Two hundred years ago, Herbert George Wells was born in Bromley, Kent (England). His parents were unremarkable middle class working folks -- a retailer and a housekeeper. Young Herbert apprenticed as a draper but later attended school and became a teacher. At age 20, he married his cousin Isabel, but left her five years later to marry one of his students. It was during those five years that he decided to become a writer, and that is where our story begins.
As a novelist, Wells (now going by the moniker "H.G.") debuted with The Time Machine (1895), a parody of English class division, with a satirical subtext and a warning that human progress was not inevitable. The Time Machine, The Invisible Man (1897), and The War of the Worlds (1898) are Wells' best-known novels. Yet the theme of human progress is the aspect of Wells' writings that has been the most studied by futurists the world over.
It is ironic that some of Wells' less acclaimed works contain a great deal of his most prophetic and instructive thought. In 1901, he wrote The First Men In the Moon, an eerily accurate foreshadowing of space flight. The War in the Air (1901) written two years before Wilbur and Orville Wright recorded the first successful airplane trials, and more than 10 years prior to World War I, tells the story of a catastrophic aerial war.
Wells clearly established himself as a futurist. As his career progressed, he focused more on the political science of the day. His short book, The Discovery of the Future (1903), suggested that the time was coming when "a systematic exploration of the future" could be used to predict social and political development.
Some may quibble with Wells' vision and ask the inevitable "chicken and egg" question regarding futurism and socio-political developments, yet even today his theory is at work in our industry. Among his contemporaries, Wells' vision was not always welcome. Trying to envision the future has always pitted the certainty of today against the unknown of tomorrow. That unknown frequently manifests itself as fear.
The Acceleration Studies Foundation, a think tank concerned with the future, asks you to imagine that you lived in the year 1800 and foresaw the "transformative future of the steam engine, interchangeable parts, chemistry, electricity and the railroad." Then move to 1900 and wonder whether you could have predicted the future represented by the internal combustion engine, the mechanical census computer, the assembly line, radio, and television.
To relate to the foundation's thesis in more modern terms, consider one of the most ubiquitous symbols of today's technology. An early use of the term "personal computer" appeared in a Nov. 3, 1962 New York Times article reporting John W. Mauchly's vision of future computing. Yet it wasn't until nearly 20 years later that personal computers became widely available. Today, it is almost impossible to imagine a time when these machines were not on our desktops (or in our backpacks).
Our industry's thought leaders recently gathered at the Consumer Directed Health Care Conference in Washington, D.C. The fall CDHCC meeting is unique in that it provides six different conferences that run concurrently: Consumer Directed Health Care; National Health, Wellness and Prevention; Consumer and Patient Enabling Technologies; Marketing to the New Health Care Consumers; Boomers Business, and Consumer Direct Access to Health Care and Retailization. Some attendees stay within their field and learn about best practices. Others wander among the sessions to gain a better overall view of how these diverse areas are informing one another on our journey into the land where the consumer reigns supreme.
A few of the technology-based sessions caught my attention and each would have made old H.G. proud to be a futurist. They highlighted the work of health care companies finding new and better ways to work. Keeping faith with Wells, the question to ask yourself about each of these entities is not whether you could have foreseen them, but what does their existence portend? The world in which we practice today needs to embrace future possibilities, not necessarily just future technology. Now there's a challenge!
TelaDoc is a Dallas-based company that has captured the attention of futurist (and former speaker of the U.S. House of Representatives) Newt Gingrich, who spoke at a session sponsored by the company. TelaDoc is interesting for a variety of reasons, not the least of which is that it isn't "high tech" but rather "high touch," a factor we ignore at our peril. The company is using 130-year-old technology in a new way that changes the landscape of patient-physician interaction and shifts the entry point for routine care questions. TelaDoc is a network of licensed primary care physicians who diagnose routine, non-emergency medical problems over the telephone.
TelaDoc physicians recommend treatment and prescribe medication (when appropriate) over the telephone, 24 hours a day, 365 days a year. Patients (age 12 and older) can access this service wherever they happen to be: home, office, hotel room, or campsite. Focused on routine conditions that arise quickly and tend to be short-term (5-10 days), the company typically handles inquiries about such conditions as respiratory infections, bronchitis, gastroenteritis, and urinary tract infections. Based on a 2003 University of Texas study, TelaDoc estimates that 70% to 75% of all primary care medical cases can be diagnosed over the telephone.
