No, EIM blog has not turned into a matchmaking site. But, we need to meet these gals.
There has been lots of press about Carol which is yet again a new way to “put consumers in charge of healthcare”. Carol allows you to shop, compare prices and offerings (including bundled packages) and purchase health care and schedule appointments. Got a question about an ankle evaluation?” You can choose between 2 different providers who are bundling some services and then also choose “enhance my care” by purchasing ankle braces and active ice!
Based on what I can tell, the provider list is roughly 30 different providers in the Twin Cities. Will this catch on? I have no idea but I do know historically health care in Minnesota has never been extrapolated across the US. If it works there, more power to them.
What is very much missing is the presence of physical therapy in Carol. Yes, you can search and get the obligatory exposure to physical therapy -that appears to be prevelant in some of the ortho groups offerings. Curiously missing is the ability to access directly a PT as well as proper front line evaluations for areas where we have high efficacy and cost-effectiveness like LBP. If you believe consumers are going to direct health care, shouldn’t at least they be able to access evidence-based practice and let them guide decisions rather than some overmarketed website?
As to Isabel, a much different approach altogether. With features in both New York Times and USA Today as well as receiving numerous awards, this is a superb effort at reducing diagnosis and decision errors thru a combination of database technology, EBM, and stored EMR’s. It forces a practitioner to consider certain diagnoses based on probability rather than rely on a quick thin slice. Isabel is featured in the chapter on EBM of Super Crunchers by Ian Ayres a chapter that I believe ought to be mandatory for every health care licensee in the US (don’t smirk, they made us take 2 CEU’s of HIV classes for about 5 consecutive years!).
PT needs to meet Isabel as well. In fact, with a more limited number of diagnoses for musculoskeletal medicine, this should not be too difficult and might in fact jump our credibility and ability to supply direct access much faster. A combination of EBP on both the diagnoses and intervention side is exactly what we need. How about we fight for direct access thru science and technology?
I will temper my optimism by the reality as best stated by Mr. Ayres in his book:
The Super Crunching revolution is the rise of data-driven decision making. It’s about letting your choices be guided by the statistical predictions of regressions and randomized trials. That’s really what the EBM crowd wants. Most physicians (like just about every other decision maker we have and will encounter) sill cling to the idea that diagnosis is an art where their expertise and intuition are paramount. But to a Super Cruncher, diagnosis is merely another species o prediction.