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A Single Point of Entry for Health Care Consumer Assistance and Advocacy The Health Rx:
A Single Point of Entry for
Health Care Consumer
Assistance and Advocacy
January 2000
Prepared by:
The Public Strategies Group, Inc.
for the
Minnesota Department of Health
As requested by Minnesota Statute 3.197: This report cost approximately $60,675.00 to prepare, including staff time, printing
and mailing expenses. Upon request, this material will be made available in an alternative format such as large print, Braille
or cassette tape.
Printed on recycled paper.
Commissioners Office
85 East Seventh Place, Suite 400
St. Paul, MN 55101
(651) 215-5800
www.health.state.mn.us The Health Rx:
A Single Point of Entry for Health Care Consumer
Assistance and Advocacy
Table of Contents
Page
Executive Summary.......................... 1
Images of Success.. 3
The Need 5
The Design
The Customer 6
The Stakeholders 7
The Expected Strategic Results 8
The Health Care System Viewed from the
Consumers Perspective
9
The Health Rx
12
Different Types of Services
The Webmaster...
14
The Gateway...
16
The Triptic Planner
18
Triage Services
19
Closing the Loop: Resolution
20
Strategic Underpinnings of The Health Rx
Staying Accountable by Focusing on Results..
23
Staying Vital by Following a Morphing Strategy
25
Staying Credible by Operating Independently
26
Staying Robust by Earning Revenues
27 Table of Contents (continued)
Page
Recommendations for Implementation
1. The Health Rx should be implemented
30
2. To test consumers specific needs, initially only selected
aspects of The Health Rx should implemented

31
3. Build and initially implement only the fundamental
information services: The Webmaster and The Gateway options
31
4. Build The Health Rx to incent the patient, the doctor, and
the payer of health care to address their concerns directly
31
5. Build and implement
The Health Rx with an unyielding
accountability for delivering on the strategic results
while not sacrificing credibility with stakeholders
across the health care system.
32
Appendices
Appendix A: The Legislative Context for This Design
Appendix B: Three Tiers of Minnesotas Health Care System
Appendix C: PSGs Approach for This Project
Appendix D: Design Principles
Appendix E: Design Participants & Interviewees*
* Over forty citizens of Minnesota, coming from quite different perspectives on the health
care system, gave generously of their time, expertise, and ideas to make this design
possible. The Public Strategies Group thanks these individuals for their essential
contributions. The Health Rx:
A Single Point of Entry for Health Care
Consumer Assistance and Advocacy
When Florence Nightingale returned to England from the Crimean
War, she worked unceasingly for health care reform---reform of the
conditions and methods of health care. It is said that whenever she
wrote messages to friends or colleagues, she would always hand-pen the
words never forget in the margin. These words served as a reminder
of the clients she had personally servedthe soldiers she nursed during
the war. It was her way to never lose sight of whom she was working
forto keep grounded and focused on the purpose of her work.
Executive Summary
While we have come a long way in medical care since the 1850s, many who participated in the
design of this service stated that Florence Nightingales words bear repeating---there are
instances where the health care system and its component parts lose sight of the consumer they
were designed to serve. In some cases, consumers are confused about how to access health
care or how to pay for it. In others, they fall through the cracks of well-intentioned services.
At times of intense personal crisis concerning the health care of oneself or a loved one,
consumers feel blocked from receiving timely answers to their questions. A complex system
awaits when they reach out for help.
The objective of this project was to respond to this need by creating a single point of entry for
health care consumer assistance and advocacy.
The service envisioned in this report is a single place to turn when consumers have questions
that have not been resolved by todays health care system. This single point of entry is not
intended to reform the complexity of the system. Rather, it is intended to provide the consumer
with the means to access, understand, maneuver through, and challenge the health care
system.
For purposes of this report, the service envisioned here has been dubbed: The Health Rx. The
actual name should be planned carefully. However, there is significance attached to this name:
The Rx name implies that this consumer service as designed is medicine for the health
care system to work at its best. Minnesota Health Care Consumer
Assistance and Advocacy Design
- 2 -
1999 The Public Strategies Group - Beyond Bureaucracy
The Health Rx is not envisioned as a single service. Entry components reach out to
consumers at predictable times of health care need, as well as provide known, easy, and available
methods to access The Health Rx across the state.
Response components help consumers directly access the information they need, when they
need it. These components must listen deeply to understand the consumers real issue and link
them with services ranging from referral to actual guidance through available avenues of
recourse. The level of service accessed is dependent on consumer preference, ability to pay,
and need.
At any level of assistance, success for The Health Rx is dependent on its ability to provide or
link the consumer with resolution to the issue. Resolution is defined as: a determination has
been made and an explanation has been given that the consumer understands. Implicit in
this definition are two important assumptions. First, resolution - not a referral - is what a
consumer most values. Second, resolution will not always equal the answer or solution that the
consumer wants. The Health Rx will measure consumer satisfaction as well as understanding
of the resolution. It will also report to the health care system on trends, issues, and unmet
consumer needs.
Thus, The Health Rx will be tenacious in seeking resolution to consumer questions and
issues, while staying neutral about the actual resolution sought. It will help citizens
access credible information so they can be informed, responsible consumers. It will bring
performance information back to the health care system so that learning and
accountability are strengthened.
Designers were clear that a service such as The Health Rx would contribute significantly to an
improved health care system. They were less certain about the shelf life of this medicine.
Forty people were involved in this design. They were divided whether the health care system
needs only cod liver oil to help it work better or whether a fundamental piece is missing.
Consequently, the implementation of this design calls for The Health Rx to morph or evolve as
the answer to that question becomes clearer.
This report recommends that The Health Rx start with credible, easily accessible consumer
information services. These services will link a consumer with the right information or resource
to answer the question or resolve the issue at hand. As designed, The Health Rx itself is
capable of evolving and learning as consumer health care issues change, as they will inevitably.
The Health Rx is also capable of evolving into more intensive consumer assistance; conversely,
it could dissolve at the point when it is no longer needed. Minnesota Health Care Consumer
Assistance and Advocacy Design
- 3 -
1999 The Public Strategies Group - Beyond Bureaucracy
Images of Success:
The Health Rx
With a successful The Health Rx in place, one can imagine these scenes occurring on a regular
basis throughout the State.
Jama
Jama and his family, having arrived in Minnesota three months ago directly from Somalia,
are without access to health care. Both Jama and his wife have heard friends mention
concern with Hepatis B but dont know what this all means. Today their teenage daughter
came home from high school with a refrigerator magnet, written in Somalian. It caught
Jamas eye because it encouraged anyone with questions about health care to call 211.
Jama goes to a pay phone and makes the free call to The Health Rx. To his surprise, he
is quickly linked with a Somalian speaking person who is able to understand his concerns,
explain Hepatitis B, and lays out basic options for Jamas family. The aide encourages
Jama to utilize the Somalian C