Accountable Care Organization (ACO), 16, 23
Accreditation Council for Graduate Medical Education, 107
ACO. See Accountable Care Organization
admission-discharge-transfer (ADT), 152
Affordable Care Act (ACA), xix, 35, 201
health insurance and, 5
history of, 37
impact on healthcare choices, xvii
aging consumers
technology and, 172–173
transformation tips, 174
AirBNB, 95
algorithms, 192–193
Allscripts, 27
AMA. See American Medical Association
Amazon, 177
American Medical Association (AMA), 36, 205
American Recovery and Reinvestment Act (ARRA), 20
American Well, 74
American Well 2015 Telehealth survey, 82
Anthem, 160
Anthem Blue Cross, 39
Application Programmatic Interfaces (APIs), 20, 118
Argonaut Project, 26
ARRA. See American Recovery and Reinvestment Act
athenahealth, 27
AT&T, 106
attacks, big data, 177–178
Baby Boomers, 165
Bennett, Russ, 105
big data
3Vs of, 176
attacks, 177–178
definition of, 175–176
in healthcare, 177
used in industries, 177
Big Data (Mayer-Schönberger and Cukier), 176
Blue Shield of California, 39
Brown, Jerry, 61
California Healthcare Foundation (CHCF), 150
cancer, 196
cardiopulmonary resuscitation (CPR), 173
Carequality, 27
case studies
health information exchanges (HIEs), 157–158
health insurance, 52, 54–55
PSRO, 134
technology, 170, 171
transformation of healthcare, 9–10
Castlight, 7
Centers for Disease Control and Prevention (CDC) Statistics & Surveillance, 106
Centers for Medicare and Medicaid services (CMS), 17, 59, 138
Cerner, 23, 27
Chan, Eddie, 106
CHCF. See California Healthcare Foundation
Chino Valley Medical Center in Chino, 31
CHINs. See Community Health Information Networks
CJR model. See Comprehensive Care for Joint Replacement model
Clearhealthcosts.com, 136–137
CMS. See Centers for Medicare and Medicaid services
CMS Compare (website), 141
CommonWell Health Alliance, 27
communication, 117–131
curating and controversy, 121–122
engagement with doctor and, 120–121
information and, 121–122
multiplechannels for, 129–130
patient engagement and, 117–119, 167
patient portal (website), 129–130
physician-patient interactions, 119–123
social media, 123–127
text and e-mail, 127–128
transformation tips, 122–123
Community Health Information Networks (CHINs), 151
community-level HIEs, 159
Comprehensive Care for Joint Replacement (CJR) model, 138
consumer diversity, 103–107
consumer engagement
hyperdata, reasons to harness, 182–183
consumerism’s rise, 1
consumer operated and oriented plans (CO-OP) program, xx
consumer profiles, new, 100–102
changeling, 101–102
indifferent, 102
progressive, 101
tips for using, 102–103
Consumer Reports (website), 140–141
consumer’s profile, changing, 3–6
age, 4
children under 18, 4
health status, 4
insurance coverage, 4
parental age, 4– 5
correlations, data, 190–191
Covered California, 61
CPSI, 27
Cukier, Kenneth, 176
customer satisfaction, 108
customer satisfaction research, 180
cyberattacks, 30–33
cybersecurity risks, 32–33
data
blocking, 150
collection, 104
correlations, 190–191
David’s versus Goliath’s, 184–187
de-identification of, 161
digital healthcare, 175
hyperdata and analytics, 194
making meaningful, 180–181
ownership, 193–194
reasons to harness hyperdata, 181–184
security and integrity, 150
security, 193–194
sensitivity, 150
super-sized, 175–177
David’s data versus Goliath’s data, 184–187
Department of Health and Human Services (HHS), 79, 133
Desert Valley Hospital of Victorville, 31
digital healthcare data, 175
super-sized data, 175–177
Doctor on Demand, 74
doctor-patient relationship, 109
do-it-yourself (DIY) health for future, 202–204
eBay, 160
eHealth Exchange, 26
EHRs. See electronic healthcare records
EHR Incentive Program, 103
EHR Meaningful Use Incentive program, 103
electronic bedside manner, 119–120
electronic healthcare records (EHRs), 20–23
