Last year Americans spent $2.3 trillion on healthcare, according to the latest PriceWaterhouseCoopers’ nationwide survey. The most frightening finding of the report is that $1.2 trillion of this cost is what the survey deems as waste.
The three largest healthcare wastebaskets are inefficient claims processing, costing up to $210 billion annually; “defensive” medical testings, perhaps more legally than treatment-motivated, costing up to $210 billion; and treating preventable conditions resulting from totally avoidable obesity, costing about $200 billion.
While John Phelan might not be able to shrink America’s expanding waistlines, he is making great strides at lessening the other baskets by keeping patients more informed and responsible. CEO of Zweena, an Everett Drive developer of web-based personalized health records, Phelan is representing the consumer’s side at the New Jersey Technology Council’s e-Health Summit, “Future Shock — What’s Next?” This day-long event takes place on Wednesday, May 20, at 8:30 a.m. at the New Jersey Hospital Association’s conference Center on Alexander Road. Cost: $90. Visit www.njtc.org.
Phelan admits to being always driven by an idealistic and practical nature. A native of New York, he earned bachelor’s degrees at Columbia in English literature and economics. Upon graduation Phelan signed up for the Peace Corps, where he worked treating polio victims in Marrakesh, Morrocco. “This was a turning point for me,” says Phelan. “I always knew I wanted to do something with sales and marketing, now I saw myself equally drawn into healthcare.
Blending these two callings, Phelan joined Squibb Pharmaceuticals, selling a wide range of medicines. When Squibb partnered with Novo (soon to become Novo Nordisk) Phelan took the Midwest territory, quickly rising to No. 2 salesperson in the company. Moving to Weyth Pharmaceuticals, Phelan handled the burgeoning field of managed-care sales.
Then in 2005 Phelan began experiencing the healthcare system as a user. Following several family illnesses, he sought comprehensive medical records for his children. None were available. With all the medical paperwork, billing, and transcribing, no provision had been made to keep any continuing record for any individual patient.
The following year Phelan launched Zweena — a name chosen from the Morroccan, meaning beautiful child. His company collects all the lifelong medical records of each subscriber, keeps it instantly updated, and places it online for patient viewing, 24/7.
“The real problem with this nation’s healthcare,” says Phelan, “is that the system is built on consumption, not healing.” Healthcare providers tally the tests and treatments, always with an eye toward either reimbursement or legality.
The only commonly used medical codes are reimbursement codes: Patient No. 74A gets three billable X-rays. Were all the proper tests and treatments administered according to medical (and legal) standard protocol? Necessary as these records are, Phelan asks, “Where is the patient in all this?”
Patients adrift. It is an unintentional conspiracy, but the patient is encouraged from every direction to take his health and healthcare passively. During his wife’s recent operation, through all the physician and anesthesiologist and nurse interviews, Phelan kept asking how much did each procedure cost. No one had any idea.
The system is arranged so that employers, government, and/or insurance companies handle all the expenses. One more test or treatment series is accepted resignedly. “People give more thought to selecting their cell phone plan, than their health care plans, because they have no skin in the game,” Phelan says.
Likewise, the physicians, hospitals, and care providers react to this lack of involvement by leaving the patient out of the loop. They have established an information flow where insurance claim adjusters learn more and sooner about a patient’s condition than the patient himself.
Lack of continuity. “When was the last time you had lab work done?” asks the physician. You don’t remember. It was some time about six or 18 months ago, you think. So off you go for another round of tests. Physicians are required by law to keep patient records for only seven years. But patients, switch doctors, go to different hospitals, and records become scattered.
“The greatest culprits are the emergency rooms,” says Phelan. “They don’t communicate their treatments or findings to the general hospital records.” Typically patients must begin explaining their treatments, as best as they can recall, all over again when admitted to a room. Thus, even the most willing and transparent single healthcare provider will not have the long, complete span of health history required by individuals seeking medical diagnosis.
Patients empowered. Amidst all this, a groundswell has been forming. Patients are increasingly demanding accessibility to medical advice and to their own histories. “After pornography, healthcare questions mark the greatest reasons for people searching the web,” states Phelan. WebMD receives over 100,000 hits per day.
“The technology is already here. It simply is not being used,” says Phelan. “Why can’t people E-mail their doctors for simple, quick advice?” The answer seems more cultural, than technological. Yes, doctors are up to their eyeballs in appointments. But many are insisting that these face-to-face appointments could be cut drastically, if they could receive an online answer to their medical queries.
Further, Zweena’s not-overly-sophisticated technology stands as proof that full medical histories can be gathered and made accessible for patient, physician, and hospital referral. With such histories, the savings begin. Lab results, current medications, and previous conditions may be viewed by the diagnosing provider.
The other kick to the medical wastebasket comes in the form of preventive warnings. Upon turning 50, the male online subscriber could receive an E-blast telling him that a colonoscopy and prostate checkup are in order. Diseases may be caught and treated earlier.
The time for individuals to take a hand in their own healthcare is long overdue. Just as necessary is the linking with physicians and other medical providers. Zweena offers an excellent service for patients seeking a full medical history, but there is no real reason why primary care physicians cannot develop their own programs. They can send out E-mail precautions and accept E-mail queries like any other busy business person.