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Consumers Are Still Held Back From Making Rational Health Decisions

Posted on November 25, 2014 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://radar.oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Price and quality of care–those are what we’d like to know when we need a medical procedure. But a perusal of a recent report from the Government Accountability Office reminded me that both price and quality information are hard to get nowadays.

This has to make us all a little leery about trends in health reform. Governments, insurers, and employers want us to get choosy about where we have our procedures. They justify rises in copays and deductibles by saying, “You patients should start to take responsibility for the costs of your own health care.”

Yeah, as responsible as a person looking for his car keys in the dark. Let’s start with prices, which in many countries are uniform and are posted on the clinic wall.

Sites such as Clear Health Costs and Castlight Health prove what we long knew anecdotally: charges in the US vary vertiginously among different institutions. Anyone who had missed that fact would have been enlightened by Steven Brill’s 2013 Time Magazine article.

But aspirations become difficult when we get down to the issue at hand–choosing a provider. That’s because US insurance and reimbursement systems are also convoluted. We don’t know whether a hospital will charge our insurer their official price, or how much the insurer will cover. It might feel righteous to punish a provider with high posted prices (or prices reported by other consumers), but most patients have a different goal: to keep as much of their own money as they can.

We can gauge the depth of the cost problem from one narrow suggestion made in the GAO report that yet could help a lot of health consumers: the suggestion that Centers for Medicare & Medicaid Services (CMS) publish out-of-pocket expenditures for Medicare recipients as well as raw costs of procedures (page 31). Even this is far from simple. HHS pointed out that 90% of Medicare patients have supplemental overage that reduces their out-of-pocket expenditures (page 43). Tracking all the ancillary fees is also a formidable job.

Castlight Health is out in front when it comes to measuring the real impact of charges on consumer. They achieve great precision by hooking up with employers. Thus, they know the insurer and the precise employer plan that covers each individual visiting their site, and can take deductibles, exclusions, and caps into account when calculating the cost of a procedure. A recent study found that Castlight users enjoyed lower costs, especially for labs and imaging. Some nationwide system built around standards for reporting these things could unpack the cost conumdrum for all patients.

Let’s turn to quality. As one might expect, it’s always a slippery concept. The GAO report pointed out that quality may be measured in different ways by different providers (page 26). A recently begun program releases Medicare data on mortality and readmissions, but it hasn’t been turned into usable consumer information yet (pages 27-28). Two more observations from the report:

  • “…with the exception of Hospital Compare, none of CMS’s transparency tools currently provide information on patient-reported outcomes, which have been shown to be particularly relevant to consumers considering common elective medical procedures, including hip and knee replacements.” (Page 21)

  • “CMS’s consumer testing has focused on assessing the ability of consumers to interpret measures developed for use by clinicians, rather than to develop or select measures that specifically address consumer needs.” (Page 25)

Some price-check sites simply don’t try to measure quality. A highly publicized crowdsourcing effort by California radio station KQED, based on the Clear Health Costs service, admitted that quality measures were not available but excused themselves by citing the well-known lack of correlation between price and quality.

Price and quality may not be related, but that doesn’t relieve consumers of concerns over quality. Can you really exchange Mount Sinai Hospital in New York for Daddy-o’s Fix-You-Up Clinic based on price alone? Without robust and reliable quality data, people will continue choosing the historically respected hospitals with the best marketing and PR departments–and the highest prices.

A recent series on health care costs concludes by admonishing consumers to “get in the game and start to push back.” The article laments the passivity of consumers in seeking low-cost treatment, but fails to cite the towering barriers that stand in the way.

The impasse we’ve reached on consumer choice, driven by lack of data, reflects similar problems with analytics throughout the health care field. For instance, I recently reported on how hard a time researchers have obtaining and making use of patient data. Luckily, the GAO report cites several HHS efforts to enhance their current data on price and quality. Ultimately, of course, what we need is a more rational reimbursement system, not a gleaming set of computerized tools to make the current system more transparent. Let’s start by being honest about what we’re asking health consumers to achieve.

Review of “Patient Engagement is a Strategy, Not a Tool” by Colin Hung

Posted on November 24, 2014 I Written By

The following is a guest blog post by Colin Hung (@Colin_Hung), Co-Host of #hcldr and SVP of Marketing at Patient Prompt.
Colin Hung
If Leonard Kish’s new eBook – http://www.hl7standards.com/kish-ebook/”>Patient Engagement is a Strategy, Not a Tool was a song, it would be categorized as a “mashup” – and that’s a good thing.

