S. health care system.\u003c/p>\n\u003cp>For physicians like Dr. Pat Basu, analogies like this one are far from perfect. But they are a useful way to describe to people how the U.S. health system really works.\u003c/p>\n\u003cp>Basu is no ordinary doctor. He works as the chief medical officer at \u003ca href=\"http://doctorondemand.com\">Doctor on Demand\u003c/a>, a startup that connects patients to doctors online. Previously, he \u003ca href=\"http://radiology.stanford.edu/blog/archives/2010/07/basu-named-whit.html\">advised \u003c/a>the White House on health care policy and reform. Given his background, he is often invited to speak at medical industry conferences.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But unlike many of his peers, Basu gravitates to consumer-friendly analogies and tries to refrain from using jargon.\u003c/p>\n\u003cp>We met for coffee this week to chat about the lack of price transparency in health care, and how the average American would react to a restaurant that kept customers in the dark about its prices.\u003c/p>\n\u003cp>On a whim, I shared the analogy with my Twitter followers late Tuesday evening.\u003c/p>\n\u003cp>https://twitter.com/chrissyfarr/status/590724373478252544\u003c/p>\n\u003cp>I was floored by the volume and breadth of responses, which ranged from laugh-out-loud funny to downright depressing. I highlighted a few, although I recommend \u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">perusing the thread\u003c/a> in its entirety.\u003c/p>\n\u003cp>https://twitter.com/djbressler/status/590824168674955264\u003c/p>\n\u003cp>https://twitter.com/matthewscd/status/590726687396126720\u003c/p>\n\u003cp>https://twitter.com/statesdj/status/590728967461699586\u003c/p>\n\u003cp>https://twitter.com/OnerousLetterLi/status/590725122908106753\u003c/p>\n\u003cp>\u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">Read the rest here.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Why the Lack of Price Transparency?\u003c/strong>\u003c/p>\n\u003cp>As Dr. Basu explained, it's long been a struggle for consumers to find out in advance how much their doctor visits and procedures will cost. Unlike restaurants, health care institutions shy away from publishing their prices, as it depends on who's footing the bill.\u003c/p>\n\u003cp>Some web-based tools do a decent job of providing cost estimates (\u003ca href=\"http://blogs.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cem>KQED\u003c/em> launched its own service, \u003cem>PriceCheck\u003c/em>, which relies on data aggregated from California-based readers)\u003c/a>.\u003c/p>\n\u003cp>But for most patients, price is still a gamble. As one recent study found, \u003ca href=\"http://www.washingtonpost.com/national/health-science/a-blood-test-can-cost-from-10-to-10000-in-calif-hospitals-according-to-a-study/2014/08/16/aba02472-24ae-11e4-8593-da634b334390_story.html\">the price of a blood test in California\u003c/a> can range from $10 to $10,000, depending on the hospital.\u003c/p>\n\u003cp>https://twitter.com/RS_Flinn/status/590932990487728128\u003c/p>\n\u003cp>Unfortunately, improving price transparency isn't a simple proposition. The debate has raged for decades among health care policymakers and academics -- \u003ca href=\"http://www.thefiscaltimes.com/Articles/2014/09/18/Why-Health-Care-Price-Transparency-May-Not-Work\">some have argued that it may not work\u003c/a> well in practice.\u003c/p>\n\u003cp>But for most consumers, who aren't knee deep in D.C. politics, it is unclear why they can compare prices online for a steak dinner or a new television -- but not for a critical medical procedure.\u003c/p>\n\u003cp>\u003cstrong>The Trouble With Jargon \u003c/strong>\u003c/p>\n\u003cp>The health care industry needs to a better job of reaching people on social media, and helping them understand the status quo.\u003c/p>\n\u003cp>Much of the available literature on the price transparency topic is confusing and downright boring. And at health care conferences, which I frequently attend in the pursuit of clear answers, speakers spew out incomprehensible medical jargon.\u003c/p>\n\u003cp>I've often wondered: Do these \"industry insiders\" actually understand each other? Or are they nodding along for appearances sake?\u003c/p>\n\u003cfigure id=\"attachment_2231\" class=\"wp-caption alignright\" style=\"max-width: 366px\">\u003cimg class=\"wp-image-2231\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/money_2.jpg\" alt='I suggested renaming my panel to \"Show me the money!\"' width=\"366\" height=\"198\">\u003cfigcaption class=\"wp-caption-text\">Forget reimbursement. \"Show me the money!\" \u003ccite>(Proverbs66.