If your 2018 business strategy does not account for providing healthcare like this, you have already lost.
I moved to town last night. I am staying in a hotel while I look for a place to live, and this morning I am in my car driving to my new office for the first time. I am not feeling well; far from it. I tell the Bluetooth device in my rental car to connect me to VideoDoc-Roemer.com. Using the car’s GPS, the service connects me to a doctor in my area.
A face pops up on the car’s dashboard touchscreen and a voice comes through the cars speakers, “This is doctor Velasquez. Am I speaking with Paul Roemer?”
“You are, thank you for taking my call.”
“How may I help you?”
“I just relocated and I have not had time to find a local doctor or to get my medical records sent here. I have heart disease, and with everything I had to do, I forgot to pack my nitroglycerine. I am feeling a stressed, I am breaking out in a cold sweat, and I am feeling a little dizzy. It’s probably nothing, but is there any way you could write me a script for the nitro?” We talked for a few minutes.
“Where should I send the script? The Doctor asked.
“I can’t even remember the address of my hotel,” I told her. “But Amazon has the address of my new office. Can you work with that? I should add that my left shoulder is feeling a little tight.”
“You bet. I can have Amazon’s RxRobot deliver it to your office today.”
“Mr. Roemer? Can you still hear me?”
A minute passes.
“Mr. Roemer, I have your GPS location, and I dispatched an ambulance to you location. If you can, please pull over.”
That is tomorrow’s scenario, and it pretty much exists today; unless of course the patient is dealing with a health system. Plus or minus a Bluetooth solution with an in-car video screen, some of the options available to every prospective patient are Walgreens, the Minute Clinic, Doctors on Demand, and urgent care.
Today’s scenario, if played out with a health system, would likely involve having to call a hospital to schedule an appointment with a cardiologist. It may require a wait of several months to be seen.
Everything described above, minus the robot delivery of medication, exists today. To those who want to argue that a robot cannot deliver medications by robot because it would violate CMS’s HICCUP (sic) requirements, that is not my point. The point is that healthcare has changed except for those institutions which believe that they are healthcare. They may have been healthcare, and they may still be healthcare, but unless they vigorously change how they deliver and market their services, they will not be healthcare.
Healthcare has already changed. The only group that did not get the email are America’s healthcare providers. Offering free Wi-Fi in your waiting rooms does not qualify as an ante at the innovation conference. Walgreens’ telemedicine services are available in 25 states. Minute Clinic. Doctors on Demand. Versus your health system, where your patient is making their third call to schedule an appointment, an appointment where the next available opening is three months from now. By the time your health system is ready to see the patient for an initial appointment, the patient with the heart disease is 12 weeks removed from having received their stent.
I recently met with the COO of a large health system. I had sent him a brief PowerPoint deck outlining what I thought he needed to do to prepare his health system for what was happening. He told me he had already prepared for the change.
“We know the delivery of healthcare has changed from the being fixated on the delivery of acute care to being able to respond in real time to delivering ambulatory services. To adapt to that change, we made some changes.”
He pointed to what used to be their grand lobby. “Instead of wasting this space, we turned it into an indoor volleyball court. You’ll have to excuse the sand, but we have tournaments going every night of the week. And if someone gets hurt, we can treat them right away. We turned the entire basement cafeteria into a global food court. Our patients, staff, and visitors use the GrubHub app to have the meal of their choice delivered — I really like the Thai deli. We turned each of our 27 waiting areas into spas, 12 of which have hot tubs. And we got the use of the spas preapproved by the payers. So we are very well positioned to combat how healthcare is changing.”
So let’s make this personal. Let’s take the discussion to the board room of your health system. How prepared is it to compete? It is no longer sufficient to simply offer care; no longer sufficient to even offer the best care. Your customers — you can substitute the word patient if it makes you feel more comfortable — want healthcare services now, and they are prepared to try new ways to obtain those services. And guess what? If patients find that having real time access to those services works, they will not walk back the cat and revert to the old way of accessing care.
Let’s be honest, the innovation train has left the station. If your health system was prepared, if your health system is prepared, it would not be questioning whether it should be amending its 2018 business strategy, it would already be hard at work figuring out how to offer these services.
Instead of trying to ameliorate patients by trying to find alternatives to scheduling appointments 90 days out, your health system would be connecting people to appointments on the phone and people on the website by offering real-time appointments. “Would you like a video appointment with a board certified cardiologist this afternoon at 2? We can send you the link to the software you need, and an easy video that shows you how to login and how to test the microphone and the camera. This service costs 20 percent less than an office appointment and the entire cost is covered by your insurance.”
An easy button. Your health system can be the ostrich with its head in the sand and continue to ignore this, or it can announce the formation of an innovation group tomorrow. Healthcare innovation is not tied to purchasing another MRI device, and it is not tied to a new way to treating an obscure illness.
People, your patients, have redefined what having access to healthcare means to them. Access to healthcare from their perspective means access today, access now, access when and where they want it. If your health system does not offer what they want, they will find what they require on their own.