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by andreipop
4610 days ago
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Delian - love the initiative! There are a few basic assumptions underlying your vision that may be useful to flush out further (I can tell you that, from similar experience, what you are going to bump in to is a fundamental lack of desire from the majority of the system to see change). 1. You are betting that Obamacare will actually drive the system towards "accountable" care -- we are a long way off from this unfortunately. I won't rehash it all here, but many ACOs are turning back from the model: http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?... 2. You are betting that patient engagement in their own health will be high, particularly for the high cost, at risk patients. This has been historically proven not to be the case. High touch intervention + technology works (i.e. take a look at the Diabetes Prevention Programs now being run digitally by organizations such as Omada) but technology by itself has had a pretty low hit rate with driving meaningful patient engagement for the at risk populations. For some reading on the challenges of adherence, check out: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661624/ I really do think we need more people working on these problems, so keep at it, and if I can help at all please let me know! (drop me a line at andrei@humanapi.co) |
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The commonest reason for transplanted organ failure is that the patient isn't compliant with medication.
This happens in UK (free surgery, free meds) and US (expensive surgery, expensive meds).
It's weird.