Welcome to consumer-driven healthcare.
Consumer-driven health care has received recent attention as a fundamentally new approach to organizing the financing and delivery of health care. Consumer-driven health care consists of tax-advantaged health savings accounts, coupled with high-deductible health plans, which theoretically would make consumers more prudent in seeking health care services. Since they would be paying much more out of their own pockets, insurance would be relegated only to those procedures of true catastrophic expense. The idea is that as patients become accustomed to shopping for health care services, they would focus more on quality and service, leading clinicians to become market responsive, thus improving the care they provide, and actively competing for the business of increasingly savvy customers.
This consumer experience increases the patient’s sense of empowerment, because he has direct input into decisions about his healthcare, with the knowledge and tools he needs to make those decisions; however, quid pro quo, the consumer must now be held accountable for the financial or medical consequences of his decisions. One could argue that with this health care model, the patient not only develops a sense of empowerment, but a sense of entitlement over this newfound capacity to take control of his health.
iTriage was founded by Dr. Peter Hudson and Dr. Wayne Guerra with the idea that the medicine world acts too much like a hierarchy of knowledge, inefficiently providing information and inefficiently allocating resources to its patients. With iTriage, their hope is to empower patients by providing relevant information, structured data, and service offerings to patients, anywhere they happen to be at their time of need, all for free on the iPhone.
iTriage, obviously, is not meant to replace a primary physician’s care, but is meant to enhance it with an efficient and cost-effective alternative to minor medical problems. After quickly registering through Healthagen (iTriage website), the app is structured with five tabs along the bottom, which indicate Symptoms, Diseases, Procedures, Facilities, and a Help tab. Each tab provides users with seemingly thousands of different symptoms, diseases, and medical procedures for users to research according to what ails them. The listings are all in alphabetical order with a search tab for ease of use; too bad there isn’t a handy Alphabet list along the side so users may search by letter family, especially since rifling through this huge compendium is incredibly daunting. All the information and methodology present is meant for the user to glean so he may be fully privy to what his Physician says or recommends, and then be able to decide his own course of action.
Say your Physician wants to perform a Percutaneous transluminal coronary. Instead of feeling your eyes glaze over with your heart pumping wildly in confusion, you can search for the procedure on iTriage to better understand your choice. Tapping the procedure name, iTriage gives you several tabs, covering the description, the specialist division (i.e. cardiology), possible complications, and the average cost of the procedure. It also gives you a link to a few reputed medical websites like WebMd and MayoClinic, a tab to find a facility – along with a search radius of up to 50 miles and appropriate mapped directions -, and even a direct advice line to either a physician or nurse. One of iTriage’s Partners is TelaDoc, a national network of board-certified physicians who provide telephone consultations to diagnose, recommend treatment, or write short-term prescriptions 24/7. With this, you always have a second opinion at hand, just in case you are unsure about that percutaneous transluminal coronary – which, by the way, is described by iTriage as “a procedure to open clogged or blocked arteries. A catheter is positioned in the narrowed coronary artery, with a tiny balloon at its tip. The balloon is then inflated and deflated sequentially to stretch or break open the narrowing and improve the opening and passage for blood flow.” A nice, layman description with a glossary should you be unsure about certain medical jargon.
Unfortunately, the caveat of providing patients with such knowledge is one of personal liability. Should the layman, with no medical school training, really be given the opportunity to direct or make suggestions to his physician? With the advent of the Internet, it has been all too easy for people to search for symptoms in an attempt at self-treating, often resulting in mistakes, or worse, dire consequences. A common example would be that of the vaginal yeast infection, also known medically as Candidosis. A fairly common fungal infection from an overgrowth of the normally harmless Candida albicans, a yeast infection’s symptoms of redness, itching and discomfort, and odorous discharge are often indistinguishable from other conditions like Bacterial vaginosis and Trichomoniasis. So, when women (or men), try to treat their surmised yeast infection with common over-the-counter antifungal prescriptions like Monistat, they could be delaying diagnosis of a different problem, such as a bacterial vaginal infection or even a sexually transmitted disease (STD). One study found that about 2 out of 3 women who think they have a simple yeast infection don’t.
Going along with the fear-mongered society our current American culture has been, sometimes having an endless array of information at our fingertips, an education of autodidactic dilettantism, results in being over-educated while ironically being under-educated. Say you display a symptom of black stools. Seeing black stools is incredibly scary, is it not? You immediately jump to conclusions like “what did I eat,” “is there something wrong with my gastrointestinal tract?” and so on. In this case, should you look up “black stool” on iTriage’s Symptoms list, you will be faced with an array of incredibly scary sounding conditions like Anal Cancer (at the top of the list!), Anal Fissure, Colonic diverticulitis, Small Bowel lymphoma. True, all of these result in a symptom of black stools, but they are all incredibly dire situations to immediately thrust in your face, especially if you do not fall into the usual demographic, particularly age group. Nowhere does iTriage say that black stools are a common side effect of ingesting benign Pepto Bismol – its main ingredient bismuth interacts chemically with sulfur compounds within the body during digestion, resulting in tar black stool, and is far more likely than a sudden onset of deep hemorrhaging in your intestines or anal canal.
iTriage is certainly useful when, as a patient, you try to navigate the choppy seas of medical jargon as a Physician explains a procedure or condition. Rather than searching haphazardly over the Internet for what may be a reputable source of information, iTriage provides you with accurate information up-front, in an easily searchable database, and gives you directions to the closest medical facility where you may obtain direct assistance. It also helps you negotiate medical bills through its partnership with Coalition America, to help you save money.
So rather than using iTriage as a source to correct your doctor or misdiagnose yourself, use it as a way to better elucidate your doctor’s suggestions. No Physician wants to hear objections from a misguided but well-intentioned patient, as he sticks out his chin in defiance with iPhone in hand protesting. As the old adage says, “A little bit of knowledge is a dangerous thing.”