Never heard a mashup song before? Just go to youtube.com and type it into the search bar and you’ll find thousands (or try this one https://www.youtube.com/watch?v=zbrWu8XyAcM). Mashups are a unique form of music. To make one, DJs will take snippets (called samples) from other songs usually from different artists and combine them into a single piece and in so doing create a whole new song in the process.

When done properly a mashup is both familiar and fresh. It has elements which you know and love yet the composition as a whole feels new. That is exactly what Kish has done in his eBook. He expertly weaves together numerous ideas, themes and approaches from different people and different industries into a single cohesive arrangement.

Kish starts by laying down a central idea that is carried like a melody from page 1 through to the end:

“The key to [patient] engagement in early stages is to get people’s attention and to let them see what’s possible by using the tools available to improve their health. It’s a process and a strategy, not a data set or any one tool”

With that idea track locked in, Kish proceeds to mix in concepts from:

  • Marketing – target audiences, key messages and clear calls-to-action
  • Product Management – inclusive design and agile development
  • Behavioral Science – Maslow’s hierarchy, social interaction and motivation

The eBook starts off strong with a nice definition of patient engagement – a rather amorphous term in healthcare right now –  and gets stronger with examples of successful “attention grabbing” marketing campaigns that could be adopted by healthcare organizations.

One particular statement that stands out:

“Engagement requires what marketers know very well: motivation, context and messaging.”

As a person who works in HealthIT Marketing, I’m tickled by this statement…but I think Kish is giving those of us in Marketing a bit too much credit. Although it is true that marketers should have a good grasp of our target audiences (their needs, wants, motivations and fears) – we are not seers. In fact, it is common for marketers to be a little “off key” when approaching new markets or when working with new products.

Truly successful marketers are the ones who are open to being wrong…and who can quickly adapt their messages/approach based on real data and feedback from the target audience. Like a good DJ, you must read the reaction of the audience and change the tune in order to keep things hopping.

The idea of iterating, fitting engagement into the world of the patient (context) and using feedback are the themes that fill the middle portion of Kish’s eBook. Using anecdotes, quotes and statistics from a wide array of leaders he encourages readers to draw parallels with healthcare and to think critically on how that wisdom from outsiders can be applied successfully in their own organizations.

Fittingly there is a section that draws a parallel between healthcare and music. Kish quotes former Talking Heads singer David Byrne in a particularly memorable and interesting chapter.

The finale is where “Patient Engagement is a Strategy, Not a Tool” shines. Having laid the ground work in the prior chapters on why getting patients’ attention is so critical and how difficult it can be to turn that attention into meaningful behavior change, Kish closes by giving readers 10 concrete steps to follow to “win the attention war” in healthcare:

  1. Know what health problem you are trying to solve
  2. Know whose attention you’re trying to get
  3. Use social tools
  4. Know behavior models and behavioral economics
  5. Focus on goals and narratives
  6. Start Simple
  7. Try something and measure results
  8. Understand context
  9. Take an open approach
  10. Follow an analysis-driven implementation plan

I was hoping for a little more depth from Kish on the Agile approach, especially as it relates to A/B testing, iterative design and high reliance on real-user feedback – something that I believe could DEFINITELY be used in healthcare – but perhaps he is keeping these concepts for his next composition.

Overall, Kish’s eBook is a solid mix of familiar theories/approaches from other industries and new ideas/success stories from within healthcare. It offers insight and practical advice on how to change from a tools-based approach to patient engagement to a process and strategy based one. If you work in healthcare and are involved in your organization’s patient experience, access or engagement initiatives this eBook should be on your reading list.

I am looking forward to Kish’s next release – which I hope drops soon.

“Patient Engagement is a Strategy, Not a Tool” can be downloaded for free courtesy of the good folks at HL7 Standards (http://www.hl7standards.com/kish-ebook/)

A Little Digital Health Conference (#DHC14) Twitter Roundup

Posted on November 17, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m at the Digital Health Conference in NYC and the Twitter stream has been going strong (search #dhc14 on Twitter to see what I mean). Sometimes I forget how much more satisfying a conference is when there’s an active Twitter stream. It enhances a conference for me in so many ways. I thought it would be fun to point out a few of the tweets that struck me today (and there were a lot to choose from).


I do think New York has made a lot of progress with their HIE. Pretty amazing that they got $30 million of state funding for it. Do you know of other states that are making good progress on their state HIE?


Topol’s comment about cigarettes is interesting. I had to throw in the CVS reference. Right now it doesn’t seem that crazy, but I wonder if 10 years from now it will be just as crazy as Cleveland Clinic giving out cigarette pack holders.


