I have no problem with involving patients through the education process at all, the problem is with “scoring” and putting folks on bar charts, “people don’t work that way”.  We’re getting down to what humans do normally and I guess having to actually “score” and document patients now is some of the old methodologies of needing statistics for everything.  Everybody is trying to engage the patient which they should be but when we can’timage function like humans and actually need a score that will be shared with insurance companies, well I guess it goes back to what Google is doing too, a study to “see how people work”…imagine that after years of creating software and bots…something got lost and they can’t figure this one out I guess. 

Furthermore I looked at this and saw not much more than a query and looked at the fact that Roche has licensed it as well.  I wrote more sophisticated queries than this for software and it boggles my mind as to why this simple query procedure and scoring effort needs a patent.  If read further it’s all about the patient feeling confident about changing their behavior and some need to change and some patients are already there.  Truth be known none of us are perfect and we could all change something.  You get to be put into a “category” which kind of reminds me of the Master Card persona thing that they market and will put you into one of those personas…yuk!  My body is tired from being shoved in and out of data bases today, much less being sold all over the place.  When it comes to Master Card just keep the fees and interest low.

I read through it and without having all the details, I looked at it and it kind of reminds me of the “junk science” used today by HR Departments.  There was a good article about that not too long ago and Google has given up some of their junk in the HR Department as it wasn’t working and the article further when on to say that even Steve Jobs if he were still with us would have a hard time passing some of the “junk type tests” that Apple has or had.

Thank goodness there were a couple doctors in this article that were not taken away with all of this too and they used medical records to remind patients with visits and follow up (which where the information should come from) and a doctor from Kaiser chimed in and said use methodologies known to motivate patients.  Those two made sense as teachers start in grade school figuring out how to motivate kids except now we are pondering the adults in the same vane.

You can read the insurer involvement below and to me this is like fork of the the FICO medication adherence program to where they use your credit scores and other data to “score”you again if you will be medication adherent.  Insurance companies buy this stuff and then they sell it in some form or another. 

FICO Analytics Press Release Marketing Credit Scoring Algorithms to Predict Medication Adherence–Update (Opinion)

Ok so now the insurance company bought your FICO score medication adherence data and guess what it’s query time.  Are they going to take this PAM score and query it with the FICO score too now?  FICO finally had to buy a revenue cycling business so they looked more like they could fit in with healthcare I think:)

Well guess what the end result of this just might be the doctor having to help you work on your FICO credit score next so you can be medication compliant and figure out how engaged you are, right (grin).  Don’t laugh, an MD told me on Twitter today it wouldn’t surprise him in the least to see this rationalization take place. 

Like I said a while back in agreeing with a banker, half of the analytics produced will be a waste of investment so someone can make a buck.  There’s query monsters out there all over the place and I used to be one of them.  Let me tell you when you do SQL queries it’s like an addiction to keep querying this data base and that data base to see if you come up with some value and some folks think there’s value to every query out there, and there’s not….”People Don’t Work That Way”…period. 

Flawed Data–Mined by Corporations Online Provides Background Checks Riddled With Errors–Attack of the Killer Algorithms Part 7

Well let’s dig a little more into the data selling/buying area, so now we have insurers buying your Master Card and Vista data as Blue Cross (and you can’t make this up) said they wanted to monitor the size clothes you are buying. 

Insurance Companies Are Buying Up Consumer Spending Data-Time is Here to License and Tax the Data Sellers-As Insurers Sell Tons of Data, Gets Flawed Data When Data Buyers Uses Out of Context Too

So let’s query that with the PAM score and admonish you or your doctor for having a low PAM score and now you have insurers knowing everything you buy with Master Card and Vista along with your FICO medication adherence data that includes your credit score too…see where this is going…JUNK SCIENCE…why do you think we have so many frustrated software developers out there as people don’t like and won’t use their software….”People Don’t Work that Way”…they need to want to have a desire to use it and not peer marketing pressure as even if that works, it’s dies off quickly. 

