Who can consumers rely on in the new healthcare ecosystem? Who in the healthcare service supply chain will prevail? Who will be the next Amazon or Yelp? Chances are it will be the organization that can deliver and mediate a centralized consumer experience — connecting healthcare consumers not only with care and treatment options, but also with pharmacists, labs, therapists, clinics, wellness coaches and other resources along the care chain.
More today than ever before as the care conundrum continues, fewer and fewer crave office visits, hospital stays or trying to reach physicians by phone. When we're well, we see no reason to visit a physician. When we're sick we increasingly wait until we're sicker. And when we're somewhere in between, we avoid calling because we know we’ll be put on hold. If there were a better way to consume healthcare, most of us would likely take it.
Interestingly, within this conundrum lies an opportunity for the myriad of healthcare players — from payers and providers at one end of the supply chain to wellness tacticians, retailers and mobile tool providers at the other end — to create a sustainable dialogue with healthcare consumers.
And don't be so sure the winner will be the two large elephants in the room: the payer or provider. Weight Watchers, for example, offers a mobile app to help people count calories, manage meals, track their exercise and control their weight. Ultimately, that blend of technology and a high comfort level in the B2C market could make Weight Watchers or an enterprise like it a destination for healthcare consumers in search of a coach to help navigate the thickets of the Patient Protection Affordable Care Act.
By all accounts, global smartphone sales are expected to reach 1.5 billion units by 2016. Indeed, social, mobile, analytics and cloud (SMAC) technology is exploding just as the PPACA kicks in. And let's not forget, tomorrow's smart phone will be smarter than today's. What will it mean for healthcare providers, consumers and payers? For starters, improved wellness, connectivity and diagnostics. Inherent in this digital ecosystem will also be better access to electronic medical records. Physicians want it: in a Black Book Rankings physician survey, 83 percent said they would use mobile EHR apps when more options become available.
And patients want it too. Kaiser Permanente recently launched an app that makes its entire electronic health care system available to all 9 million members. So far, it has generated nearly 100,000 downloads. Kaiser patients now use their smartphones to make appointments as well as renew prescriptions and check on lab tests.
Take a moment and think about how we use our smart phones. When an app like Kaiser's becomes widely available — and it will — what smartphone user won't welcome it? How many will prefer to wait on hold on a landline, tethered to a cord or to the confines of their home or office?
Electronic records are just the tip of the iceberg. The market for mobile health apps is expected to quadruple to $400 million by 2016, according to ABI Research — and it looks as though government regulations won't get in the way.
Full speed ahead
The U.S. Food and Drug Administration has issued final guidance for mobile medical application developers, promising limited regulation for most health and wellness apps while applying risk-based standards to diagnostic and quasi-medical apps. According to an FDA media release, the agency will exercise "enforcement discretion" for most healthcare apps "as they pose minimal risk to consumers." These include apps that help patients self-manage their disease or conditions "without providing specific treatment or treatment suggestions," such as for tracking exercise and diet, automating health tasks or communicating with providers via EMRs.
This opens the door for enterprises like Weight Watchers to take a leading role in optimizing the healthcare consumer experience.
The SMAC platform puts a record number of healthcare consumers in direct contact with providers. The key question is: Which provider will create the optimum experience, seamlessly connecting individual consumers with numerous points along the supply chain?
Here are five areas where entrepreneurs — not necessarily hospital systems or insurers — are improving healthcare delivery:
- Patient engagement: Who do you know who wouldn't appreciate a text when their physician is running late or when their prescription is running low? Who would rather stand in line at their pharmacy than tap a button on their smartphone to refill the prescription and have it ready for pickup or mailed to their home?
- Patient safety: SMAC makes healthcare safer by providing patients with tools to manage their own health on their own terms. If you or a loved one has had surgery, you know about exiting the hospital in an anesthetic haze, clutching a folder full of papers and little memory of what to do when you get home. Imagine if all that information were on a digital app that reminded you to take your pills — while monitoring your vitals and checking for side effects.
- Patient access: In a digital age, patients living with chronic diseases — especially those in rural areas — can "visit" with specialists anywhere in the world. Instead of relying on payers to determine which visits must be in-office, patients and physicians can use mobile digital apps to decide that for themselves.
- Business models: In addition to enabling payers to better organize and bundle billing, new healthcare apps can monitor vital signs and symptoms; they can record blood levels and transmit the data directly to care providers. In the digital age, new companies that specialize in data management will run large call centers staffed by nurses, physicians, pharmacists and technicians who monitor and respond to the incoming data. This in itself represents a sea change in public health — and a significant opportunity for entrepreneurs.
- Medicare fraud: Annually, Medicare fraud is a $60 billion black eye on our economy. Digital apps will tackle this travesty head-on because they can track millions of transactions like no system that has come before, correlating claims data with location to identify fraud.
The first enterprise to put all of this together — connecting millions of consumers to high quality service and care — will win the race. Thanks to SMAC, today's explosion of digital healthcare apps is merely a first wave. As technology advances, consumer-centric enterprises across the healthcare spectrum will improve the provider-consumer connection, leading to lower costs and better clinical outcome — and increased reliance and loyalty.
Ron Wince is the president and general manager of Peppers & Rogers Group, a management consulting firm and leading authority on customer and patient-based business strategy.