How Consumers Will Fix The Healthcare System, Part II

As I wrote in my last column, consumers are going to be the ones that drive health care reforms in two ways. First, they’re using technology to improve their own health. Second, and the topic of today’s column, consumers will help revolutionize the way health care is delivered. Companies like Teladoc and American Well were first to break the traditional office and clinic-based visit model on a large scale, promising and delivering physician access 24/7/365. They have given consumers the first good look at where health care delivery is going. And it’s the current and next generation of health care technologies—from relative newcomers like Scanadu, CliniCloud and First Opinion—who will help completely revolutionize the health care delivery model from the outside. I also see ways how giants like, CVS Health Corp., Qualcomm, IBM, Verizon Communications and Walgreen Co. can and will get in on the action. To see just how badly we need reforms in health care delivery, let’s look at a common health system encounter from the lens a typical consumer. I’ll use our family as the storyline, as we have five children, so have frequent opportunities to access health care, with hundreds of encounters over the past 20 years.


Scanadu Scout is designed to check temp, BP, heart rate, oximetry, ECG, HRV, stress and share with a doctor. (Photo courtesy Scanadu)

Our youngest woke up sick on a recent Monday morning—sore throat, fever—right before a major trip my wife and I had to take together. I whisked her to the doctor’s office while my wife got the other kids to school and scrambled to make last-minute daytime care arrangements for the sick one.

 Now you’d think that since we called ahead and briefed them on the symptoms, we’d just be able to get into a room and be seen. But that’s not how the system works. First, despite the frequency of our visits, I am treated like a complete stranger. I have to fill out a paper form repeating what I said on the phone, and supply the insurance card they already have on file. After this dance is done, we wait in the lobby until we get called, and a nurse takes us to a room and starts to record all of the necessary vitals from my daughter: blood pressure, temperature, heart rate, oxygen level, and weight.

After all data is captured, none of it is shared with me. On top of that, I am asked a barrage of questions about our family’s health history—information we’ve given to them at least a half dozen times before, with each child we’ve had there. I struggle to understand the connection; I’m only here to find out if my daughter has strep throat or not.

Finally, the doctor comes in: The person who has all the power of reading my daughter’s body and interpreting the data from the vitals and telling us what is really going on. It’s most likely strep throat, says the doctor after a short assessment, and orders a throat swab. Five minutes later, the diagnosis is confirmed. (A couple of days later, our then-well daughter brought home a note from the school nurse; over 30 1st graders had contracted strep throat over a 2-week period, so we should be on the lookout look out for symptoms in our kids. Hey, IBM Watson: consumer product idea here!

Million consumers go through this time-consuming engagement experience with our health care system. There’s only one doorway to diagnosis and treatment, and that’s through the doctor’s office (or ER, or clinic) for most consumers.

In my opinion, interacting with the health care system provokes the same feelings I get when I go through airport security and/or trying to recover lost luggage. There is a huge opportunity for disruption in this space, as disruption almost always comes via creating better consumer experiences. And the need for disruption in this space is critical.

We’ve consulted with large and small health care systems across the country as part of our practice. We’ve talked to many physicians who tell is that, in their estimation, well over 50% of all in-person visits are unnecessary. This estimation is backed up by a recent article about First Opinion, which states that the American Medical Association estimates that up to 70% of in-person doctor visits could be replaced by phone, email or video consultations.

The fact that a physician must physically see a patient to be reimbursed for care is a big flaw in the delivery model. A second model flaw is that doctors and clinicians have been the only ones empowered to interpret what is happening to our bodies.


ClinicCloud Bluetooth-connected stethoscopes and thermometers that enable consumers to check their own vitals and have a doctor access them via the cloud. (Photo courtesy of CliniCloud)

Fortunately technology has begun showing us glimpses of a much better way that we can begin to change the engagement dynamics.

Scanadu Scout is a hockey-puck shaped scanner that records a host of vitals: temperature, heart rate, blood pressure, oximetry, ECG, and heart rate variability, among others. This is the baseline data a physician uses to help guide diagnostics. But for the first time, devices like Scanadu Scout give consumers the ability to read their own body data and make educated judgments on what we think the problem might be.

Saliva-based, over-the-counter test strips could let us test our kids and ourselves in the comfort of our own homes. Instead of having to wait until office hours, taking up the time and attention of at least 4 clinic staff members, and 3 critical hours out of our day, we could have diagnosed our daughter’s strep throat in a much more efficient and cost effective way. Using a Scanadu Scout to record vitals and a home rapid strep test (already available at Walgreen Co., CVS Health Corp and even Inc.), and accessing our pediatric clinic via email or phone, we could have saved ourselves valuable time, and had a much more delightful experience, both for our daughter, who could have been treated sooner, and for us, who would have wasted no time.

Home-based monitoring and diagnostic testing capabilities, combined with the sheer amount of basic physiological data we can already extract from the myriad fitness wearables in the market, mean companies like Teledoc, American Well, and First Opinion, will start to make real headway in helping consumers access the care they need, when they need it, not when it’s most convenient for the health care system to provide it.

Bottom line: Consumers will direct health reform, not the established health care players. Aside from the new digital delivery models we’ve discussed here, new players are on the horizon. I would not be surprised to find mobile telecom giants (Qualcomm Incorporated and Verizon Communications Inc., for example) moving into this space, since they rule the communication pipelines that enable these new access channels.

We now have the foundation to provide consumers incredible insight into their own bodies, tools to enable consumers to support their own health, and companies known and unknown determined to drive meaningful change in population health as well as health care delivery.

The ingredients are here. Let’s see who takes up the challenge.