This straightforward process creates a cost-effective mechanism for employers while offering convenience to employees. It also relieves the cost (to both employer and patient) and inconvenience of reading tattered magazines in a waiting room full of sick patients while waiting to be "fit in" to see your personal physician for what amounts to a routine question or condition. TelaDoc's metrics indicate that the average time between a client's initial call to being on the phone with one of their participating physicians is less than an hour, and they offer a three-hour guarantee.
A testimonial comment from a business executive captures one application for this service. "I don't have time for doctors if it's not an emergency. One day I was on a business trip and needed some medicine. I was completely miserable. I called TelaDoc. The doctor recommended antibiotics and phoned in a prescription to a pharmacy near my hotel. By morning I was feeling much better and didn't miss the important meeting." You can learn more about the company on their Web site: www.teladoc.com.
Another interesting company I chatted with at the conference is DestinationRx. Research from my own company indicates that for many individuals, the health care consumerism experience begins in the pharmacy. With that in mind, there is a renewed focus on engaging the consumer with actionable pharmaceutical information. The opportunity for savings for all constituencies is immense. Humana VP of Innovation Beth Bierbower told an audience at the conference that savings from the company's "Maximize Your Benefit" program, a voice-automated technology outreach that offers information about lower-cost drugs, has saved employees more than $18 million in out-of-pocket costs over the past two and a half years.
DestinationRx offers a tool called Rxaminer that takes the drug information continuum to the next level, in a way that resonates with consumers. You may be familiar with the company -- its software is behind parts of the federal government's Medicare Part D Web site, and it markets to other large providers as well. DestinationRx believes that tools are necessary to access actionable information. This is supported by the fact that the company produces one of the nation's leading drug comparison datasets and claims that its dataset is the only one that compares drugs based on real-world prices.
"Rxaminer provides a member decision support tool that shows plan members their cost for equivalent dosages of lower-cost medications available under their formulary, drug pricing, and plan design," said DestinationRx President Michael Cho. The information is used as a springboard for a conversation with the member's physician.
As an example, Rxaminer cites Prevachol as being non-preferred in a particular formulary. Additionally, this drug is not available as a generic. The tool shows the user six different options, from Lovastatin to Mevacor, as well as the member's co-pay, the plan's cost, and the member's cost. Each entry also includes a line showing the member's annual savings. In this example, the member could cut his or her annual cost by $468 and the employer would save $188 a year. The tool also shows when, with the physician's approval of course, splitting a larger dosage of the same medication into two doses would yield a savings. This is very consumer-friendly and helps to move the patient along the consumer continuum.
On the emerging technology front, old-school Honeywell (with roots going back to 1885) has acquired HomMed, which is among a number of companies creating and marketing remote (home-based) technology that monitors patient conditions and reports them to a central station. You might think of it as analogous to a home security system, but instead of monitoring break-ins and fires, it keeps an eye on vital signs and other significant medical indicators.
HomMed is not the only company occupying this rapidly-growing space. Motiva (Philips), Motorola, Viterion, ADT, InTouch Health, and HomeFree Systems are just some of the competitors. The interest in this type of technology is purely boomer-driven. All of us (of a certain age) intend to stay in our homes as long as we want. That need to define and control our environment will serve a variety of other systemic needs as well. If you recall the school building boom of the 1950s and 60s that attempted to keep up with boomers' burgeoning numbers, you can add 50 or 60 years and discover that there aren't enough medical facilities to keep up with boomers today. The ability to be monitored and advised from the comfort of our homes boosts the effectiveness and efficiency of a system that doesn't have (and won't likely build) external facilities in sufficient numbers.
The conference was an amazing experience and if you are interested in consumerism (which includes CDHC but broadens the view considerably beyond health plans), you may want to plan to attend one of these conferences (www.cdhcc.com). I am still mentally sorting through everything I learned at the meeting, but using existing technology is something that our friend Herbert understood all those years ago in The Discovery of the Future when he wrote, "The past is but the beginning of a beginning, and all that is and has been is but the twilight of the dawn."
Readers may write to David Saltzman at Humana Inc., 3401 SW 160th Avenue, Miramar, FL 33027, or e-mail him at dsaltzman@humana.com. David is a past president of NAHU and has been a health, disability, life, and employee benefits consultant and broker for more than 25 years. He is the director of consumerism for Humana's Southeastern U.S. Market.
