Small steps toward a better world

by on March 16, 2010 at 2:55 pm in Medicine | Permalink

In Hawaii, Kaiser Permanente has started a pilot project that churn through its database of patient data to predict which patients might need which tests – and then sends individuals email alerts suggesting they come in for a test or checkup. It's the same sort of technology that Netflix uses to recommend movies. And the Cleveland Clinic has teamed up with Microsoft to bring self-monitoring tools to patients managing chronic diseases, successfully engaging them in better health behaviors without expensive visits to the hospital.

Here is more, via Steve Silberman.  How much of the health care cost-saving revolution will occur in the hands of the individual patient?

1 Ted Craig March 16, 2010 at 3:22 pm

The biggest hurdle, in my experience, is doctors wants to CYA and discourage self-monitoring. Equipment manufacturers promote it.

2 John Mansfield March 16, 2010 at 4:48 pm

I have a hard time imagining an e-mail sent by KP’s computer getting much more attention than a spam ad.

3 Adam Hyland March 16, 2010 at 5:30 pm


What part of that statement clashed with mine? Just pointing out that Hawaii has the same basic plan (more, actually) that HCR is bent toward and yet innovation continues. Obviously KP isn’t based in Hawaii–for reasons beyond regulation. And you are right. It is one thing to argue in favor of nationalized health care. Good thing no one in this thread is doing that.

4 Lourdes Q. March 16, 2010 at 7:15 pm

Going through patients’ data and emailing them about tests they might need. Wouldn’t that be a violation of patient’s privacy, especially if the patients have already been discharged from the hospital and are not currently seeking any medical attention? Besides just because KP emails individual patients does not mean that these patients would respond and take the suggested test. If the tests were covered by the patient’s health insurance then there might be a slight probability that they would follow KP’s suggestions. However, if it is not covered then I doubt the patient would come in and take the test. I think that this is just similar with what doctors do when a patient walks in for a check up, every possible test that can be done for the patient that is covered by health insurance will be done even though it is unnecessary. This is just another way hospitals can get more money from their patients.

5 shecky March 17, 2010 at 3:06 am

Lourdes Q: How is it a violation of privacy if your doc emails you (or calls, or writes) about your health matters? Unless you feel your privacy is violated by the very act of having a doctor, voluntarily informed of your medical condition by yourself.

Also, it seems unlikely that KP will suggest a test that it does not cover. Here in So CA, they do just about everything in house as part of the plan. A test or procedure they don’t cover seems likely to be a test or procedure they don’t even offer. There just doesn’t seem to be many things they offer that are not on the plan. And the things they’ll do that are not part of the plan, like elective non-reconstructive cosmetic surgery, are also probably not the things they’ll recommend via email.

I suppose an email program might filter a KP email as spam. But it seems unlikely, as they regularly use email to communicate with patients. It’s a system the user has to sign up to use. My guess is that such notifications would come from your doctor via KP’s system. So, yes, you’d have to unblock KP’s address, if it’s blocked by default. This doesn’t seem like rocket science, or is there an actual issue being brought up here?

6 DOuglas2 March 17, 2010 at 10:31 am

I’m sure that things have changed mightily since I left the US in ’91, but at that time KP was my insurer, my doctor’s office, the ER I should go to if the situation allowed, and the hospital.
I don’t think I would have viewed the above program as any imposition. I probably would have valued it — because the KP medical offices were such an assembly line operation, I felt really bad going in for things that were not immediate issues but worried me anyway, such as new moles. The doctor’s office inviting me to come in for something that probably isn’t important but might be? What a nice change.

7 Andrew March 18, 2010 at 1:41 pm

Just saw this come in about that pillar of equality, Hawaii.

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