The Rise of Patient-Centered Healthcare: An Interview with Reed Tuckson, MD

Dr. Reed Tuckson is Executive Vice President and Chief of Medical Affairs for UnitedHealth Group. A leading voice in healthcare issues throughout his career, Dr. Tuckson has overseen the work of more than 10,000 clinical personnel, gaining a national perspective on the health issues of the 70 million people served by UnitedHealthcare since joining UnitedHealth Group in 2000.  We caught up with Dr. Tuckson on the heels of his keynote at the Digital Health Summit.

Watch Rock Health companies as they demo at the UnitedHealth Group booth today at 3 pm.  Directions here.

What are some examples of ways that UnitedHealth has innovated on the patient and provider side?

Dr. Reed Tuckson: UnitedHealth Group has driven innovation on the patient and provider side in countless ways in recent years. One example of how we are leading the industry is in the emerging trend of the “gamification of health,” which uses video games to engage people in physical activity. This phenomenon shows particular promise in terms of combatting our national childhood obesity epidemic. UnitedHealth Group will be returning to the Consumer Electronics Show in Las Vegas this year with some exciting news related to gamification—so watch this space!

Another very important health care innovation for patients is the growing availability and sophistication of health care cost calculators and estimators. These tools help people better understand their entire treatment “care paths” and the costs associated with their treatment options to empower them to make well-informed decisions that are tailored to their personal needs. This is the very definition of the term “consumerism,” or the ability of consumers to become more actively involved in making their own health care decisions.

UnitedHealthcare’s tool—myHealthcare Cost Estimator—brings the ease and simplicity of retail-like “comparison shopping” to health care. It provides quality, as well as cost and education resources all in one easy-to-use online service. It’s the latest example of how UnitedHealthcare is using technology to advance transparency—and simplicity—in health care.

What are your predictions for the future of consumer health?  How will this affect the marketplace for payors?

One of the biggest trends that’s sure to impact the future of consumer health is our nation’s aging population. About 10,000 American baby boomers are turning 65 each day, which means that the health of a new generation of senior citizens will become a critical issue for the nation. In 2008, almost one third—or nearly $370 billion—of total health care expenditures were spent on care and treatment of the elderly.

The confluence of several factors—an aging population, rising costs, an expected dearth of primary care physicians, and millions more consumers soon to enter the health care marketplace because of reform—makes it a necessity for the industry to find ways to innovate in practical, scalable ways.

Last year, I wrote a book called The Doctor in the Mirror, intended to be something of a common-sense guide to everyday health issues for older Americans. One of the book’s core concepts is how the key to much of one’s wellness rests in the hands of the doctor in the mirror — “Dr. You.” The Doctor in the Mirror aims to provide older Americans and their families with information and practical tools to help them recognize the barriers that might stand between them and better health as well as the strategies, ideas, and resources to help them overcome those obstacles.

Our health care system is becoming more patient-centric, meaning the patient is in the middle of all health care activities and working directly with physicians, family members, and others to make major health decisions on his or her own behalf. It’s critical that people get more informed about their health—like knowing one’s personal medical stats like blood pressure levels and cholesterol numbers and whether your doctor, specialist, or surgeon has hospital admitting privileges. That warhorse expression is true: knowledge is power, and nowhere more so than when it comes to a person’s health.

Similarly, how has the digital health movement and increase in mobile penetration changed your business model?

One of the powerful ideas that underscores our third consecutive presence at CES this year is how we’re able to demonstrate that the future of health care really does exist in people’s hands today in the form of popular technologies that they already enjoy using. The digital health movement and increase in mobile penetration empowers people to become more educated about and engaged with their personal health than ever before. These advances are all about ease-of-use and engagement and speaking to consumers where they live, breathe, work, and play.

Mobile apps that focus on health allow many tech-savvy consumers to do practically anything online: find a doctor or hospital, check the status of claims, monitor their fitness, and/or track their food intake. . For example, one of the first-ever “mobile fitness challenge” apps, OptumizeMe allows you to use your smartphone to create your own health and fitness challenges and compete against—or collaborate with—friends and family through Facebook and other social network platforms. Building on the proven idea that community involvement promotes better health, we’re helping people grab a friend and start “Optumizing” their way to running that extra mile or choosing healthier foods.

