Sept 1st : UPDATED : see below article !!
In this age of resource scarcity proposals romp over us. Political parties make plans, industry solutions and insurers do their two cents. Also the Council for Public Health and Health Care (English version !!) take its responsibility in this regard with their recent reports and advices to the Dutch Minister of Healthcare.
The thing that surprises me the most, is that often only the cure and care sides is addressed. It looks like control of the existing situation is the main perspective. New treatment here, some pharmacy there or a new healthcare-centre on another spot. In my opinion very little about prevention, while if we ought to believe some respectable studies, it would be the greatest shift in solving problems on this frontier.
Professor Ralph Keeney (Duke University) wrote a paper (2008 Operations Research) with the expressive titel“Personal Decisions Are the Leading Cause of Death”, in which he states that 55 procent of all death in the USA in the ages 15-64 year were attributable to personal choices. Choices like smoking, eating, (not to)sport etcetera. In The Decision Tree (must read !) Thomas Goetz addresses this study amongst others like the Framingham Study.
A study of the effect of choices made by people and the effect of it on their health and of the problems that arise from them. Responsible also in the way of making these choices to DO something or no to DO anything, creating health problems or making them more severe.
Creating awareness is about reaching out to those who it might concern and is without any doubt THE challenge. “we’ve been at it already for al long time, but it doesn’t get behind the tipping point”. Agree, partially that is. Agree on the effort put’ in, but not on the approach being used lately. I see many chances in a different approach added to the current roadmap.
A short sidestep to what we call in Holland the HPV-“case” (on ovarian cancer) young girls in social networks with YouTube videos sharing information, and the director of the National Institute for Public Health and the Enviroment in our National late night discussion “show” (audience regularly 35-50 year) was explaining why this information was incorrect.
Missed opportunity; he had to be thére where the targeted audience was : so in social networks and on YouTube. Be thére where your customers are; lesson 1 in communications, no ?
Creation of awareness of course is very important on matters of decreasing alcohol-use amongst youngsters, preventing obesitas and therefore I call on all parties to start thinking on a different way.
Let’s face it : Sesame-Street started back in 1969 to for our kids (or maybe even ourselves) to combine education and entertainment, what could be the impact of addressing kids through these communication channels on matters of obesitas, dangers of smoking and the power of sports for your health. Please start using these creativity, knowledge which almost (or did already) reached scientific level in putting the audience in the middle, and start talking the way they do.
Web 2.0 in healthcare
Recently I gave a talk at the Dutch Healthcare Conference in Rotterdam about the impact of the internet in healthcare. More specific on the role web 2.0 could obtain in the prevention-side of Healthcare. What surprised me was that there has been only little research on the impact on how to reach out to the target groups, at least besides the demographic structure. The question “how to address people who are not patient yet, in the ambition of preventing them to become one”, was obvious. But my advice of “start talking wíth your target audience” was rather new.
Also the National Institute for Public Health and the Enviroment nowadays is looking how to reach out to target audiences. For new they “monitor” what’s going on in i.e. the web. Great, for a start, but I urged them to start talking to the guys from Wal-Mart or MTV for instance. They have scientist too, although maybe not always academic, but the really now how their costumers think, choose and act. So start looking FOR, but most of all start talking WITH in stead of ABOUT the target audiences. Ask them what they (would like to) know, what information they are looking for IF ANY and where they would look for it. Next íf you come to the conclusion that nobody is waiting for your message –which isn’t so strange in case of prevention-, think twice before you adopt the classic failure of “ We know what’s best for them and what they want to know”.
If I have to believe weblog’s, magazine, interviews then patients want to adopt these innovations already “en masse”. But from what is see in present healthcare this would take some years I’m afraid, before patients as well as healthcare providers will start to use it on a large scale. But it will come and it will change healthcare.
Market research in healthcare, and most certainly within the prevention-side of it, isn’t institutionalized. But in fact – looking for the things at stake- it had to be by now.
In the upcoming years we are to be flooded with nice solutions on e-health, m-health and communities Things we as Radboud University Nijmegen Medical Centre also are very much into also. Crucial in these developments ought to be “is the targeted group waiting for these solutions, or even not aware of the necessarity of it.
Especially m-health will be a game changer since we all have one (or two) cell phones within elbow-length.
One of our own examples of m-health is www.aed4.eu, to speed up finding an AED, and thereby increasing the chance of survival and/or recovery. Also it involves the citizens (potential patients) in creating better health, since fundamentally it is crowdsourcing; people can admit a AED and his location. Periodically they will be checked i.e. throughout our partnership with the Dutch Red Cross.
In conjunction with the opportunities of matching and checking your data against the outcomes of i.e. the Framingham Study, could mean huge prevention of illness, diseases and also healthcare costs. But, it will take some years to get there in my opinion.
Maybe we also should look some more into the wellness aspects of healthcare in terms of prevention. What would be the impact of a nationwide First Aid course on often heavy cost-consuming treatments of injuries. How would nationwide CPR courses improve health and survival rates. And why is Coma-drinking broadly condemned and smoking still isn’t? Shouldn’t we consider to invest more money into prevention that at present, since what won’t occur, you won’t have to treat.
I am writing all of this with mixed feelings. Since only recently a foreign Professor in Public Health was dismissed from his University, since he couldn’t quantify the costs he saved or money gained, in front of a committee looking for money reductions.So : En Garde, there is work to do.
Update : September 30th Prevent 2010 conference in the Netherlands on this very important matter.