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Sound Advice


Buying a home. Choosing a career. Getting married. Are there any decisions more important than these? What about choosing the best hospital?

Make that choosing the best hospital for cardiac care when your spouse is in cardiac arrest in the back seat of your car. That's what happened to Ann Mond Johnson, co-founder and CEO of Subimo LLC, supplier of online healthcare decision-support tools to HMOs, employers and consumers.

"A year after we started [Subimo], my husband went into cardiac arrest in the back seat of my car as I was driving him to the hospital for what we thought was acute gastritis," Mond Johnson says. "The EMTs wanted to take him to one hospital, and I insisted on another, a bit further than the first. I was adamant because I was familiar with the data, and we were lucky because we knew this in advance."

After undergoing quadruple bypass surgery, Mond Johnson's husband now is in good health. "Not a week goes by without reading about what you might do in the event of a stroke, a coronary or other emergencies," Mond Johnson says. "As people become familiar with healthcare using credible data-in conjunction with a host of other sources they may rely on-they often tell us that our information confirmed what they had heard previously, or gave them cause to research their options further. This is especially true of parents with small children or individuals who are living with certain conditions."

Q. How do decision support tools help consumers achieve better health?

A. When a consumer is given reliable and credible healthcare information, they will use it to seek the most effective treatment. When the company started, we learned about the Voluntary Hospital Assn.'s consumer market research, where consumers were given brief explanations of evidence-based medicine or what should occur, for example, if you are brought to an ER with a suspected heart attack. The interesting thing was, consumers readily understood what "good medicine" was and were outraged when they learned it wasn't practiced at all hospitals.

The American consumer is fundamentally smart and knows how to use information, even in the field of medicine where problems frequently lack a clear solution. Our approach is to provide the relevant data and information in a fashion that people can understand and use to make better decisions. Consumers who are more engaged in their care have a better likelihood of a good outcome. Consumers know that the healthcare system in not infallible, and are beginning to realize that they can help mitigate their risks by making informed decisions.

Q. How do online decision tools help control healthcare costs?

A. Our suite of tools help consumers understand their options, and the relative risks and cost of their choices. Take the hospital selection tool, as an example. One of the misperceptions we address is that people are initially afraid that they are at a high risk of dying when they undergo a particular procedure. In fact, the risk of death is pretty low for most procedures. The real risks are in the avoidable complications (e.g., infections), which add costs to the system along with other factors. Doing it right the first time costs less.

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