Consumer Driven Healthcare
John Church
CEO
Arthritis Ireland
Source: 2008 Pfizer Health Index
Arthritis – a Major Population Health
Issue
Any Condition
2008
2005
Blood Pressure
2008
2005
Arthritis
2008
2005
High Cholesterol
2008
2005
Asthma
2008
2005
Chronic Pain
2008
2005
Infections
2008
2005
Heart Disease
2008
2005
Diabetes
2008
2005
Depression
2008
2005
Cancer
2008
2005
Osteoporosis
2008
2005
Other Mental Illness
2008
2005
Other Serious Illness
2008
2005
36
10
10
10
9
7
7
6
5
3
4
4
3
5
3
4
3
2
2
2
1
3
1
0
*
3
3
40
1,370,000
1,185,000
355,000
339,000
349,000
310,000
245,000
218,000
196,000
177,000
99,000
137,000
135,000
98,000
156,000
90,000
138,000
87,000
75,000
78,000
55,000
48,000
102,000
46,000
16,000
9,000
98,000
95,000
Source: 2008 Pfizer Health Index
Duplication of Conditions
All
Adults
Blood
Pressure
Arthritis
High
Cholesterol
Asthma
Chronic
Pain
Heart
Disease
Diabetes
%
%
%
%
%
%
%
%
Blood
pressure
10
100
25
39
8
14
36
30
Arthritis
10
25
100
24
9
24
39
29
High
Cholesterol
7
27
17
100
12
11
22
15
Asthma
6
4
5
9
100
17
6
5
Chronic pain
3
4
7
5
9
100
7
4
Infections
4
5
2
1
5
14
2
-
Heart Disease
5
16
17
14
4
11
100
19
Diabetes
4
12
11
8
3
6
17
100
Depression
2
3
4
4
4
4
2
3
Cancer
2
*
-
3
1
-
-
-
Osteoporosis
3
8
11
6
3
4
9
10
Early Diagnosis Essential
12 Months
What Do we Do?
Supporting
People living
with Arthritis
Voice of
Rheumatology
in Ireland
Finding a Cure
Board Make-Up
• 4 Patients
• 4 Medics
• 7 Co-opted
members
The Challenging Environment
• Healthcare Budget Cuts
– More for Less
– Decisions made Now!!
• Current Rheumatology service issues
• Ageing Population
– More dependency on system
– Increased chronic diseases
• The Patient’s voice
– Hierarchy of Medicine
• Managing Patient expectations
Consumer Driven Healthcare
• Listening to the Consumer
• Active involvement in care pathway
development
• Education and Health Promotion
• Promoting active self-management
– Taking more Responsinility for their health
– Monitor consumer expectations over the years
“An Informed patient is a better self manager” (PARE)
Consumer’s Role
OLD
NEW
Defer to Providers Authority
Share Responsibility for own
Health
Be Passive
Be Active. Self-manage
health & condition
Share History, when asked
Share goals, history, values,
beliefs and preferences. Be
Assertive
Learn about condition from
provider
Learn from provider, inform
self. Access reliable
information
Don’t worry about
medications (it’s all in the
medicine cabinet)
Share responsibility for
keeping medication list up to
date
Respond to provider
questions about progress
during clinical visits
Keep track of own progress
between visists, share
duirng visits
Consumer Driven Healthcare
Best Practice
• Arthritis Self-Management Programmes
– Stanford Model
Consumer Driven Healthcare
Case Histories
• Arthritis Self-Management Programmes
– Stanford Model
• Let’s Talk Arthritis
Let’s Talk Arthritis
Consumer Driven Healthcare
Case Histories
• Arthritis Self-Management Programmes
– Stanford Model
• Let’s Talk Arthritis
• Patient as Educator
Consumer Driven Healthcare
Some Early Wins
• Consumer role in HTA
• Better Care = Reduced drug dependency = less cost
• Reform HSE budget system
– PCCC versus Hospital Pharmacy
• Innovative thinking on Resource deployment
Thank You