Neither of those sound like good news for Oracle Health. After the lofty proclamations of the last couple years. still…
Readers Write: Oh, To Be a Dog in Boulder
Oh, To Be a Dog in Boulder
By Bonny Roberts (and Juneau and Lily)
I adopted my standard American bulldog, Lily, from the Humane Society of Boulder Valley (HSBV) about two years ago. Due to her excessive and exuberant tail-wagging that resulted in a chronically open wound at the tip of her tail, we decided that, while the burgundy, Jackson Pollock-esque wainscoting that now decorated our home was provocative, we needed to dock Lily’s tail.
HSBV’s veterinary clinic agreed to do the procedure “at cost” since she had so recently been adopted. The bill was $300. Since that experience, I have taken both our dogs to their veterinary clinic for annual checkups and emergent needs. The staff is friendly and responsive and the veterinarian has a strong bedside manner and always calls post-procedure.
My other dog, a Siberian Husky named Juneau, required two surgeries in 2014 to remove mast cell tumors, the first near her shoulder, the second on her hip. The latter healed poorly based upon its location and required both an after-hours urgent care visit and one additional “observation day” at the clinic. I paid for everything out of pocket – prep, anesthesia, supplies, vet time, OR time, meds, the “Cone of Shame,” recovery time in post-op, urgent care, observation day, suture removal. The total was $875, not to mention the complementary pedicure they had given her while under anesthesia.
A couple of weeks ago, the HSBV veterinary clinic sent me a link to a Pet Portal. After an easy enrollment process –consisting mainly of creating a login id and password, I instantly had access to both my dogs’ vaccination, visit, and medication history. I also had the option to:
- Set alerts and reminders for vaccinations and appointments (medical management).
- Join community groups (social).
- Read care guidelines on everything from behavior and aging to safety and disease (education).
- Review diet details, if applicable (education).
- Create a customize care instruction document, which after investigating in detail, could only be compared to discharge instructions inclusive of a pre-populated med list and exercise routine (care transition).
- Complete a customer survey (satisfaction and quality improvement).
- Schedule our next visit based on visit categories, such as vaccinations, sick exam, follow-up, blood work, etc.
I couldn’t help but compare my own lack of portal access with my primary care provider or the fact that my children’s pediatrician used to charge to fax over immunization records. If only I were a dog in Boulder County, my information would be far more accessible.
Interesting facts about the Humane Society of Boulder Valley, a non-profit facility based in Boulder, Colorado:
- HSBV is a no-kill, or live release, shelter that also offers behavioral training and medical services to stray and relinquished dogs and cats.
- On average, dogs are adopted in seven days, cats in 12. In 2013 alone, they facilitated 5,698 adoptions. The relevance to this volume is that according to their annual report, “Medical rehabilitation mends the bodies and spirits of more than 40 percent of the animals in the shelter annually. In concert with our medical care, we are dedicated to the mental health of our animals as well. Techniques and protocols developed at our facility are now being used by shelters to save more lives all across the country.”
- The HSBV has ~700 volunteers and each dog gets three walks a day, while each cat is played with or stroked four times a day.
- Fifty percent of the organization’s income comes from investment and trust income and contributions, with 55 percent of that going to healthcare for the sheltered animals
While this study and comparison is apples to oranges on many levels, I do think there is relevance and value to the comparison. What can we learn from organizations serving other verticals with similar missions, much like we do with foreign healthcare systems? In addition, I am convinced that the innovation and technology we have developed and are promoting here in the US has incited progress and more encompassing services to meet the holistic needs of more than just humankind. Here is to small victories.
Bonny Roberts is director of sales operations for Aventura of Denver, CO.
I agree with your main points but you’ve oversimplified a bit. You (and Juneau and Lily) were able to obtain primary, specialist, and surgical visits (plus ancillary services) all from the same provider. And using single payer system. Easy-peasy.
But when you’re looking at three different providers, plus an outside lab and/or imaging center or both and at a minimum two payers (patient and primary insurance) it just gets messy. Most folks (including me) have similar access but it’s fragmented across each provider’s portal. It’s easier when my family receives care from the larger health system in my area (ultimately, one “provider” and one record). But not everyone has that option and while I’m satisfied with our current conglomerate I’ve experienced a varied level of service quality in other health systems that eliminated them as a provider option for me.
I’ve heard that argument that if Banking can figure out how to update my bank account with my purchase from Target by the time I get to the parking lot, why can’t healthcare get it figured out. True, Banking has multiple “provider” vendors, on various platforms and using various service providers – however, they are only exchanging one data element. I argue they’d struggle just as much if they had to transfer a more complex data set such as “simple” vitals, let alone tackling H and P. So, just getting everyone to use computers is a step in the right direction (similar to retail shops using POS software vs. the mechanical carbon-copy CC slip of years past).
Border Collie,
Agree the distinction between single-provider/payer vs. multiple is very important, as well as the importance of not assuming finance and healthcare are at all equivalent. However, I think the main reason both of those (and many more good arguments just like it) matter so much is mostly motivational, not technical/operational.
The big health system has an interest in providing you a unified experience. It keeps you in the system and is a win-win.
Target and the bank also are interested (today) that you be able to easily buy here and pay there. Perhaps in theory, they would prefer if it was really hard to change credit cards or shop in different stores. They’d prefer that you be dependent on regular interaction with one main system/provider as keepers of information and knowledge that you can’t do without. Or that you have to stay in one “partnership system” that allowed you to buy/pay easily from an operational standpoint. But they have no illusions that they can lock you in that way. So they focus on differentiated offerings and service, convenience, loyalty programs, etc. Healthcare isn’t there yet.
Hard to predict what will be the inflection point and what the timing will be. But between self-insured employers, greater out-of-pocket cost for individuals in new plans, digital records, mHealth, tele-health, retail store clinics, etc. it’s going to happen. We WILL get to a consumer-centric, transactional model in healthcare (not for all of it, not all at once).
There are indeed many good arguments why even a generally healthy consumer can’t/shouldn’t experience healthcare the way they experience online commerce or vacation planning. And plenty of good arguments why it is very hard to get from “here to there” even if it was a good idea. But I believe in a few years, in retrospect, all of that will seem like a lot of molehills that were turned into a mountain range.
Bonny – Thanks for a really great read!
Brian