While there are uncertainties in forecasting what health IT will look like in 2009, one force is already undeniably influencing the health IT market: American consumers.
Health IT has gone mainstream and in 2009, consumers will help decide where exactly it fits in the stream. President-elect Barack Obama has said health IT will be part of a stimulus package to help revive the country's ailing economy. But even without the government's help, 2009 will be a crossroads kind of year for health IT.
In the second half of my annual iHealthBeat end-of-one-year, beginning-of-another look at health IT, we'll examine the consumer drivers shaping the industry.
Health Financing and Medical Banking
In this era of economic downturn, employers continuing to sponsor health insurance for workers are looking for ways to manage costs. This past year saw growth in health savings accounts coupled with high-deductible health plans. These are tools that help employers compel workers to put more financial skin in the game of health coverage. And the consumers who opt into these plans have, in aggregate, serious monies to manage in the funds.
In 2008, HSAs amounted to about $6 billion in the second quarter of 2008, according to Information Strategies. We'll see expansion in medical banking functions that manage this business. Besides UnitedHealth (OptumHealth Bank), WellPoint (Arcus Bank), and the BlueCross and BlueShield Association (Blue Healthcare Bank), other plans will create banks that will be FDIC-insured to manage the HSA balances.
These funds, along with other consumer-facing health monies, will add up to at least $40 billion by 2013.
Telehealth Takes Off
The growth of broadband to the home, consumers' comfort with IT and health providers' need to extend caregiver resources beyond their institutional walls will converge in 2009 for telehealth applications to move into the home. Here's an instance where recession will be the mother of innovation for patient self-care and home care.
Hospitals need to staff even more efficiently during this economic-conservation era. Institutions can add volume without adding significant cost by adopting telehealth approaches to help patients with chronic illnesses avoid entering the hospital.
FDA's approval in 2007 of Intel's health device, the Health Guide, is another market signal that technology is available to provide real-time telemetry from the home to the provider by a major trusted market player. With aligned incentives between provider, payer and patient, the home could begin to become a central node for chronic care in 2009.
Online Search vs. The Doctor
Americans now favor the Internet as the source for health information compared with their doctor, based on Manhattan Research's latest Cybercitizen survey. 2007 was the first year that more consumers went to the Internet for health information than to their doctors.
"We've seen the Internet continue to grow," Manhattan Research's Meredith Abreu-Ressi said, adding, "Consumers are a lot more comfortable than they were in 2002 and are more satisfied with the content they're finding."
The top health portals looking to 2009 will be stalwart WebMD and EverydayHealth, the latter of which gained a lot of momentum in 2008 through its acquisition of RevolutionHealth and content expansion.
What's driving online searching now is consumers increasingly facing growing health care costs and decisions. For example, 40 million people didn't fill their prescriptions in 2008.
A big part of online use is essentially health shopping. Consumers are driven online to ask questions about drug information: A physician might mention a drug by name and a consumer will decide whether filling the script would be 'worth it' based on perceived value, price, and convenience. Another consumer who is in a workplace drug plan might be faced with a formulary decision for a drug that's not on a list, comparing it with an over-the-counter medication.
There's also evidence of consumers' growing interest in researching ratings for prescription drugs online. Key sources for this information are Daily Strength and WebMD as of late 2007.
Getting Engaged!
In times of uncertainty, which is the watchword for 2009, it helps to get informed and engaged. My first recommendation on getting smart is to read Tom Daschle's book, "Critical: What We Can Do About the Health-Care Crisis." If you want to read more, check out David Cutler's "Your Money or Your Life."
These two influential health intellects will inform the Obama health reforms that will be rolled out over several years. Pay-for-performance, value-based health care and clinical effectiveness will be features of a new-and-improved U.S. health system.
But don't just read. In the Obama version of Government 2.0, ideas will be coming from all kinds of places -- from social networks and mothers and kids, from the 50 states and overseas. This is no time for disengagement. In 2009, health IT professionals, policymakers, payers, suppliers and patients especially need to be fully engaged in health, and the empowerment that health information can bring.