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2014, I was asked to interview a panel of medical experts at a conference on the topic of \"reimbursement.\" Half-joking, I suggested that we would have done a better job of filling the room by amending the description to \"show me the money.\"\u003c/p>\n\u003cp>\"So...What even is reimbursement,?\" I asked the panel.\u003c/p>\n\u003cp>Crickets.\u003c/p>\n\u003cp>That opening question was met with a minute or so of excruciating silence. Eventually, several of the speakers piped up, each giving me a slightly different answer.\u003c/p>\n\u003cp>Dr. Jordan Shlain, a physician I bumped into at a recent health-tech conference, had a similar experience when he asked an audience of 400 people if they understood the meaning of the term \"patient engagement.\" Two hands went up.\u003c/p>\n\u003cp>I strongly agree with Shlain, \u003ca href=\"https://www.linkedin.com/pulse/20141028232337-30819-cracking-open-medical-jargon-case-1-patient-engagement\">who shared this experience in a blog post\u003c/a>, that if we want patients to participate in important, ongoing policy discussions about the future of health care, we need to cut down on our use of jargon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If analogies resonate with people and prompt a discussion about health care, bring 'em on.\u003c/p>\n\n","blocks":[],"excerpt":"At this hypothetical restaurant, you're told that the cost of the meal will fluctuate based on where you sit, and who happens to serve you. And you'll only receive a detailed copy of the bill four weeks later, when it arrives via fax machine.","status":"publish","parent":0,"modified":1434049021,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":816},"headData":{"title":"What if restaurants, like hospitals, refused to share their prices? | KQED","description":"At this hypothetical restaurant, you're told that the cost of the meal will fluctuate based on where you sit, and who happens to serve you. And you'll only receive a detailed copy of the bill four weeks later, when it arrives via fax machine.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"2224 http://ww2.kqed.org/futureofyou/?p=2224","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/22/what-if-restaurants-like-hospitals-refused-to-share-their-prices/","disqusTitle":"What if restaurants, like hospitals, refused to share their prices?","path":"/futureofyou/2224/what-if-restaurants-like-hospitals-refused-to-share-their-prices","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Imagine walking into a restaurant, and you're handed a menu with no prices.\u003c/p>\n\u003cp>At this hypothetical restaurant, you're told that the cost of the meal will fluctuate based on where you sit, and who happens to serve you. And you'll only receive a detailed copy of the bill four weeks later, when it arrives via fax machine.\u003c/p>\n\u003cp>Welcome to the U.S. health care system.\u003c/p>\n\u003cp>For physicians like Dr. Pat Basu, analogies like this one are far from perfect. But they are a useful way to describe to people how the U.S. health system really works.\u003c/p>\n\u003cp>Basu is no ordinary doctor. He works as the chief medical officer at \u003ca href=\"http://doctorondemand.com\">Doctor on Demand\u003c/a>, a startup that connects patients to doctors online. Previously, he \u003ca href=\"http://radiology.stanford.edu/blog/archives/2010/07/basu-named-whit.html\">advised \u003c/a>the White House on health care policy and reform. Given his background, he is often invited to speak at medical industry conferences.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But unlike many of his peers, Basu gravitates to consumer-friendly analogies and tries to refrain from using jargon.\u003c/p>\n\u003cp>We met for coffee this week to chat about the lack of price transparency in health care, and how the average American would react to a restaurant that kept customers in the dark about its prices.\u003c/p>\n\u003cp>On a whim, I shared the analogy with my Twitter followers late Tuesday evening.\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"590724373478252544"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>I was floored by the volume and breadth of responses, which ranged from laugh-out-loud funny to downright depressing. I highlighted a few, although I recommend \u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">perusing the thread\u003c/a> in its entirety.\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"590824168674955264"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"590726687396126720"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"590728967461699586"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"590725122908106753"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">Read the rest here.