Friday, July 19, 2013

Electronic  Health Quotient  A Potential Revenue Source for Diagnostic Laboratories
What is this thing called health?
H.L. Mencken (1880-1956)
Some of the biggest cuts are aimed at independent laboratories, which will see 26% of their fees slashed.. Laboratory services provide answers in test results that provide up to 75% of the information that drives clinical decision making in diagnosis.
Cheryl Clark, “Proposed Medicare Fees’ Winners and Losers,” HealthLeaders Media, July 15, 2013
As a former owner of a diagnostic laboratory,  I am sensitive to the issues of health and laboratory tests
Let’s begin with the issue of health.   Everybody talks about it, but no one defines in other than general terms of feeling well and being thin, active, and fit.   Health supplements,  vitamins, and weight loss programs are all booming.  The state of your “health” and how to improve are huge  businesses,  consuming 18% of the GDP, and generating unprecedented revenues  (and political debates)  on how to improve it and decrease its costs. 
Isn’t it about time we defined “health” in understandable metric terms?.   I had a go at defining it some I could measure back in 1985 when I developed The Health Quotient (HQ).  The idea was that the HQ was the analogue of the IQ, with a normal range of 80 to 120.   We based the HQ on a simple questionnaire, which included a family history of diabetes and health disease,   physical findings (height, weight, blood pressure,  waist circumference) and common laboratory tests (glucose, blood lipids).  An algorithm then calculated the HQ and sent it to the patient.  

A letter accompanied the result, telling them the clinical significance of an average,  low, or high HQ.  The letter, written in plain English encouraged them to visit their physicians in any results were abnormal.  We test marketed the concept in Minneapolis and Oklahoma city, and both patients and doctors to whom the patients self-referred liked the idea.  I described the outcomes in more detail in my 2007 book Innovation-Driven Health Care; 34 Keys to Transformation (Jones and Bartlett)
The idea of the HQ resurfaced when I read diagnostic laboratories were taking a 26% cut in Medicare reimbursement and again when I took my wife for a visit to Yale.   At Yale,  they had a weight,  height, pulse measurement machine that automatically entered the data electronically into the patients’ clinical record.   Why not, I thought,  have a similar machine at diagnostic laboratory  drawing stations, along with a simple questionnaire?   And why not send patients the results of their electronic health quotient to give them a sense of their overall health?
Tweet:   This blog presents the concept of the Electronic Health Quotient (EHQ) and suggests it be made available at  laboratory drawing stations.

1 comment:

Anonymous said...

If patients are furnished the results of their electronic health quotient with the misguided notion that it might provide them with a sense of their overall health, it would fail for they could not possibly understand its meaning and significance? Thus, would it not just serve to cause distress rather than bring comfort?

In his analysis, Dr. Reece sadly failed to develop the balance of the actual analogy of HQ with IQ.

It is incontestable that we are all born with fixed IQ potential, and reading and study will not raise our potential for learning and understanding above the level of that with which we are born.

Likewise, we are born with a fixed HQ, and we can neither improve our life expectancy nor our wellness above the level with which we are born. Simply put, one can neither diet nor exercise their way to a higher level of wellness than that with which they were born.

Fundamental to this assertion is the fact that we are all born with defects. For example, if someone is predestined to contract (inherit) pancreatic cancer, there is nothing they can do about it until it occurs, and then they are limited to undergoing mostly futile treatments. Heredity plays a far more important role than those selling vitamins and exercise programs, among other snake-oil promises, will ever admit. And, useless anecdotal evidence is used as a sales tool.