I love imagery and this is great imagery that could inspire a lot of people. What I don’t think many tech people realize is that they’re going to need to work collaboratively with scientists, chemists and doctors to do surveillance on the blood stream. Talk about an area that needs multidisciplinary efforts.


The common error that we compare the new way against perfection as opposed to comparing the new way against the alternative (or the previous model). I’ve been seeing this problem come up over and over in healthcare IT.

Darth Vader Diagnosis

Posted on November 12, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The creativity of humans will never cease to amaze me. Here’s a good example from a tweet from the Exponential Medicine conference:

I think I’ve seen ZDoggMD reference some of the clinical issues of Darth Vader before as well. I’m honestly not sure what value this has to your work, but it gave me a good laugh, so I thought you might enjoy a laugh too.

The Financial Need for Quality Improvement in Healthcare Infographic

Posted on November 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently received a well done infographic on the negative financial impact of poor quality healthcare on the health system. The infographic was created by Caradigm, a population health company. I think you’ll find some interesting insights in the benefits of quality healthcare in this infographic.
Need for Quality Improvement in Healthcare

Data Sources:
GE Healthcare. “Clinical Decision Support Decision: Defining our Problem Statement. 2011.
The Advisory Board. 2008. based on Kleven, RM. “Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals 2002.” 2007.
The Advisory Board. “The Tip of the Iceberg: Adverse Events are Costing You More than Ever.” 2011.
GE Reports. “The Unknown Killer: Healthcare Associated Infections.” 2011. http://www.gereports.com/the-unknown-killer-healthcare-associated-illnesses/
NEMJ “Care in US Hospitals” July 2005.
HealthAffairs. Reducing Waste in Health Care. December 2012. http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=82
Centers for Medicare and Medicaid Services, “National Patient Safety Initiative: Saving Lives Saving Money,”

Karen DeSalvo Remains as National Coordinator of ONC Along with New Position

Posted on October 31, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed it, last week it was announced that Karen DeSalvo had been appointed Assistant Secretary of Health focused on Ebola by HHS Secretary Burwell. In that same announcement Jacob Reider also announced his departure from ONC.

While the news was true that DeSalvo was taking on a new role at HHS as Assistant Secretary of Health, ONC also published a blog post that DeSalvo would stay on as National Coordinator of Health IT as well:

Dr. DeSalvo will serve as Acting ASH while maintaining her leadership of ONC. Importantly, she will continue to work on high level policy issues at ONC, and ONC will follow the policy direction that she has set. She will remain the chair of the Health IT Policy Committee; she will continue to lead on the development and finalization of the Interoperability Roadmap; and she will remain involved in meaningful use policymaking. She will also continue to co-chair the HHS cross-departmental work on delivery system reform.

Lisa Lewis will provide day to day leadership at ONC. Lewis served as Acting Principal Deputy National Coordinator before Dr. DeSalvo joined ONC, so she has had experience with all parts of our work. She will lead our extremely talented and very strong team during Dr. DeSalvo’s deployment to the Office of the Assistant Secretary for Health.

But most importantly, the team that is ONC is far more than one or two leaders. The team of ONC is personified in each and every individual – all part of a steady ship and a strong and important part of HHS’ path toward delivery system reform and overall health improvement.

Seems like an awkward arrangement if you ask me. DeSalvo will be providing high level leadership on policy direction, but Lisa Lewis will handle the day to day leadership. That job description for DeSalvo sounds like something an Assistant Secretary of Health might do and Lisa Lewis’ job sounds like something the National Coordinator would do.

I’m sure there’s more to this story. Maybe moving DeSalvo to Assistant Secretary was a way for ONC to save money and keep DeSalvo on board working on healthcare IT. If ONC’s budget gets cut, then HHS still has a way to pay for DeSalvo. Maybe that’s why Lisa Lewis can’t be promoted to full National Coordinator. Then again, maybe it’s like I mentioned when we first heard the DeSalvo news, DeSalvo is more of a public health person than she is a healthcare IT person.

The fact that DeSalvo is remaining as National Coordinator is interesting. However, I just came back from CHIME (healthcare CIO conference) where DeSalvo was scheduled as one of the plenary session speakers. However, she didn’t show and so the whole session was cancelled. I guess you could make the case that she’s got Ebola to deal with right now, but it also illustrates how health IT will be playing second fiddle for her going forward. Likely says something about the future of ONC.