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Why the Lack of Price Transparency?\u003c/strong>\u003c/p>\n\u003cp>As Dr. Basu explained, it's long been a struggle for consumers to find out in advance how much their doctor visits and procedures will cost. Unlike restaurants, health care institutions shy away from publishing their prices, as it depends on who's footing the bill.\u003c/p>\n\u003cp>Some web-based tools do a decent job of providing cost estimates (\u003ca href=\"http://blogs.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cem>KQED\u003c/em> launched its own service, \u003cem>PriceCheck\u003c/em>, which relies on data aggregated from California-based readers)\u003c/a>.\u003c/p>\n\u003cp>But for most patients, price is still a gamble. As one recent study found, \u003ca href=\"http://www.washingtonpost.com/national/health-science/a-blood-test-can-cost-from-10-to-10000-in-calif-hospitals-according-to-a-study/2014/08/16/aba02472-24ae-11e4-8593-da634b334390_story.html\">the price of a blood test in California\u003c/a> can range from $10 to $10,000, depending on the hospital.\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"590932990487728128"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Unfortunately, improving price transparency isn't a simple proposition. The debate has raged for decades among health care policymakers and academics -- \u003ca href=\"http://www.thefiscaltimes.com/Articles/2014/09/18/Why-Health-Care-Price-Transparency-May-Not-Work\">some have argued that it may not work\u003c/a> well in practice.\u003c/p>\n\u003cp>But for most consumers, who aren't knee deep in D.C. politics, it is unclear why they can compare prices online for a steak dinner or a new television -- but not for a critical medical procedure.\u003c/p>\n\u003cp>\u003cstrong>The Trouble With Jargon \u003c/strong>\u003c/p>\n\u003cp>The health care industry needs to a better job of reaching people on social media, and helping them understand the status quo.\u003c/p>\n\u003cp>Much of the available literature on the price transparency topic is confusing and downright boring. And at health care conferences, which I frequently attend in the pursuit of clear answers, speakers spew out incomprehensible medical jargon.\u003c/p>\n\u003cp>I've often wondered: Do these \"industry insiders\" actually understand each other? Or are they nodding along for appearances sake?\u003c/p>\n\u003cfigure id=\"attachment_2231\" class=\"wp-caption alignright\" style=\"max-width: 366px\">\u003cimg class=\"wp-image-2231\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/money_2.jpg\" alt='I suggested renaming my panel to \"Show me the money!\"' width=\"366\" height=\"198\">\u003cfigcaption class=\"wp-caption-text\">Forget reimbursement. \"Show me the money!\" \u003ccite>(Proverbs66.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2014, I was asked to interview a panel of medical experts at a conference on the topic of \"reimbursement.\" Half-joking, I suggested that we would have done a better job of filling the room by amending the description to \"show me the money.\"\u003c/p>\n\u003cp>\"So...What even is reimbursement,?\" I asked the panel.\u003c/p>\n\u003cp>Crickets.\u003c/p>\n\u003cp>That opening question was met with a minute or so of excruciating silence. Eventually, several of the speakers piped up, each giving me a slightly different answer.\u003c/p>\n\u003cp>Dr. Jordan Shlain, a physician I bumped into at a recent health-tech conference, had a similar experience when he asked an audience of 400 people if they understood the meaning of the term \"patient engagement.\" Two hands went up.\u003c/p>\n\u003cp>I strongly agree with Shlain, \u003ca href=\"https://www.linkedin.com/pulse/20141028232337-30819-cracking-open-medical-jargon-case-1-patient-engagement\">who shared this experience in a blog post\u003c/a>, that if we want patients to participate in important, ongoing policy discussions about the future of health care, we need to cut down on our use of jargon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If analogies resonate with people and prompt a discussion about health care, bring 'em on.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2224/what-if-restaurants-like-hospitals-refused-to-share-their-prices","authors":["3252"],"categories":["futureofyou_1"],"tags":["futureofyou_233","futureofyou_34","futureofyou_138","futureofyou_232","futureofyou_177","futureofyou_234","futureofyou_80","futureofyou_174","futureofyou_179"],"featImg":"futureofyou_2229","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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