Co-Creation Trends in Online Healthcare

Co-Creation Trends Report

Power to the Patient: Seven Co-Creation Trends in Healthcare

By Edward Prewitt

September 2009

Healthcare reform is always in the news, and never more so today. In fact, many websites have appeared in recent years that make healthcare information more transparent, create dialogue between practitioners and patients (and even among patients), improve access, and reduce the risk of a bad transaction. Collectively, these websites shift both control of and responsibility for healthcare from the experts to the consumer.

1. Drinking from the health information fire hose

In the not-too-distant past, specialized knowledge about healthcare and medicine was limited largely to specialists. Today, however, anyone can quickly find massive amounts of medical information online at no cost. Hospitals, doctors, insurers, government agencies, for-profit companies, and private individuals all maintain healthcare websites. A website information company lists over 59,000 websites on health. Of the top 10, four are published by the federal government (the National Institutes of Health and the Centers for Disease Control), two are from a private medical information company (WebMD), two are portals drawing from multiple sources (Yahoo Health and Drugs.com), one is from a pharmacy (Walgreens), and one is from a healthcare practice (the Mayo Clinic). Frankly, the challenge for non-experts today is to wade through the thousands of Web pages and separate the useful information from the irrelevant.

To take one example, WebMD.com draws 17 million visitors per month, on average. Part of its appeal lies in the way the free site sorts health information in many different ways; WebMD.com is particularly known for its in-depth A-to-Z guides on diseases, symptoms, medications, and other topics. Site visitors can use a Symptom Checker to investigate their own possible medical conditions, and from there are guided to information on over 30,000 pharmaceuticals. Popular topics and current news stories are featured, and there is a special focus on four high-interest areas: healthy living, health eating and diet, parenting and pregnancy, and mental health. The guides and summaries are compiled by a full-time staff comprising physicians, nurses, and medical journalists, except for certain overviews that are provided by pharmaceutical companies and other advertisers (which provide the bulk of WebMD.com’s revenues).

On WebMD.com’s SymptomChecker, you can find out more about that nagging ache. Just click on an area of the body diagram (a), find your symptom from a long list (b), and read all about the possible conditions (c). (Warning: it may be more than you really wanted to know.)

(a)

(b)

(c)

2. Tiptoeing toward co-creation: community members diagnose and support one another

As would be expected, many healthcare websites incorporate social media to allow two-way communications. For instance, MedHelp.org, which receives 7.5 million visitors per month, bills itself as “the world’s largest health community.” The site is built around 186 “medical support communities” on a dizzying range of topics. The discussions by registered members on these forums are wide-ranging, and people share their experience and expertise freely. One blogger wrote, “Is your doctor not listening to you? Do the words coming out of his mouth make you feel like he’s from another planet? Have no fear, MedHelp is here.” That the commentators on the forums are not experts is beside the point; these exchanges lead to more informed, engaged, and empowered patients.

On the MedHelp.org website, you can find a health forum (a) for just about every medical issue conceivable. Each forum is moderated by volunteers (b), and the discussion threads (c) are often quite extensive.

(a)

(b)

(c)

3. The doctor will see you now online

Patients and medical providers are meeting online, a development that speeds the pace of medical appointments and improves communication on healthcare. RelayHealth, which is owned by the giant medical distributor McKesson Corp., links medical practices and existing patients. RelayHealth sets up Web pages for individual patients, who are encouraged to communicate electronically with their doctors on non-emergency issues. Doctors respond online and have the option of using templated messages, which speed their response. RelayHealth streamlines common patient needs such as appointments, refills, referral requests, and lab results. The patients’ Web pages also contain records of previous visits and can serve as a repository for personal health records. As of June 2008, over 2 million patients were linked via RelayHealth with 16,000 physicians or medical groups. This electronic medium is leading to the co-creation of medicine – patients can use the resources collected on their personal websites to be more informed and active about their own care.

You can have your own healthcare Web page (a) courtesy of RelayHealth. The page stores medical records and enables communications with doctors (b) and medical offices. Doctors reply via a private email (c).

(a)

(b)

(c)

4. Doctors can cure their IT anxiety

According to health information firm Manhattan Research, as of 2009 39 percent of U.S. doctors have communicated online with patients in some way, up from 16 percent in 2004. An online company, American Well, matches people who want an immediate medical opinion with physicians who have registered that they have available time. Patients upload their health history on the site for doctors to see, and then doctors can electronically prescribe medications. Patients can choose to forward the record of the online exchange to their usual medical provider. Doctors get to choose when they want to practice medicine.

Each doctor practicing on American Well has a Web dashboard through which he controls interactions (a). Before a consultation, the doctor can review a patient’s medical records and reason for calling (b). The actual medical visit can take via Web chat, videoconferencing, or phone (c).

(a)

(b)

(c)

5. Those who care carry their own health record

Many medical practices, hospitals, and insurers use electronic medical records (EMRs) to improve the comprehensiveness of healthcare, reduce errors, and lower costs. But EMRs are also useful to another party: the individual patient. Google Health and several other websites allow people to take charge of their own medical records, to which they can choose to grant access. People can use these Personal Health Records (PHRs) to store all their medical records from hospitals, labs, and pharmacies at no cost. They can then view and track their medical history, organize their medications online, and find out how different medications might interact. They can link their PHR to a doctor’s practice and search for other medical professionals.

On Google Health, you begin by creating your own healthcare profile, based on prior medical visits and your self-knowledge (a). All medical records can be stored on the site to create a Personal Health Record (b).

(a)

(b)

6. Patients like us like PatientsLikeMe

On PatientsLikeMe.com, people suffering from chronic diseases co-create with one another to take control of their conditions. Groups on the site self-organize in a series of online communities around chronic medical conditions, such as multiple sclerosis. Tools on the site allow participants to track their symptoms, treatments, and responses over time. Patients’ experience with medications and treatments is aggregated so that individuals can compare their response and see how others are treating similar conditions. Overall efficacy and side effects of medications can be viewed at a glance. Many participants on PatientsLikeMe.com comment that they welcome this deep degree of sharing. The data assists them, caregivers, and doctors with understanding the manifestation of their disease and the proper treatments.

Patients just like you may already have formed a community on PatientsLikeMe.com (a). You can use the site to track the history and severity of your symptoms (b), your treatments, and other health indicators. The site summarizes the use, efficacy, and side effects of treatments (c) so that individuals can compare their own experience.

(a)

(b)

(c)

7. Now doctor, what appears to be your problem?

The Web has been a boon to buyers of all sorts of products and services, who can read about others’ experiences, add their own two cents, and comparison-shop for a better experience and price. Several websites now do the same for medical providers. These sites are compiled by the federal and state governments, private companies, and individuals. RateMDs.com, for example, claims over 800,000 ratings for more than 200,000 doctors across the U.S. You can read comments by individual patients – positive or otherwise – and ratings are summarized for a quick overall view. Just as market transparency enabled by shopping websites has shifted a considerable amount of market power to consumers, patients now have far more insight into the medical process than before.

On RateMDs.com, you can search for a highly rated doctor, see what others say about your doctor, and comment on your own experience (a). The site shows verbatim comments from patients and summarizes theiroverall ratings, whether nice or not (b).

(a)

(b)

Patient-centered online communities and e-health websites are changing the dynamic of health care, by opening up the processes of healthcare to a much greater degree than was previously possible and giving patients the means to co-create their own healthcare with providers. To discuss co-creation trends in healthcare and learn more about ECC Partnership's methodology for enabling co-creation among and between companies and their clients, please contact us.