Reality Check: From Headlines to Prime Time

Reality Check (rē-ăl’ĭ-tē chĕk) n.

1. An assessment to determine if one’s circumstances or expectations conform to reality.
2. The act of letting a real user try out prototype software.
3. Conversationally, saying “sanity check” means you are requesting a check of your assumptions.

My wife recently notified me that one of my sons was going to need to have bilateral myringotomy with Tympanostomy tube placement. Apparently the persistence of fluide behind his ear drum was beginning to have an impact on his hearing. So, trying to be true to the new paradigm of health, I wanted to see if I could leverage some of the new Health 2.0 consumer tools to help me make better choices about the care that I needed for my family.

So here is what I did:

• Review Indications for Procedure. First thing I did was to review the indications and medical reasoning behind the procedure. In essence, the internet now serves as the virtual second opinion consult, allowing well over 100 million Americans to have access to medical information. I had some advantage with this, given my experience as a physician, but thoutht it was a useful exercise nonetheless. I did searches of Revolution, WEbMD, and of course Wikipedia. The problem with these sites, as with searching in general, is that it is just too much information even for me. I know there are better sites with more simplified information, and as a consumer I would prefer to have a single source of easy to use information. So while I am confident amidst all the health information available that this simple source exists, I have not yet found it (most of the sources I referenced were good enough). It does highlight the ongoing opportunity for health plans to provide this concierge style services to truly help members with their specific health care information needs (I personally had no appetite to deal with the 20-25 minute hold time).

• Review Pricing Information. After getting confirmation about the medical indications and course of therapy, I went to learn more about the pricing of these services. I logged into my HealthEquity account, went right into the consumer tools section which has a procedure price comparison tool by Ingenix. This tool is designed to show me general in/out of network pricing that I should expect. It was unclear to me how or where this information came from, but comparing it to what I was quoted by the surgery center I was able to see that my chosen surgery center was actually slightly lower. Placing a few calls to other local surgery centers confirmed that the pricing was within norms for my area.

• Review Physician and Quality Information. After determining how much the procedure was going to cost me, I worked backward to determine who should perform the procedure (I didn’t realize that I had made a cost first, quality second decision). Since my son already had an established with Dr. Michael Jakobsen, I went right into his physician ratings score available through HealthGrades. This proved to be frustrating as it would cost me $29 to order the full booklet of his information (for a much larger surgery, perhaps this would be worth it). So I went to Blue Cross of CA (found just basic demographic information but no healthcare quality information), Dr.Score (not listed), RateMD’s (not listed), Find Your Doc (not operational), and Dr. Scorecard (not listed) before giving up. While alot of these scoring systems are grabbing headlines, I have yet to find one ready that actually provided me with the information I was looking for.

So . . . mmm . . . there is room for improvement!

Now, my above example is just representative of the type of expected experience as these tools get more and more functional over time. It appears that the health care information is definitely out there but disorganized from the consumers perspective, the pricing information is getting out there, but that the physician quality and outcomes ratings is essentially vaporware at this point.

I am sure as I repeat this experiment, along with millions of other online health consumers, these tools will improve dramatically. But as for now, its “Back to the Lab again, Yo!”