Another mobile app we’re very proud of that we’ll be showcasing at CES this year is called Health4Me, which enables users to use their GPS location to find care providers, including hospitals, urgent-care centers, and clinics that participate in their health plan’s provider network. It also allows users to ask questions about their coverage and learn more about their benefits.

In terms of how all of this might be changing our business model, we believe strongly that more engaged, knowledgeable consumers help contribute to better individual health outcomes, lower costs, and the creation of a more efficient health care system.

How do you think physicians can best harness the power of digital innovations so they become an integrated part of clinical care?

From the physician perspective, doctors and health care professionals look to address six core areas where information and technology improve patient care*:

1.      Assisting patients with their treatment decisions at the point of care;

2.      Improving patients’ care by ensuring it is coordinated among multiple care providers;

3.      Tools and support to help them take a broad, more prevention-oriented approach to managing patient populations;

4.      Streamlining practice workflow so they can focus on care provision;

5.      Simplifying reporting and compliance processes; and

6.      Managing claims and reimbursement functions so they can be paid correctly upon first submission of claim information.

All of this invisible back-end technology helps patients in numerous ways, including: enabling the use of data-rich electronic medical records (EMR) that give doctors and other health care professionals a total view of a patient’s health and medical history; identifying potentially dangerous drug interactions and automating alerts to physicians and pharmacists (especially when treating elderly patients who might take multiple medications); and making available and bringing to scale proven, community-based chronic disease prevention and management initiatives like the Diabetes Prevention Program and UnitedHealthcare’s incentive-based Diabetes Health Plan, which help curb our nationwide “diabesity” epidemic and reduce total health care costs.

What is transformed when both patient and doctor embrace advances in digital and consumer tech is the simple, powerful, and eternal exchange at the heart of our health care experience: patient-doctor interaction—from the invaluable 15 minutes we spend with our physicians at their office to the operating room.

How does UnitedHealth partner with entrepreneurs and startups? What are your biggest challenges to achieving successful partnership with small startup organizations?

UnitedHealth Group is proud to partner with businesses as large as Microsoft, non-profits as venerable as the YMCA, and government agencies as authoritative as the CDC in order to bring health care innovations to scale. Within our company, we pride ourselves on having developed an “intra-preneurial,” ground-up model so that good new ideas can flow from those closest to working on the biggest challenges facing the health care industry today. We approach those issues using our vast resources and a nimble approach to innovation that Forbes suggested has “as much energy, enthusiasm and passion as any Silicon Valley startup.”

One avenue with which we’ve had success engaging with entrepreneurs and startups are our regular “Innovation Challenges,” which seek to tap the creativity of those working outside the company and even beyond the health care industry sector to bring fresh concepts and solutions to bear. We see the value in working with these groups—and with regular people who have good ideas about how to improve health care. It’s where real change comes from. We’re working right now on a very exciting project to reach these individuals and organizations and solicit their ideas on how to work together to improve care.

As a leader, how do you encourage a culture of innovation at a large organization?

Our “intrapreneurial” innovation model described above fosters a creative environment that allows UnitedHealth Group to identify, develop, pilot, fund, and broadly distribute products, programs, and services that enable people to live healthier lives while upgrading and strengthening the basic infrastructure of the health care system. Research and development across both parts of our business—UnitedHealthcare (health benefits) and Optum (data-enabled services)—are guided with practical ends in mind, namely: empowering consumers; enabling access to quality care; helping the system work better; and improving affordability.

We were applauded last year for exhibiting at CES—and our very presence at this all-important trade show speaks to our commitment to the applicability of innovation in all its myriad forms. Especially noteworthy was the fact that UnitedHealth Group was the only major health care company to exhibit at CES in any meaningful way. For the third year in a row, we have made CES a fixed date on our calendar because we understand the necessity of fostering a culture of innovation that allows us to connect with consumers in fun and impactful ways.

*Statement of Andrew Slavitt , Chief Executive Officer, Ingenix To the HIT Policy Committee , Hearing on Health Plans , December 15, 2009

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