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The Patient-Centered Medical Home and Health 2.0 Beyond the Bricks. MEDICAL. Jane Sarasohn-Kahn, MA, MHSA THINK-Health and Health Populi blog AHRQ 2009 Conference, Bethesda, MD September 15, 2009. THINK-Health. Roadmap – PCMH & Health 2.0 Beyond the Bricks.

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The Patient-Centered Medical Home and Health 2.0Beyond the Bricks


Jane Sarasohn-Kahn, MA, MHSA

THINK-Health and Health Populi blog

AHRQ 2009 Conference, Bethesda, MD

September 15, 2009


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Roadmap – PCMH & Health 2.0Beyond the Bricks

  • Setting the context: What are PCMH and H2.0? What’s driving them? Where are we ‘today?’

  • A view from Dr. Jason Mitchell, AAFP

  • A view from Dr. Michael Barr, ACP

  • Reactions from the panelists

  • Questions, answers, prospects for moving Beyond the Bricks

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Total U.S. Health Spending in 2007= $2.2 trillion

Source: Chronic Disease Overview, Centers for Disease Control and Prevention.

Available at: accessed July 21, 2009.

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“In our country, patients are the most under-

utilized resource, and they have the most at stake.

They want to be involved and they can be involved.

Their participation will lead to better medical

outcomes at lower costs with dramatically higher

patient/customer satisfaction.”

Charles Safran, M.D., President, American Medical Informatics Association

From his testimony before the Subcommittee on Health of the House Committee on Ways and Means


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“It Stresses Me Out Too Much To Think About Health Care and Costs”

% of Americans

Source: CIGNA, learn4yourhealth survey, conducted July 2009, published September 2009

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Why We Don’t Get Preventive Care in the U.S. and Costs”

Source: Fixing Health Care: What Women Want, AAFP survey, May 2008

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Americans’ Health-Responses to the Economic Downturn and Costs”August 2009In the past 12 months, have you or another family member living in your household…because of the COST?

Source: Kaiser Family Foundation Health Tracking Poll, August 2009

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The Patient-Centered Medical Home and Costs”Definitions

  • “An approach to providing comprehensive primary care that facilitates partnerships between individual patients, their personal physicians, and the patient’s family”

  • It started with kids in 1967: first introduced by American Academy of Pediatrics in 1967, expanded in 1992 and 2002.

Source: American Academy of Family Physicians, American Academy of Pediatrics, American College of

Physicians, and American Osteopathic Association. Joint principles of the patient-centered medical home, 2007.

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The Patient-Centered Medical Home and Costs”Drivers

  • Enhance access

  • Build on consumer-driven health and patient satisfaction

  • Activate patient engagement and whole-person care

  • Rationalize and coordinate health care processes and utilization

  • Improve outcomes.

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Health 2.0 and Costs”Definitions

  • "The use of social software and IT-based tools to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health.”1

  • "New concept of health care wherein all the constituents (patients, physicians, providers, and payers) focus on health care value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.”2

Source: 1Wisdom of Patients, Jane Sarasohn-Kahn, California HealthCare Foundation, 2009.

2Scott Shreeve, The Enabling Technologies and Reform Initiatives for Next Generation Health Care, 2007.

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Health 2.0 and Costs”Drivers

  • Ubiquitous Internet connectivity among health citizens

  • Universal adoption of mobile phones and  use of smart phones

  • > access to health information online

  • > social networking online overall; health has followed other consumer verticals

  • > consumer-directed care: >OOP costs drive engagement

  • > “DIY” care (esp. in recession – remember KFF tracking poll data).

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Patients See and Costs”Conversations with Docs Will Become More Important

Along with Personal and Health Expert Channels

Health companies’ Web sites

TV News coverage

Articles in magazines

Web sites for specific brands of medication

Films or documentaries

Online message boards, forums or newsgroups

Articles in newspapers

Net becoming more important

Net becoming less important

Radio news coverage

Personal blogs

Social networking websites

Web-based video sharing sites

Corporate and product advertising

Source: Edelman Health Engagement Barometer, October 2008.

Accessed at


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The promise of moving beyond the institution for health care and Costs”

  • Achieving optimal health outcomes is a team sport; patient as engaged player

  • Enabling technologies are in place: broadband, mobile (mHealth), Internet

  • Local markets forging ahead…pioneers…

    • Innovating payment: Kaiser, Geisinger, etc.

    • Innovating care delivery: Center for Connected Health Cleveland Clinic

  • The emergence of participatory health care…

  • Let’s listen…

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Jane Sarasohn-Kahn, MA (Econ.), MHSA and Costs”

Health Economist and Management Consultant


[email protected] Blog