Solving the Maze Wise use of the healthcare system © 2008 Purdue Research Foundation.

Solving the MazeWise use of the healthcare system

© 2008 Purdue Research Foundation

Objectives By the end of this module, participants should

be able to: Identify why wise use of the system is necessary Discuss proper utilization of the current health plan Recognize the importance of using generic drugs Discuss the difference between the emergency room

and urgent care and when to use each Recognize key steps to taking control of personal

health


Why be Wise?

Increasing costs to employers Shift to greater cost-sharing with employees

Effects everyone’s bottom line Improved medical care

Eliminate unnecessary or repetitive treatments


Where to Begin? Understand your health plan Choose a primary care physician Get appropriate care Prevention


Understand your health plan Customize to the company


The Right Doctor Primary Care Physician

Commonly known as family practitioners, general practice, internal medicine or pediatrics

First stop in the healthcare pathway Can open doors to specialist care

Can address a variety of issues Often refers to other specialties if needed Cost effective approach to general care


The Right Doctor When selecting a doctor, consider this:

Is the office convenient? Are office hours reasonable? Is the staff friendly? Can you talk to the nurse if the doctor is busy? What hospital does the doctor have privileges at? What is the doctor’s philosophy on medicine

(traditional or alternative)?


The Right Doctor Research your doctor

Information from the office, online, etc Interview (may incur a charge)

Already have a primary care doctor? Do you like them?

Are you satisfied after the visit? Don’t feel guilty for changing

When is the last time you visited?


The Visit Healthy history

Do you know your history? Useful templates

Medications- avoid interactions Prescription drugs Vitamins and minerals (ex- niacin) Supplements (ex- St Johns Wort)

Allergies/intolerances


The Visit Wise use of limited time

Bring a list of concerns Act as a reminder Give to the doctor at the beginning of the visit If several concerns exist, make staff aware in advance

and schedule extra time Ask questions about proposed treatments

Why this treatment? Do other options exist with similar outcomes? Are generic drugs available? OTC?


It’s 10:00 pm and you can’t sleep. You have had a 103.5°F fever for five hours. You haven’t been able to eat or drink anything for over 12 hours. Although the rest of your body feels fine, you have a very stiff neck that hurts to try to turn. What should you do?

A. Call the doctor and ask advice

B. Use a self-care guide for information

C. Go to the ER


Appropriate Care Self care guides

Guide you through the decision making process Multiple formats available

Gender and/or age oriented Family oriented First aid only

Purchased online, local bookstore, etc



Appropriate Care Seeking immediate treatment

Emergency room (ER) Treats major, life threatening conditions

Heart attack, stroke, car accidents, major burns, major traumas, poisoning, seizures, etc

Urgent care Treats other conditions that are not life-threatening

Cuts/scrapes, back pain, asthma (mild to moderate), ear pain, rashes, fever, small broken bones, sprains, etc


Appropriate Care Why use Urgent Care versus ER?

Efficiency of care Potential for less waiting time

Cost savings Median cost for ER visit = $300 Starting cost for Urgent care = $70

What is the closest urgent care? Customize to company location


Appropriate Care Prescription drugs

Brand Original version of the drug Expensive due to research and marketing costs

Generic Chemically identical to brand name versions Cheaper than counterpart since no need for additional

research Not always available if brand version is still covered

by patent


Appropriate Care Prescription drugs

Potential for cost savings Prilosec = 20mg (30 day) $142→ $426 (90 day) omeprazole = 20mg (90 day) $64 Prilosec OTC = 20mg (14 day) $20

Pharmacy discounts $4 drugs

Target, Wal-Mart, K-Mart, Kroger, CVS (by request) Free generic antibiotics (Meijer)

Over the counter (OTC) options


Preventive Care Visit your physician regularly for overall

physical Every 1-3 years depending on your health and

overall condition Complete preventive exams as needed by age

and gender


Take Control!

Take an active role in your care Ultimately, it’s your body

Ensure quality of life


Take Control of Your Healthcare Expect knowledge

Ask questions at the doctors office Expect answers you can understand

Do your own research Use reliable websites/journals/resources


Take Control of Your Healthcare Personal health record

Keep track of vital information Allergies Conditions Surgeries Health history

Great resource for various doctors Keep one for each family member


Summary Great care starts with good communication Wise use of the system will save everyone

money Taking control of your health and healthcare

can lead to improved overall health


Web Resources Healthcare provider link WebMD

www.webmd.com Mayo Clinic

www.mayoclinic.com Personal Health Record

Microsoft – www.Healthvault.com American Red Cross (CPR and first aid)

www.americanheart.org


Acknowledgements This class was designed by:

Allison Bryan MS

Certified Health Education Specialist

This product was funded by a grant awarded under the Workforce Innovation in Regional Economic

Development (WIRED) Initiative as implemented by the U.S. Department of Labor’s Employment & Training Administration. The information contained in this product was created by a grantee organization and does not necessarily reflect the official position of the U.S. Department of Labor. All references to non-governmental companies or organizations, their services, products, or resources are offered for informational purposes and should not be construed as an endorsement by the Department of Labor. This product is copyrighted by the institution that created it and is intended for individual organizational, non-commercial use only


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