Tuesday, January 6, 2015

Protecting the Wealth of Your Health

How much is your life worth?  Of course, it is priceless.  But economists actually monetize it at more than $70 thousand per year of life.  At birth, we are given the gift of life which, for a person born in 2012, amounts to 79 years and a lifetime value of $5.5 million.  For 99.9% of us, it is the most important asset we will ever have. 

Unfortunately, the American way of producing a long and healthy life is failing.  Abundant research indicates that the U.S. ranks 28th out of 34 OECD countries in producing a long life as measured by years of life lost due to premature mortality.  When compared to countries with the lowest premature mortality rates, Americans lose 36 million years of life every year.  The years of life lost have a value of $2.6 trillion which is nearly equivalent to annual health care expenditures of $2.8 trillion.  The fact is that producing a long and healthy life and capitalizing on our lifetime worth is not on any organization’s mission statement but our own.

The health care system is focused on sickness, not health; on services, not outcomes; on medicine, not on prevention or social determinants of health.  Public health program budgets have been slashed and programs tend to focus on the emergent, e.g. one ebola death in the U.S, but not on the important, e.g. over a million deaths attributed to lifestyle behaviors.  Government attempts to improve health through social programs are beaten down with socialist rhetoric and contempt for redistributing wealth.  And, food, alcohol, tobacco and marketing companies seduce us with tasty but very harmful foods, play to our hopes through advertising, and keep us coming back for more by getting us addicted.

It’s up to us.  Research shows that our own behaviors are far more consequential in determining our healthy longevity than the actions taken by others on our behalf.  Indeed five behaviors of everyday life account for almost two-thirds of the loss of healthy years of life.  These behaviors include eating poorly, smoking tobacco, drinking alcohol, exercising too little, and not taking medications.   

Doctors, governments and a burgeoning self-help industry exhort people to change these behaviors and have achieved a modest degree of success, but there is still a yawning gap as evidenced by the numbers above.   The missing piece is that people have not invested in their health asset for a variety of very understandable reasons.

But, this is changing.  People are breaking free of the medical paternalism that breeds dependence.  More information has been liberated for their use and technologies make it more accessible and sharable.  With the large increase in out-of-pocket financial exposure due to the new generation of health insurance plans with astonishingly high deductibles, people are more vigilant about the value of health care.  And people want convenience, eschew encumbrances, and believe in themselves to do many of the tasks previously owned by professionals in many aspects of their lives. 

They are also being equipped to be more self-reliant.  People are going to box stores like Walmart and health stores like CVS Health to receive “retail” clinic care for common ailments.   It is equivalent, quicker, more convenient, and cheaper.  And while in these stores they see an expanding display of high quality products they can use to take care of themselves.  I call these products SOPrDiMoCa, an acronym that stands for Self-Oriented Prevention, Diagnosis, Monitoring, and Care.  These tools include self-administered diagnostic tests previously controlled by doctors and labs, self-monitoring devices and coaching software to control glucose and blood pressure, smartphone apps and sensors to maintain healthy behaviors, and more.

Technology can play a strong role in bringing about this person-centered health movement by perfecting better analytics designed for people.  The business model has to change, however, from making us click to generate advertising revenues to understanding what makes us tick in order to make behavior change stick.  For example, it can produce wise information to know the individual better than she knows herself thereby providing fresh insights. It can develop “digital hugs” in order to engage the individual emotionally because that is so important for change.  And it can provide ongoing, smart coaching to help people master barriers and achieve goals. 

Investing in our health asset is fundamental to a long and healthy life.  Herophilos, a Greek physician from 335 B.C. said, “When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.”  The surest way to reap the benefits from our birth asset is to stay healthy and manage the five behaviors of everyday life.  Increasingly, people are grabbing the baton, others are welcoming them as true partners in health, and powerful tools are emerging to equip them to be successful.  

Using Person Centered Analytics to Live Longer:  Leveraging Engagement, Behavior Change and Technology for a Healthier Life
By Dwight McNeill, PhD, MPH

Using Person Centered Analytics to Live Longer is about empowering and equipping people to take a more active role in mastering five behaviors of everyday life that cause and perpetuate most chronic illnesses. 

It is three books in one.  It provides:
-A framework for understanding why person-centered health analytics is important by describing five convergent realities:  The American way of producing health is failing, people are the drivers for improving health, converging trends demand a person-centered orientation, everyday behavior changes are the interventions that matter, and analytics provides new insights to catalyze it. 
-A toolkit for people that includes information, tools, and a quick reference guides to links that people can use on their own. 
-An opportunities guidebook for stakeholders to understand person-centered health from the person’s perspective, describes how analytics can contribute, and what actions they can take to support it. 

It is different from other books.  It goes beyond a call for action and provides tools and resources.

It describes a new generation of analytics for health.   It diverges from the usual health care analytics that focus on business intelligence for the two Ps (providers and payers) by zeroing in on the health needs of the forgotten P, people.  It is not about worshiping the art of the possible of information technology; it’s about putting analytics to work to engage people to achieve their health destiny.

The defining elements of person-centered health analytics (pchA) are:     
pc:  The focus on the person in terms of what really matters (healthy years of life) and the means to achieve it (personal behavior change). 
      h:  The focus on health that covers the continuum from wellness to sickness and places a priority on well-being and prevention. 
      A:  The focus on capturing and integrating a wide variety of health data and using connected devices, advanced computing, and social networks. 

It is published by FT Press with a release date of April 2015.  For more information on the author, Dwight McNeill, please see his author page.