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From elsewhere: Tracking health indicators hints towards disruptive innovation in doctor patient relationship

Pew Internet’s Susannah Fox, today, released the official report behind her amazing Stanford Medicine X talk. The report is a great read for data geeks, health wonks and ePatients alike. But there’s one part in particular I find especially indicative of an impending disruption in how we approach medical care as patients.

According to Pew:

Seven in ten (69%) U.S. adults track a health indicator for themselves or a loved one and many say this activity has changed their overall approach to health, according to a new survey by the Pew Research Center’s Internet & American Life Project.

This is the first national survey measuring health data tracking, which has been shown in clinical studies to be a tool for improving outcomes, particularly among people trying to lose weight or manage a chronic condition.

Of all the results, I find one in particular compelling:

40% of trackers say it has led them to ask a doctor new questions or to get a second opinion from another doctor.

I’m predicting 2013 and 2014 as the years we see a sea-change towards true consumer-driven health. In the past, wonks have spoken about high deductible plans and health spending accounts as the economic vehicle to compelling consumer behavior. The problem with that version is it assumes people will consume less healthcare services if they are footing the bill.

There is some truth regarding spending usage. But, largely sick people will seek care and people without access —via insurance or a government program —will delay care until the need is chronic and more costly.

What I’m excited about, based on the Pew results, is the potential of true consumer driven healthcare. Today, it’s increasingly easier to wear a gadget and get direct access to cutting edge lab tests. For $99, 23andMe will examine your DNA an report back some pretty amazing data.

So, if 40% of people report asking new questions based on following their own health indicators, how long before patients become the initiators of a care plan? Rather than rely on doctors to discover whats wrong with us, we’re moving a world where we might know more about ourselves before we seek a doctor than after seeing one.

That idea might challenge some people, including doctors. Rest assured, it doesn’t eliminate the need for doctors. We’re simply looking at a period of disruptive innovation which will change the role of physicians (in some circumstances). It’s a bit like coming to an architect with your own rough draft of blueprints.

For more about Susannah Fox, Pew and the report, check out the video interview from Medicine X:

Susannah Fox - Medicine X Conversation from Larry Chu on Vimeo.

Blue Ocean Strategy

There is a longstanding beliefe about how patients chose their healthcare providers and services. "[P]atients [are] passive health care consumers of physician services..." We go to a doctor a friend or someone at work tells us about, and if we need a specialist or study, we go where that doctor suggests. Is that the case because people want to be passive? Or is it because the "system" is structured in a way which makes consumer choice too difficult to contemplate?

Sometimes the universe gives you subtle hints, and sometimes it smacks you upside the head. Within the last four weeks, I've been inundated with references to Kim and Mauborgne's Blue Ocean. Blue Ocean is book and way of thinking about strategy.

When I first read Blue Ocean a few years ago, I didn't have a context for it and consequently didn't fully appreciate it.

Among other hints, we've been studying Blue Ocean in our graduate program which has given me a renewed interest. So, I'm re-reading it. Or rather, re-listening to the audio book on runs. Same difference.

The biggest lesson for me, to boil it down, is the need for any business to understand its market and its customers.

Understanding customers and markets isn't the same as asking them what they want. It's more about designing strategies, products, processess and services which addresses needs, even if they are unspoken, or even unknown.

Patients (and we're all patients aren't we?) would gladly chose their healthcare in a consumer directed world.

We've built a system around monolithic hospitals with radial arms touching pockets of outpatient care. Imagine if we reversed today's design. What if, instead of one huge epicenter, we had storefronts everywhere? Family medicine, internests, and other primary care practitioners, operating as a unified, front-line brand under consistant quality expectations which could be deployed around the service area as the face of the brand.

What if:

  • Care and experience were top priorities for providers (I'd be willing to be compassion is the biggest unmet, unspoken need)
  • Going to the doctor was as easy as going to Starbucks
  • Patients could schedule their own appointments, on mobile devices.
  • We could use FaceTime rather than waiting in waiting rooms.
  • Healthcare data belonged to patients, and providers would access it, with our permission, as they need it.
  • There would be navigators who's job would include making sure meds were picked up and appointments scheduled.
  • Docs would follow up about tests and treatment directly. And, they'd be accessible (within reason) by email or phone or twitter or text...

I know what you are thinking, many of these things are happening now. But not as a cohesive strategy for provider organizations. Providers are not thinking about designing strategies around emerging consumer wants. Why? The perception is the money is in the old school way of operating.

Remember when coffee used to come in a can from the grocery store? Did we think we wanted a coffee store on every corner? Starbucks tapped into that consumer desire and it seems to have worked out for them.

From the Blue Ocean site:

If the value and profit propositions are strong but the people proposition does not motivate the organization to move forward with focus and commitment, it will result in execution failure. Alternatively, if the people proposition is powerful but the value and profit propositions are weak, the company’s performance will be lackluster due to formulation failure.

via Blue Ocean Strategy.