Don Kemper and Molly Mettler are retiring from Healthwise this coming year. Kemper is CEO of the nonprofit, and Mettler is senior vice president of mission.
Kemper has led Healthwise — which creates easy-to-understand health information for hospitals, front-line medical providers and consumers — to grow from a few people to a $40 million-a-year organization with about 275 employees. Healthwise has expanded from publishing a healthy-living handbook for families to producing content for hundreds of medical providers.
One example is the “Pregnant Me” program for women who are pregnant. It is being tested now with a national company’s employees, Kemper says. The program includes “patient decision aids,” a Healthwise product that could help an expectant mother understand the risks and benefits of a cesarean section versus a vaginal birth if she faces a decision about how to deliver her baby.
“Unless a patient is leaving each encounter smarter than she came in, then it is a wasted encounter,” Mettler says.
The organization also has been recognized nationally as a good place to work. Employees can bring their dogs to work, and their health benefits include a wellness program that offers financial rewards for healthy living.
Kemper, 69, and Mettler, 61, are married. They met decades ago, when they shared a common passion and eventually a common workplace. Mettler’s role has been to ensure the company hews to its core mission: empowering people to make better health decisions. Her post-retirement role, like Kemper’s, will be that of a world traveler.
Q: How did your story begin?
Don: We met when Molly was at University of Washington, and I was here. We were funded by the same Kellogg Foundation grants, so that’s how we met.
Molly: Actually (both laugh), you had a grant from the CDC [Centers for Disease Control], and I had a grant from the Administration on Aging. We were both interested in health promotion for older adults, and there were only three places in the country that were paying any attention: Healthwise here in Boise, Dartmouth and the University of Washington School of Social Work. It was like finding somebody else who’s as passionate about that. And we were like (gasp), “You like health promotion for older adults? Wow!” So, that’s how we first met, and then we just started collaborating, and then I got recruited to come to Healthwise.
Don: One of the creation stories was I was in the Public Health Service, and one day I heard a talk by Vern Wilson [then an administrator in the federal department that later became Health and Human Services], and he said, “The greatest untapped resource in health care is the patient.” That was sort of an a-ha moment for me to say, well, maybe that’s what I should focus on.
So I started to work on the federal government. I said, “What the world needs is a Dr. Spock book for the whole family, that will help them take care of common health problems.” I tried to get the federal government to write the book and give it to every home in America. But it didn’t work. So, at the end of [the Public Health Service’s] two-year service, I took that idea with me, and a few years later, I ended up in Boise, Idaho, with the opportunity to pursue that.
[My boss in Boise] had just started to run a nonprofit, and his mission was to rock the boat in health care. “Let’s get something done that’s different.” That nonprofit was known as Health Systems Inc. We did a lot of training — the first nurse practitioner training in Idaho, the first EMT training in Idaho, we created a consumer-governed health maintenance organization. And I was able to start this health education program initially, called The Parent’s Role in Health Care. And we tried to see what we could do to help people do more for themselves, to ask for the care they need — to say no to care that doesn’t seem right to them.
We started Healthwise a few years later, 1975 — a separate not-for-profit organization with the same mission, to help people make better health decisions.
Q: With the constant shifting in medical research — not to mention junk science — how do you make sure you’re telling consumers the right things?
Don: We are very good at finding the best collection of evidence and presenting it to the patient. If there are questions about it, we present the questions. “We don’t know the answer to this. Some research has shown one way, some has shown the other.”
We’ve also involved a group that we call our medical editors — people who are in medical research and medical schools all over the country who are often the doctors that are helping to write guidelines for physicians. So we can get that information often a little in advance of the published guidelines.
We are trying to get the patient the absolute best, latest information, because they are going to bet their life on it. That’s our job.
We’re real good at the three sides of that:
• Finding the evidence, and understanding what we know and what we don’t know.
• Writing it in a really simple way — and it’s not just in words, it’s in video and animations and other things — but presenting it so everyday people can understand the evidence.
• And we’ve also gotten very good at delivering the information to people, whether it’s in their electronic medical records or their smartphones or through whatever means we have.
Q : What are you proud of accomplishing in your time as leaders of this organization?
Don: One of the things we’re quite proud of, as of late, is that about 25 percent of U.S. doctors are able to prescribe our information through electronic medical records. [For example,] St. Luke’s has an electronic medical records system called Epic, and within Epic there are patient instructions that go with virtually every clinic visit, and it gets sent to your MyChart in the St. Luke’s system.