adoption of, 151
application programming interface (API), 118
consumers trust with, 94–95
cyberattacks and, 30–33
cybersecurity risks and, 32–33
functionality and features in, 94
Incentive Program payments, 22–23
interoperability, 23–26
meaningful use, defined, 21
meaningful users, 21–22
online access to, 94–95
physician bedside manner, 119–120
rise of, 94–95
significant value in, 94
switching from paper to, 20–23
communication, 127–128
security, 128
exabytes (1018), 176
Facebook, 161
Fast Healthcare Interoperability Resource (FHIR), 20, 27–28, 118
FDA. See Food and Drug Administration
Federal Communication Commission (FCC), 79
Federal Trade Commission (FTC), 79
FHIR. See Fast Healthcare Interoperability Resource
Fitbits, 178
Flexible Savings Account (FSA), 76
flow of information, 29–30
consumer access, 29–30
no information blocking, 30
standards, 30
Food and Drug Administration (FDA), 60, 79
FSA. See Flexible Savings Account
FTC. See Federal Trade Commission
GAO. See Government Accountability Office
Gene2Gene, 111
Generic Pharmaceutical Association, 61
gigabytes (109), 176
Google, 177
Government Accountability Office (GAO), 5, 25
Greenway, 27
GrubHub, 95
Guroo (website), 137
HCCI. See Health Care Cost Institute
healthcare, transformation of, xx, 1–18
case studies, 9–10
changing with time, 2–3, 15–18
deductible plans, 13–15
drivers of, 1–2
insurance and, 8–13
Patient Bill of Rights, 11–13
shopping for, 6–8
tips, 15
Healthcare Bluebook, 137
Healthcare Consumer Manifesto, 91–92
healthcare consumers
attracting, 96–97
choices and value, 5
communication and, 117–131
cost shifting to, 49–51
guidelines for treating, 108–109
manifesto, 91–92
needs, 47
NEMS story, 105–107
new mindset and behavior, 110–111
newly insured, 47
online rating systems and, 139–145
patient paradigm shifts, 109–114
patient-turned into, 97–102
shopping list, 5– 6
transformation tips, 115–116
understanding new, 92–97
view of health insurance, 45
healthcare delivery, reframing, 65–89
consumer demands, 93
house calls encore, 87–88
less hassle and better care, 67–70
technology-enabled model for primary care, 69–70
traditional concierge-based care, 68–69
speed clinics, 70–74
telehealth, 76–84
traditional primary doctor challenges, 66
transformation tips, 88
transforming, 66–67
virtual care on demand, 74–76
healthcare ecosystem, 114–115
Healthcare.gov, xx, 201
healthcare in 21st century
faxes and, 19
incentives to convert paper records to EHRs, 20–23
healthcare industry
big data in, 177
do-it-yourself (DIY) health for future, 202–204
future of, 201–207
perpetual transformation in, 201
qualitative and quantitative research in, 178–180
healthcare payment model, 8–13
healthcare professionals
electronic black bag, 114–115
healthcare systems, hacking of, 31
healthcare tools, 118
health disparities
action plan for reducing, 103–104
NEMS patients and, 106
Healthgrades (website), 139–140
Health Information Exchange Organizations (HIOs), 151
health information exchanges (HIEs), 147
assessment of state, 153
as the term, 150–151
benefits for, 149
case studies, 157–158
consumers, 154–155
health data security and privacy, 161–163
HITECH Act, 148–150
meaningful use and, 152–153
obstacles for, 149
privacy rule, 159–160
privacy rule and, 159–160
privacy transformation tips, 163
sharing involves risks, 160
survivability and sustainability, 155–158
types of, 159
Health Information Technology for Economic and Clinical Health (HITECH) Act, xix, 1, 8, 21
health insurance
case studies, 52, 54–55
consumer needs, 47–49
consumer’s view of, 45
exchange marketplace plans, 44–47
new consumers, 47
paying for uninsured, 41
premium versus deductible, 46
prescription drugs, cost of, 59–63
problem with, 38–42
quagmire, 51–56
reality of, 35–37
requirements of, 43–44
risks in, 38
self-selection, 39