6 Physician Website Tips

Posted on October 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was asked to write an article for gMed users about Building a Better Physician Website. It’s an important topic that often gets overlooked by clinics and doctors and something I’ve worked on building physician websites. Here’s the intro to the article:

In this ever changing world, a physician’s website is how a new patient is going to judge that physician’s skills and capabilities. Whether they find their doctor on their insurance list, Google, a physician rating site or from a friend, a large majority of patients are now reviewing websites before scheduling an appointment. What does your website tell your patients about you? Does it portray a doctor who’s still stuck in the 90’s and hasn’t stayed up-to-date with the latest changes in technology? Does it allow a visitor to your website to easily become a patient? Does it make the patient feel like you are the best doctor for them?

I also offer the following 6 tips for physician websites:

  • Make Your Website Beautiful
  • Mobile Optimized Website
  • Engage Potential Patients
  • Engage Existing Patients
  • Online Payment Options
  • Regularly Updated Content

Be sure to read the full article where I go into more detail on each tip. What have you seen with Physician websites?

Full Disclosure: gMed is an advertiser on this site.

Connected Health takes the stage at Partners symposium

Posted on October 28, 2014 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://radar.oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The Connected Health Symposium is not one of the larger health conferences, but it is one of the most respected. I met a number of leaders in health IT there who praised it for the conference scope and seriousness, and told me they were glad to see me there covering it.

Many issues in health IT and patient empowerment, however, are best learned not from any conference, but from the tussles and tears of everyday life. Let us hope no reader has undergone the personal experience of having her reports dismissed and of being misdiagnosed, as did several speakers at the conference.

But many of us have spent three hours on the phone with an insurer to approve a single medication shipment, or fought in vain to get the medical records that US law requires providers to give us, or watched our doctor fumble with his new EHR for fifteen minutes while trying to stay engaged with us.

It’s encouraging to see the progress of patient engagement at Massachusetts General Hospital, as reported by Gregg Meyer of Partners Healthcare System (the funder behind the Center for Connected Health that put on the symposium). But can small and rural providers struggling with cash flow join the movement?

These institutions would be comfortable using swyMe, a HIPAA-compliant telemedicine system that allows doctors to interview patients over everyday mobile devices and perhaps avoid a trip to the hospital. swyMe can also transmit audio and video from devices that EMTs can connect up to the phone. (Not many devices with the necessary hardware connectors are on the market, though.)

swyMe was one of the “innovators” highlighted in a conference demo. Jeffrey Urdan, COO of the company that makes it, told me later that he felt “low tech” compared to some of the fancy, expensive devices at the demo. But most of the providers in the US, and elsewhere, are more on swyMe’s level than theirs.

Another hurdle to forming connected teams that serve the patient is interoperability. A sign of the distance we have yet to come can be found in iCancerHealth, a service for cancer patients offered by Medocity. A free app is available to individuals, but the main integrated service is offered through providers or pharma companies doing clinical trials. The service includes such conveniences as medication tracking, treatment plans, a diary, audio and video connections to their physician, and even a way to form communities with other patients.

This is great, but iCancerHealth works with data from only one provider. This can be a limitation even for the few months that cancer patients typically use the service, and could certainly be a problem if the service were expanded to a broader range of illnesses. Similarly, there’s no seamless way to share data with patient communities; it has to be re-entered manually. Enhancing the service to encompass multiple providers would probably require wider adoption of electronic health record standards.

As an example of finding a creative solution to devices that lack interoperability, Mobile Diagnostic Services demonstrated an app that could photograph the display panel of a device, interpret the bars on the display to create digital data, and transmit the values to a health record in the cloud. This is a process well-known to computer programmers from thirty years ago as “screen scraping,” now relevant to the health industry.

One of the strengths of the Connected Health Symposium was the platform it gave to patients and doctors to express their frustrations with the old way of delivering care and the slow pace of change. The testimony could come from entrepreneur Robin Farmanfarmaian, who lost three organs unnecessarily to misdiagnosis, or Sarah Krüg, president of the Society for Participatory Medicine, whose parents died from diseases that might have been caught if the doctors had paid attention to their reported symptoms.

Or the testimony could come from Greg LaGana and Barry Levy, MDs who write and perform in a musical review called Damaged Care that skewers everything about doctors behavior as well as the legal and financial environment in which they have to operate.

