America’s Biggest Problems: Our Behavior and Our Culture

Question: What are some medical costs and conditions that Medpedia is aiming to tackle?

James Currier:
So there's a whole lot of them. Seventy-five percent of medical costs stem from behavioral and cultural issues, overeating, eating too much corn syrup, smoking, lack of exercise, the basics. The absolutely basics are causing tremendous cost in the system and tremendous misery among the people who have the conditions. Helping people understand their role in their own health, helping people move through a mental space where they actually participate in making their health better, which ends up producing costs for their companies and for their insurance companies. Is what we need to use this technology to do and lots of people might respond to the ability to earn money by keeping yourself healthy.

But some people might not. Some people might only responds to other motivations like loosing money or social pressure, or entertainment, or being in the know - being helpful to others. If you give someone an opportunity to be helpful to others with your condition you see their health improve dramatically, for some personality types. At our last company Tickle we had 100 million registered users, 20 billion questions answered. We had five PhDs on staff around the psychology of your personality and where you work and that sort of thing. Taking that understanding about human motivations and creating a set of experiences which address the seven or eight main motivation types which apply to seven or eight different personality types is going to start to deepen our ability to help people move through behavioral changes they need to make to really change their health and the costs of their health - of maintaining their health.

So that's one of the things that we're trying to do. The main cost comes from diabetes, heart disease, obesity, and asthma, and allergies. Those are the sort of main low hanging fruits. That's where if you look at where your costs are coming from, that's where they're coming from. You know diabetes is an epidemic in this county. Eight percent of people have diabetes at this point. That's a major cost center. So going after those diseases with these new methodologies, you know, we've tried disease management in the past but it’s generally been only going after one personality type which is a nurse calls you twice a week to berate you into maintaining your health.

That works for some people but it only works for one personality type. You need to apply many more tools to getting people to change their behavior. And you need to deploy them in a  much more cost effective way which having an experience nurse twice a week to the whole population is a pretty experiences way to do it. And so those are models that have failed but there are many more models to try and some of them are going to work over the next five or ten years. And so that's what Medpedia is. It's a platform for trying out all these different ideas and then capturing those stats about what's working and then iterating on that. And focusing people on the things that are actually working.

Those are evidence based sort of behavior change and that's where we're going. Another big cost canter is misdiagnosis. So in your local area you're going to have a physician diagnosis you and they may or may not have the up to date information about how to diagnosis someone with these things. It's estimated that upwards of 40 percent of serious cancer cases are misdiagnosed. No that you don't have lung cancer, it's just what type of lung cancer and the stage you're at could be misdiagnosed, which causes you to have the wrong drugs, or the wrong program for taking those drugs, or the wrong treatments.

And if it's 40 percent, that's an incredible cost to the person to be misdiagnosed and an incredible cost to the system to have to treat them for five or six months in the wrong way before they actually get the proper treatment. So that's another way Medpedia can help is by processing the information more effectively and having the most up-to-date stuff available to everyone including your local physician who can then tap into that knowledge base and help that physician diagnose you properly more often that not.

Recorded May 27, 2010
Interviewed by Andrew Dermont

Most of the United States’ health care costs come from diabetes, heart disease and obesity—problems that could be fixed by changing our behavior.

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