spending for, 38
Health Insurance Portability and Accountability Act of 1996 (HIPAA), 6
HealthMine, 81
Health Savings Accounts (HSA), 76
health status, 99
Health Tap, 74
Heartland Payment Systems, 160
hepatitis B during pregnancy, 106–107
Hepatitis C drugs, 59–60
HIEs. See health information exchanges
HIPAA
privacy rule, 159–160
violation, 160
Hispanic Americans, 105
HITECH Act, 148–150
Hollywood Presbyterian Medical Center in California, 31
hyperdata, 2
hyperdata,
reasons to harness, 181–184
advancing population health, 183–184
consumer engagement, 182–183
internet of things (IoT), 182
potential for precision medicine, 183
reducing cost of healthcare, 183
IBM’s Watson computer, 113, 177
Information. See also health information exchanges
and communication, 121–122
flow of, 29–30
health data security and privacy, 161–163
instant communication, 2
insurance and healthcare, 8–13. See also health insurance
insured consumers, 99
insurers, ACA and, 56–58
internet of things (IoT), 182
internet review, 124–125
interoperability, 23–26, 150
government’s big bang for, 29–32
infrastructure, creating, 28–32
standardization to, 29
investment in social media, 126
Kaiser, 39, 59, 62, 78
e-mail system in, 128
King v. Burwell, xix
kiosks, 72–73
Kudzu, 125
Latino Solutions, 105
Leapfrog Group, The (website), 139
Lee, Tom, 69–70
Madara, James L., 205
Manhattan’s Lenox Hill Hospital, 31
marketing return on investment analysis (MROI), 179–180
Mayer-Schönberger, Viktor, 176
McGregor, Carolyn, 189–190
McKesson, 27
MD Live, 74
Medicaid, 8, 22, 35
medical apps for Android, 86
Medi-Cal insurance program, 62
medical tourism, 112–113
Medicare, 8, 22, 35
mHealth = mobile, masses, motivated, 84–87
mobile health (mHealth), 78
National Business Group on Health survey (2015), 81
National Institutes of Health (NIH), 196
National Labor Relations Board, 36
Nationwide Health Information Network (NHIN), 26
NEMS. See North East Medical Services
Netflix, 161
NextGen, 23
NHIN. See Nationwide Health Information Network
NIH. See National Institutes of Health
nonemergency care, 73
North East Medical Services (NEMS), 105–107
ObamaCare. See Affordable Care Act (ACA)
Office National Coordinator (ONC), 10
Office of Civil Rights (OCR), 10
Office of the National Coordinator for Health Information Technology (ONC), 20, 147
on-demand services, 1
characteristics of, 97
popularity of, 97
One Medical, 69–70
online rating systems
quality and cost, 141–143
transformation tips, 145
transparency in, 139–145
online shopping, 7
Oration, 8
Pacific Business Group on Health (PBGH), 14
patient-centered care, 94–95
patient connection with social media, 125–126
patient engagement, 99–100, 117
CMS requirements for, 118–119
communication and, 167
meaningful use (MU) requires, 118–119
patient paradigm shifts, 109–114
demands, 111–112
new mindset and behavior, 110–111
next generation models, 113–114
patient portal (website)
communication through, 129–130
transformation tips, 130
Patients Like Me (website), 125
patient-turned to healthcare consumers
consumer profiles, 100–102
consumers activism, 98–99
consumers connected online, 98
health status, 99
insured consumers, 99
level of income, 100
patient engagement, 99–100
value-oriented consumers, 98
PBGH. See Pacific Business Group on Health
perpetual transformation, 201
Physician Orders for Life-Sustaining Treatment (POLST), 173
physician-patient interactions, 119–123
POLST. See Physician Orders for Life-Sustaining Treatment
Post-Affordable Care Act, xvii
Pre-Affordable Care Act, xvii
precision medicine, 111
future of, 197–199
initiative, 195–197
new path, 195
objectives of, 196–197
potential for, 183
privacy protections, 196–197
public-private partnerships, 197
regulatory modernization, 197
transition tips, 199
predictive analytics, 2
