What will patient empowerment look like?

Nobody knows what patient empowerment will actually look like, because it hasn't been invented yet. Like most entries into new markets, this one will probably begin with tentative and primitive forays into the landscape, seeing what patients will respond to and not respond to. When they recognize the possibilities, patients will begin asking for specific products, services, and features; that is, the customers will begin to better define the market. And, seeing the growing demand, more and more entrepreneurs will jump into the fray, testing an array of ideas. Sooner or later, there may come a killer app, a VisiCalc  of patient empowerment, that forever changes expectations and makes the empowered patient as common as the personal computer. If we reach this stage, covert rationing will be doomed.

We already know some of the things patients want. More than increased longevity, they want to remain healthy and independent into their old age. They want to avoid disability and institutionalization. The sandwich generation wants the tools to keep their aging parents out of institutions, without neglecting their own young families. Patients with chronic illnesses that need a lot of management-diabetes, heart failure, and difficult-to-control hypertension immediately come to mind-want the tools to do most of that management themselves. And those at high risk for treatable cardiovascular emergencies-heart attack and stroke-want to prevent these emergencies and, if they cannot be prevented, to immediately detect and treat them whenever and wherever they occur. These are among the things that many people will pay for themselves.

A lot of tools can be brought to bear to begin meeting these needs, including a multitude of technologies, sophisticated communication systems, and data management and decision support systems, all aimed at providing remote monitoring, self-monitoring, effective diagnostics, and novel therapies and services.  In Fixing American Healthcare I provide concrete illustrations as to how doctors, patients and biomedical entrepreneurs can evolve systems that empower patients, re-establish doctors' professional integrity, and remove the biomedical industry out from under the Wonkonians and Gekkonians. Here, I'll just assert that such things are imaginable and eminently possible - it's a largely a matter of realizing the potential, and just doing it.