Harry Nelson

Digital Healthcare, Part II: Where do we go from here?

My post last week offered an overview of the different strands digital healthcare, including three elements that I characterized as foundational to the digitization of healthcare — electronic health records (EHR), data analysis, and artificial intelligence (AI)) — and four clinical uses: telehealth, telemonitoring, therapeutic virtual reality, and health robotics. Since then, a few people have asked whether personalized, genomic-driven healthcare also belongs on this list, as perhaps the most significant therapeutic outgrowth of the data revolution. It would be reasonable to include it on the list, but I will explain in a future post why I consider it a related but distinct transformation.

As a follow up to the digital health overview, I wanted to offer some thoughts for healthcare organizations that are not sure how relevant digital healthcare is to their businesses, let alone how to get ready for the transformation. Many organizations that I work with already “get it” and are actively involved in telehealth or other parts of the digital health marketplace.  I have concerns for everyone else—the healthcare providers and organizations that are not actively thinking about how digital healthcare may disrupt their businesses in the not-too-distant future.  If you fall into this category, this post is for you.

In the current environment, keeping up with technology trends, products, and services relevant to your part of the healthcare world is not optional. I worry, for example, for the countless healthcare providers out there who are ignoring the information security threats to their systems and data. More broadly, I worry for the providers and organizations that aren’t addressing the question of whether and how new technologies might sustain or marginalize current providers. By aligning with and adapting new technologies, providers have the potential to generate new clients and develop new products and service.

Healthcare providers need to ask themselves some basic questions: What threats are emerging that are going to weaken my current patient base in the future? And, more importantly, what can my organization do to address those threats?

In my previous post, I noted the demand for digital healthcare solutions as a manifestation of the “Starbucksized” consumer-patient. The same patient who has been trained by Starbucks, Amazon, Uber, and a host of other web-based tools that he or she can have exactly what he or she wants, as soon as possible, is inevitably looking for a new experience of healthcare. Every week brings a new article speculating about when there will be an Uber for healthcare.

We are still early in the process. Many patients have not yet gotten familiar with the convenience of digital-service provision. But that’s changing quickly. In the process, a market is steadily growing for more and more services for more and more patients. Rather than a single “killer app,” I believe we are heading into an era of dozens and potentially hundreds of “Ubers” for healthcare.

“Healthcare” encapsulates an enormously broad range of consumer needs and conditions that are likely to be met in a multiplicity of solutions that compartmentalize and simplify particular problems: parents wanting help with their baby, teenagers needing medication for acne, busy professionals looking for a virtual appointment for travel medicine, and so on. While certain conditions (e.g. abdominal pain) may need a hands-on examination and some kinds of care call for a personal relationship, the vast majority of non-life-threatening conditions are likely to be addressed with convenience-driven, online solutions.

Recognizing this trend, smart healthcare organizations are asking how they can leverage digital health tools to meet patient needs and ensure their future. Starbucks, Amazon, and all of the other legendary disruptive companies began by asking a simple question: what do customers really want? They then built out offerings that met those identified needs, and in the process challenged how things had been done by competitors.  They dug deeper into the need, and in the process reenvisioned the solution.

Many existing healthcare providers and organizations are still stuck in the way that things have been done for a long time, and failing to ask: What services and products do patients want? What will they pay for? Most providers are not spending enough time asking patients what they really want, and they are not doing enough creative thinking about how to deliver just that.

The time to undertake this process is while business is still healthy: when the existing patient base is intact, and the focus is on retention and expansion. Don’t wait until the signs of competitive erosion are evident. It is a safe bet that the list of services patients will want once they learn what’s possible will only grow, and the question is whether patients will get them from their current providers or migrate to new resources to find them.

To use a personal example, I never gave much thought to the inconvenience of going to gas stations to refuel.  It wasn’t an optional activity — at least not until my wife turned me on to the possibility of someone coming to my car fill my gas tank via the application, Purple. Even though I hadn’t ever thought about this as a “need,” I quickly realized that going to the gas station is an activity I don’t miss and that, even if it only saves me five minutes every few weeks, it feels good to take stopping at the gas station off my to-do list by using my smart phone to order gas and have it brought to me. Healthcare companies like Lemonaid Health are tapping into this same appeal, creating super-convenient offerings that offer a level of convenience patients never imagined they needed.

The bad news for “conventional” healthcare providers is that the sources of competition from remote providers are growing rapidly and getting better and better. It’s critical to be paying attention to risk points of losing patients to online conveniences. At the same time, the good news is that healthcare remains a universe of unmet needs, and that if patients experience you as a healthcare provider who is working to meet those needs, there is no shortage of opportunities to engage existing patients and find new ones.  In fact, being a provider who is an early adopter of new technologies is a good way to engage curious patients open to something new.

The first step for providers who are still running traditional practices is to identify every aspect of care that patients may experience as inconvenient. A safe place to start is with the onboarding and scheduling processes. Can new patients find information and complete forms online? Can they schedule appointments without speaking to a human being? I recently experienced a painfully drawn-out scheduling process where it took over a week to get an appointment. I suggested to the provider that he consider an online appointment scheduling tool, such as Schedulista and DocMeIn, which would have gotten rid of the hassle of back-and-forth options to schedule an appointment. I know a number of physicians who use ZocDoc for the same reason—an unmet need for simple scheduling. The key to the new world of digital healthcare is maximizing convenience and meaningful, personalized services for patients every step of the way.

Many small and solo healthcare professionals see telehealth and digital health as more of a threat than a promise. This pessimism overlooks the value of the relationship of trust that providers have with patients who know them and have an off-line, real-world relationship with them. While patients are clamoring for more digital convenience, there is still, and in some ways, even more of a hunger for meaningful human connection.  Just as the general erosion of privacy in the information age has made patients more, not less, protective of their medical privacy, the shift to an economy of anonymous transactions for small convenient tasks heightens the demand for meaningful, real relationships for important decisions. This translates into a big opportunity for doctors who can engage online with patients who know them offline. The key for healthcare providers is to recognize that the marketplace and consumer expectations are evolving more quickly than in the past. The most successful providers and organizations will be those that identify a “change need” and are able to offer new services that improve on some aspect of healthcare delivery.



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