basics, 188–189
moving from universals to individuals, 191–193
success of, 193
technology and, 187
transformation tips, 194
preferred-provider-organization (PPO) plans, 57
prescription drugs, price of, 59–63
price of prescription drugs, 59–63
price transparency, 137–141
primary care physician
behavior modification in, 143–144
educating patients, 121
resetting mindset about old, 169–172
Prime Healthcare Services, Inc., 31
proactive consumer, 98–99
Professional Standards Review Organizations (PSROs), 134
ProPublica (website), 140
protected health information (PHI), 31
PSROs. See Professional Standards Review Organizations
public-private partnerships, 197
Qualitative/quantitative research, 178–180
quantitative tools
discrete choice analysis, 179
marketing return on investment analysis (MROI), 179–180
reactive consumer, 98–99
Regional Health Information Organizations (RHIOs), 151
remote patient monitoring (RPM), 78
research
customer satisfaction, 180
qualitative/quantitative, 178–180
segmentation, 180
ResearchKit, 199
RHIOs. See Regional Health Information Organizations
risks
cybersecurity, 32–33
in health insurance, 38
in sharing data and personal information, 160
RPM. See remote patient monitoring
Santa Barbara Care Data Exchange (SBCDE), 150
Savage, Mark, 103
SBCDE. See Santa Barbara Care Data Exchange
security, e-mail, 128
segmentation research, 180
self-selection, 39
Sequoia Project, 26
smartphones, 95, 104
social media
communication, 123–127
as friend, 126–127
internet review, 125
investment in, 126
patient connection, 125–126
transformation tips, 127
Sony, 160
speed clinics, 70–74
advantages of, 73–74
importance of, 74
types
kiosks, 72–73
shared retail clinics, 71–72
Stabilization Act, 36
State HIE Cooperative Agreement Programs, 151
state-level HIEs, 159
statistical methods, 187–188
Sunquest, 27
super-sized data, 175–177
team’s electronic black bag, 114–115
technology
case studies, 170, 171
design and usability of, 103
enabled model for primary care, 69–70
monitoring, 167–169
old folks and, 166–167
predictive analytics uses, 187
resetting mindset about old, 169–172
special care and, 173–174
support, 172–173
Teladoc, 8, 74
telehealth, 76–84
defined, 77
downsides and upsides of, 80–82
future of, 83–84
telemedicine
modalities of, 77–78
payment and, 79–80
terabytes (1012), 176
Text4Baby (app), 127
texting, 127–128
Thomas Jefferson University Hospitals (Amwell), 76
T.J. Maxx, 160
traditional concierge-based care, 68–69
transformation tips
aging consumers, 174
communicating with patients, 122–123
consumer focused healthcare, 56
cybersecurity risks, 32–33
for insurers to reduce costs, 58
online rating systems, 145
patient portals, 130
predictive analytics, 194
precision medicine, 199
privacy, 163
providers attracting new consumers, 15
reducing price of prescription drugs, 63
social media, 127
telehealth, 88
on transparency, 145
transparency in healthcare, 133–145
finding provider scores and star ratings, 139–141
lack of, 135–137
price, 137–141
PSROs and, 134
quality and cost, 143–145
23andMe, 111
Uber, 95
UCLA (LiveHealthOnline), 76
UHClatino.com, 105
uninsured
characteristics of, 41–42
paying for, 41
UnitedHealthcare, 105
University of Arizona Health Network, 23
University of Missouri, 165
University of Ontario, 189
University of Texas, 161
U.S. Department of Veterans Affairs, 62
value-oriented consumers, 98
variety, 176
velocity, 176
veracity, 176
videoconferencing, 78
virtual care on demand, 74–76
benefits of, 75
insights, 76
virtual health visits, 81–82
volume, 176
Wall Street Journal, 15
Walmart, 72
website
CMS Compare, 141
Consumer Reports, 140–141
Healthgrades, 139–140
Leapfrog Group, The, 139
ProPublica, 140
Yelp, 141
www.cahealthcarecompare.org, 135–136
Yelp (website), 125, 141
yottabytes (1024), 176
zettabytes (1021), 176