The Patient of the Future

But patients do want to know what their healthcare will cost—and they don't just want a doctor's bill or a hospital bill; they want to know what the total costs are, from drugs to devices, Keckley says. Healthcare reform will also affect this, swelling the numbers of people who have individual policies, which already stands at about 18 million. Many will choose high-deductible plans. Insurance companies and employers will drive change, too. They're saying to providers "you must provide this info," Keckley says.

"This is the beginning of a change," Keckley says. "It's at the bottom of that S curve, but it's a significant, sustainable trend, and increased numbers of end users will reflect these behaviors. It will grow ... We're past the novelty stage of this, and we're probably moving past early adopters. We're into early majority."

Indeed, a full 94% of respondents to Deloitte's consumer study said they believe that healthcare costs are a threat to their personal financial security.

"We're at a point where people on the street are voting with their pocketbooks and they're voting with their feet. It may not be the majority today that through their own behavior and their own purchases are forcing doctors and hospitals to behave differently, but I think that's generational," Keckley says.

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Gienna Shaw is senior editor for marketing for HealthLeaders Media. She may be contacted at gshaw@healthleadersmedia.com.

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The Partnership of Physician and Patient
When Dave deBronkart was diagnosed with stage four kidney cancer in January 2007, he turned to the Internet. "I've always been an online guy, so of course I Googled my butt off," he says. What he found: "Outlook is grim. Prognosis is bleak." But then his doctor told him about an online chat room for kidney cancer patients on the cancer-support site Acor.org, where the patient community provided vital validation about Interleukin, a treatment he already had researched. The potentially toxic cancer treatment is decidedly not for everyone. But deBronkart's doctor said he was qualified for the treatment and he followed his doctor's advice, which he says shrunk his tumors—and saved his life.

Since then, he's become an online advocate for patient engagement and empowerment, and is known to many as e-Patient Dave.

The "e" in e-patient represents a number of descriptors: equipped, enabled, empowered, engaged.

Effective e-patients are involved in their own health in a number of ways, deBronkart says:

• They look at their medical records online
• They may share medical records with family and friends who know medicine
• They use e-mail to correspond with their doctors
• They are active partners with the various physicians involved in their care
• They're often active in patient communities
• They may become active researchers

deBronkart works late into the night—long after knocking off work at his day job as a software marketer—spreading his patient empowerment message in chat rooms, on blogs, via Twitter, and in other forums. "My message has simplified. I just believe that patients have every right to know what their options are and they have a fundamental right to pursue those options," he says. "My point here is not that doctors can't do the job—it's that patients can help. We actually have the ability to contribute and help in this economically difficult industry."