Anna MCollister-Slipp, co-founder of Galileo Analytics and a sufferer from type 1 diabetes, regaled us with the dozens of vital sign measurements, treatments, and other details she has to manage on her own manually. She still get lab reports only because her doctor sends them via email (using a private account, so that HIPAA zealots don’t discipline him–the rights and wishes of the patient are supposed to be paramount). Like other conference attendees, though, she reported progress in tools and patient-oriented culture.

Less was heard at the symposium from other sectors of the medical field, but we did hear from Michael of Aetna, Jonathan Bush of athenahealth, and Beverley Bryant of England’s National Health Service. The panel on which Bryant spoke proved to be discouraging. Many of us in the US like to think that other developed nations with their universal health care systems have solved the coordination and interoperability messes that the US is in. But the panelists expressed many familiar frustrations.

I plan to return to the Connected Health Symposium next year, and I’m sure each year will bring a bit of progress toward better communication among staff, better use of patient data, and better integration of tools. The mood at the show was largely positive. But a little probing turned up barriers in the way of the healthcare system we all want.

#MGMA14 Twitter Roundup

Posted on October 27, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been spending the past couple days at the MGMA Annual conference in Las Vegas. It’s been interesting to talk to many of the leaders in healthcare. There seems to be a lot of confusion and uncertainty in the air. In fact, that seems to be the case at all the healthcare conferences I’m attending lately. While the industry is going through a turbulent period, it’s still been interesting to see the ongoing evolution that’s happening.

The Twitter stream has been a little disappointing to me. I’d like to see more attendees tweeting content. The vendors are extremely active. However, I found a few tweets which highlight a few of the topics being discussed.


I’m always amazed with how many people want their EHR to be connected. If it being connected was so valued by end users, then why hasn’t it happened? There’s still a misalignment of incentives that needs to be solved.


Lots of these ideas floating around. Everyone agrees that the move to some sort of quality based reimbursement is coming. We’re going to see a lot more discussions like the one above. Unfortunately, right now it’s a lot of speculation.


I wasn’t able to make this session, but it certainly brings up some interesting questions. We’ve written a number of times before about the value of a practice with and without an EHR. This certainly seems to call into question whether a practice without EHR is worth saving. This is going to become a really interesting topic as more doctors who’ve never used EHR in their practice decide to retire.

The Return of the House Call? – UberHealth

Posted on October 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’d been hearing rumors about Uber (the black car service) creating an Uber Health service. I don’t think anyone is clear on the details and I’m not sure how they can do Uber Health when it seems like they have enough growth opportunities and challenges with their car service. Undeterred, yesterday Uber Health dipped its toe in the water with a Flu Prevention program for 1 day in 3 cities.

Uber partnered with Vaccine Finder to bring flu prevention packs and flu shots directly to you at the push of a button (an Uber button of course).

The offering was obviously really compelling. This version of Uber Health was free and Uber made it possible for the service to come to you and your 10 closest friends. I haven’t seen any reports on how it went, but I’ll be surprised if I hear that the service wasn’t swamped all day. They made it really convenient to get a flu shot. Hard to argue with something that comes to you for free.

What’s interesting to me is whether Uber can scale this kind of house call service in healthcare. No doubt they already have the transportation infrastructure in place to move the doctors and other medical personnel around as needed. However, that comes with a pretty steep cost which will have to be passed on to the patient. Plus, I don’t know how an Uber ride is any cheaper than the doctor driving her own car. I guess the doctor could chart the previous visit while the Uber drives her to the next one. Either way, it’s still an added cost that will have to be incorporated into the house call doctor visit.

You have to remember that Uber comes from the startup centric culture of Silicon Valley. In that culture, these companies will happily pay for a house call service like what Uber Health could be. First, these startup companies are competing for the best talent and being able to tell their employees that the Uber Health house call service is one of the benefits of working there could be a way to attract and retain the best talent. Second, these startup companies want their employees working as much as possible. A visit to the doctor takes a big chunk out of the day when they could be working and building their company. The lost productivity alone is reason enough for these companies to pay for a house call service like what Uber Health could become.

The real question is how will this scale across the nation. Are other companies as willing as silicon valley startup companies to pay for a service like this for their employees? My guess is that they won’t be, because the competition for talent isn’t nearly as fierce.

The reality is that I think most of us love the idea of a house call medical visit. I can’t think of anyone that wouldn’t love to avoid time spent waiting in the waiting room. However, we have to understand what that costs. There’s a reason why the house call doctor died in favor of office visits. They seem to be making a comeback, but I wonder if they’ll only work for the wealthy who don’t care about price.

Side Note: I just saw that Uber finally came to Las Vegas. That means you can try them out if you ever come and visit my beautiful town.