Quality and cost savings through consumer engagement

Some of the things consumers are expected to do in the name of health care quality and cost strike me as a stretch. Telling their doctors to wash hands and researching the efficacy of different procedures and facilities are two that are tough. But there are areas where consumers can make a big impact if they're given the proper information.Deciding whether to call an ambulance is a good example. A new study from the UK, reported on MedPage Today (People Confused Over When to Call an Ambulance) illustrates some of the specifics:

When a baby has a stiff neck and a high fever, or an elderly person starts slurring their words without being under the influence of alcohol, it's time to call an ambulance -- but not many people know this...These signs of meningitis and of stroke are worthy of a lights-flashing, sirens-blaring trip to the hospital, but 53% of Britons responding to a survey said there was no need to call emergency transport for the meningitis scenario and only 25% would call an ambulance for the stroke.On the other hand, almost 50% thought a woman in labor deserved such a ride to the hospital -- just one of many scenarios found to be illustrative of inappropriate use of ambulances...

The study itself is pretty weak since it relied on survey responses from a small number of people, many of whom knew the investigators and some of whom had medical training. And we don't know the implications for the US. Still, there is ample food for thought. For example:

• Calling an ambulance is something consumers initiate so they have a lot of control over whether it happens or not, unlike trying to influence events once they are in the hospital
• There is both overuse and underuse, so consumer engagement is not merely a euphemism for cost cutting or cost shifting as is sometimes alleged
• A modest amount of education should be sufficient to train people on what to do in many common situations, such as those described int he study