Q : What has kept you here?
Molly: I came to manage a grant-funded program for older adults called Growing Wiser. I’ve had this ‘older adult health’ as my heartthrob. I just am fascinated by it. So this opportunity came up back when we were tiny — tiny, tiny, I was the eighth employee. And then Healthwise just kept being interesting, because there’s always something new and special to do. So I stayed with it.
Q : What’s fascinating about older adult health in particular?
Molly: (They) lived through history and survived. ... And the fact that people get to the age of 70 or 80, and they know a thing or two. And that gets woven into a society that totally discounts that, that shelves aging and wants to turn our backs on it, and we can’t. I’m very interested in how we’re going to adapt as a country when every fifth person is over the age of 65.
Q : How might I, as a health care consumer, have seen your work product?
Don: If you’ve ever looked up info on WebMD? Likely written here in Boise. Of the 10 largest health plans in the country, all 10 license our stuff. Many hundreds of hospitals put our information on their websites, and many include our information — like St. Luke’s — built into their electronic medical records.
Much of our recent growth has been through these health systems. Health systems are now changing their business models, so they are much more interested in keeping people healthy than in just having more surgeries and more procedures. So we’ve had a lot of growth in the hospital system world, where they’re trying to have more empowered, more engaged patients.
Molly: People think of it as the Kaiser website or the Mass General website, but if you keep scrolling, scrolling down ...
Q : What’s your vision for the next era — the post-Kemper, post-Mettler era — of Healthwise?
Don: It’s built around the concept of My Care Plan. We want things to be much more person-centered than they are now in health care, and it begins with the goals of what each individual are. So, if we can find out, no matter what your age or your current condition, etcetera: What are your goals in life? What do you really want? How does that relate to your health? And how to make sure that the care team — your doctors, and you might have a number of doctors — all know your goals. And to make sure that others in your life who might help you achieve the goals are aware. That My Care Plan concept, we think, will bring health care back to health. Now that we’ve gotten a little too medicalized.
Try to put the person first, not just the patient.
We have a program we’re developing here called More Good Days. It’s a different way to think about treatment late in life. So often the question is, “Well, do we give mom more care or less care at this stage in life?” And it’s hard to say, “Less care.” We’re trying to change the conversation to, “Let’s give mom all the care that will give her more good days, because these treatments will take away good days.”
Q: How would Healthwise change the conversation?
Don: It’s easy for the doctor to click in the electronic medical record and send a video to the patient or the family. ... “What are your goals going forward, and here’s what you can think about, what questions you want to ask, and depending on the answers what would be your choice? What’s right for you now?”
The technology is there. The social readiness is still fragile. This is sort of a developing program. We want to pilot it, so check in with us next year, we’ll see how far it’s gone, but we’re getting a really good welcome for it, but always people are a little nervous (about bringing up the decision between aggressive treatment or end-of-life care). They want to try it on a small group first and see how it goes. We are patient, we’ve been here 40 years, we’re ready when they are.
Molly: There’s a growing national awareness now about quality of life at end of life, and a whole lot of coordinated movement to do it. And I think people are softening toward it.
Q: You have said Healthwise is a policy mover and shaker as well. The Affordable Care Act incorporated some of Healthwise’s ideas about patient education. What else is Healthwise doing?
Don: We did a merger [in 2014] with the Informed Medical Decisions Foundation, and they’ve been along with us really waving the flag for shared decision-making. They’re promoting the certification of decision aids, so that both in the legal world if the patient has gone through a certified decision aid, the doctor’s pretty well protected because the risks are well-known, so it’s more of an informed decision. And the patient is protected because they know the risk in advance of the procedure.
Molly: I think we come back to if you want a better health care system, start with the patient. Build a better patient, because that’s the lever for implementing a good system — making the patient as involved, as informed, as possible.
Don: The next generation of leaders here will own the culture. And the key thing is it will change, but it needs to be changed with intentionality.
Molly: We do see a lot of change in technology and products. But we see a sort of DNA strand. We are convinced that there will always be work in helping people make better health decisions. We’ll never be out of a job for that.
But we [also] want to have an organization that really values the people we serve and the people who work here. Some things that won’t change, we’re hoping, are the mission and culture and the emphasis on being a really good place to work.
Edited for length and clarity.