My Phillipino/Indian/Canadian Nurse

My Phillipino/Indian/Canadian Nurse.

We have been doing a lot of work in the healthcare industry recently. So, we have been thinking about what needs to be improved in the US healthcare system.

The statistics attached to the US healthcare system are stunning. We spend 30% more than any other country. Yet. approximately, 25% of the US population has no insurance. Plus, patient outcomes and satisfaction are well below acceptable standards across the industrialized world. A whopping 70% of health care costs stem from preventable chronic diseases. For example, 91% of diabetes cases could be avoided by better eating. Diabetes cost the healthcare system $92 billion dollars each year. Imagine finding a way to save $80 billion dollars a year.

Obviously, the system has lots of problems. Here is one solution that provides a huge bang for the buck.

I want my family to have our own nurse for 5-10 minutes a day, average 2 days a week, 12 months per year. My estimate is that we will need our nurse's time for no more than 12-20 hours per year.

For a little background, one of the fastest growing job descriptions in healthcare is the telephonic triage nurse. Thousands of nurses are sitting behind phones right now talking to patients recovering from serious illnesses or dealing with chronic conditions. They are trying to keep these sick folks from getting sicker.

We should all have access to a telephonic wellness nurse. In Massachusetts, our family's health insurance costs more than $15,000 per year. The annual rate increase is 10%. So, does spending approximately $500 per year to provide my family access to a nurse who gets to know us make any sense.

There are 4 people in my family.We are blessed to be healthy with no serious, chronic, or complex issues. We are not heavy users of the health care system. Does this personalized wellness service make financial sense for our HMO?

Lets say our family makes a couple of unnecessary trips to our primary care physician each year. Could we saves $300 on preventable visits? Do we always get the most cost effective prescriptions? Could we try off the shelf medications instead? I know that Doc's don't pay attention to the unit cost of prescriptions that they write. Lets just say the savings are $200 per year on drugs?

By my estimates for a healthy family, this telephonic wellness nurse is a break even proposition for the first year. For a family with serious illness or chronic conditions there is certainly a very strong use case for this system.
My point is that this system would work wonders for most families over time. The truth is that most of us don't drop dead, we rust away, or eat ourselves to death having developed poor lifestyle habits.

If I lose 25 pounds thanks to my wellness nurse's regular questions and information can I eliminate the need for cholesterol or blood pressure medication? Can this service prevent 20 years of dependency on medications? Does it prevent one visit to the ER or a stay in the hospital. These would be huge successes. The savings start to add up when lifestyles are changed for the better. I haven't even mentioned the most important emotional benefits of improved wellness for my family. Who knows maybe I would pay a premium for this service?

There are some challenges with this idea.
First, there are not enough nurses in most big cities across the US. However, there are plenty of nurses outside the US and willing young people wanting to be educated. As you can tell, the level of service that I am asking from my family's wellness nurse is not extraordinary. It may be an LPN or health nutritionist on the phone. My assumption is my nurse will have access to lots of current healthcare information and additional experience when a tougher issue comes up.I am also assuming that my wellness nurse has access to my family's relevant medical history and is able to communicate with our physicians when needed. I'm also assuming that the labor costs are fair but not at the same rate of big city US nurses. Yes, this service could be outsourced to the very countries that are currently sending us nurses on immigrant visas.

What is extraordinary about this concept of a wellness nurse for every family is the technological requirements to support this service are non factors when it comes to the overall business model. Modern telephony and web based tools allow this type of service infrastructure to begin with a model and scale incredibly well with costs that are 90%lower than just a few years ago. The industry specific and business efficiency limitations that we face going forward are no longer technical but entirely creative or organizational.

Start doing the math, my guesstimates of potential costs and savings could be way off; yet any HMO that implemented this concept for all its rate payers would still be considered brilliantly innovative,highly profitable, and loved by all.

We must start changing our assumptions about what is possible.