Again I don’t see anything wrong with getting information to find out what can be done and worked on at all and that should be already be going on by all means but when we have to absolutely stop and starting scoring and quantitating this, we have a problem in the fact that we have forgotten how to be humans.  If you are the doctor, well then you get graded too in this entire scheme, so you can add this into your already complex pay for performance standards you need to meet as well.

Questions like this don’t need to be given a scored and wrapped in more analytical data by all means that might get sold by an insurance company that they might resell if there’s a buck to be made. 

Nothing wrong with asking a certain set of questions to try to narrow down where some focus might be needed but for God’s sakes cut the Junk Science approach here and communicate like human beings without the big drama of “scoring” and creating more data that could possibly leak out there and be used in a negative fashion against a patient.  If you have hung in this far, then this post is the next one to read…people can’t tell the difference between virtual and real world values anymore and it covers a lot more than what I did here.  Bots are worth about $100 on the web and we are free as humans and 61% of web traffic is bots, non human. 

Virtual Worlds, Real World We Have A Problem And It’s A Big One With A Lot of Gray Areas Finding Where The Defining Lines Exist, Confusing Many With A Lot of Weird Values And Strange Perceptions…

I like good data that is accurate and makes me smarter by all means but I seem to also see where again we are going to some extremes here to quantify everything and it makes people nuts as “people don’t work that way”.  So again the fact that this query process has a patent is also crazy, so let’s cut out the scores and relate like humans to each other, doctor can ask the questions or provide a set for the patient to do a self study and answer on their own to get the thinking process going but cut the darn scoring and analytics in an area that should be “safe” for humans to relate as such.  Again the danger of all of this is such a score getting out in circulation as a negative as when you put data together it’s all about context so one can look like a hero or a zero. 

Of course the data selling epidemic has an influence on this as well and we know insurers will run you over for one more stick of data they can gain as they want to capture every single risk assessment piece of data they can get:)  BD 

Senator Rockefeller Puts the Data Sellers on Notice–We Need to Index and License All Data Sellers to Include Banks, Insurers And Other Companies In Addition to the Data Brokers..

"Patient activation" is a measure of how engaged patients will be in their own care. Patients who are highly activated have better outcomes and incur lower costs, studies show, even though as many as 40% of Americans lack the skills, knowledge and confidence to become model patients. They fail to take their medications, skip preventive screenings and end up back in the hospital soon after discharge. Activation is especially important for patients leaving a hospital after surgery or trying to manage diabetes, high blood pressure or other chronic conditions.

More hospitals, health plans and employers are scoring patients on how engaged they will be in their care using an assessment called the Patient Activation Measure, or PAM. Scores make it easier to customize information, coaching and other interventions. The aim is for patients, rather than feel overwhelmed by instructions, to become confident that they can change their own behavior.

Michael Kanter, medical director of quality and clinical analysis at Kaiser Permanente's Southern California Permanente Medical Group in Pasadena, says it isn't always obvious how to turn a patient's PAM score into higher activation. "In a one-on-one encounter, it is easier to use techniques known to motivate patients," he says.

Insignia Health, in Portland, Ore., has the exclusive license for PAM from the University of Oregon and markets it along with coaching and self-case resources to clients such as WellPoint Inc., WLP -0.46% the health-benefits provider, and Roche, the pharmaceutical and diagnostic company. Insignia helps clients design online, phone and in-person coaching to improve activation. A single point increase in a PAM score can result in a 2% improvement in medication adherence and a 2% decline in hospitalization, says Insignia Chief Executive Chris Delaney. Clients have reported savings ranging from $260 to $3,700, per patient on an annualized basis.

WellPoint, the health-benefits provider, uses a six-question version of PAM in its health-risk assessment of new Medicare members and in care-management programs for chronic disease. The aim is to predict "what level of support this person needs from the health plan," says Dan Newton, a staff vice president who oversees behavioral economics.

http://online.wsj.com/news/articles/SB10001424052702304432604579473301109907412?cb=logged0.025332459572868227

0 comments :

Post a Comment

 
Top