At Some Point In Life You Will Be A Patient: This Will Require Patience
No, this is not a fortune cookie message.
It’s the story of what I’ve felt any time I’ve touched a healthcare system, worked with a provider or navigated the administrative practices of a payor — (aka, an insurance company). This is true whether I was a patient, an executive leadership coach & strategy consultant, or as patient advocate for a family member or friend.
My most recent experience is one I have been documenting over the past year, sharing lessons learned along the way — the useful, the helpful and the painful. These experiences have led me across three internationally recognized hospital systems and ambulatory care centers based in and around Boston.
My larger observations have to do with the consistent fragmentation of how healthcare and wellness are perceived and delivered in America. Very few of us believe that our healthcare system is something that is managed and delivered well. This is because the overall system is not optimized for wellness.
What drives people, systems and processes in healthcare is still tied to incentives that don’t always drive behavior change. While we’re in the midst of transitioning from fee-for-service to value-based healthcare (rewarding better outcomes for patients) and embracing digital health platforms, we still don’t experience healthcare in America as an integrated approach to wellness — we deliver treatment for acute illness or emergencies.
You break your arm, you have an appendectomy, you need a valve replaced, have open heart surgery—prostate surgery, or breast surgery — some are immediate needs and you’re treated immediately. This is good, we need that —lucky are we to have experts in abundance in Boston and many other cities.
But what challenges healthcare systems is that patient experiences are still networks of silos and narrow paths. These paths lead somewhere, but not to a holistic platform that enables discussion with multiple providers about individualized healthcare for a patient that links tele-health with digital notes across specialty areas, medical records with care plans and apps, community support with wellness coaching and more.
You may be thrown into interacting with doctors, departments and procedures if you need treatment — but rarely do medical teams get together outside of speciality areas to collaborate & discuss you: patient as a whole being, what a patient universe may look like and how to marry conventional medicine & complementary treatments toward shared decision-making for better outcomes.
Hand-offs from one specialist to another happen all the time. Your primary care physician, the one who typically sees more than 20 patients on any given day, ideally helps navigate the healthcare system you’re in to foster patient activation and engagement. Rarely does this work as well as it should, could and this article outlines a few reasons why.
And yet, we’ve witnessed a shift in how medical practices are treating patients with wellness in mind. This has come with a focus on prevention and a plethora of healthcare apps aiding anyone tech-savvy and disciplined enough to monitor vitals and communicate them with physicians in a more facile and frequent manner: blood pressure, sugar levels, activity levels, heart monitors and much more. This is also a good thing.
While apps are a gateway to the bigger goal of transformation in healthcare focused on the consumer, the world of healthcare apps is also challenged by fragmentation.
Apps are designed to create efficiencies for healthcare providers, payors and patients: from speciality areas to administrative functions. All of this is improvement. But conversations about architecting a holistic system to support a patient universe stalls when medical practices embrace apps while still following silo approaches to delivering healthcare in the digital world also.
We need to architect a broader conversation and set of solutions on how to help patients experience disparate pieces of information: from multiple providers to multiple hospital systems — one that applies design thinking to capturing and monitoring healthcare data in a centralized place.
What could this look like?
A secure integrated platform for patients to reference notes, labs, images, instructions, provider messages, patient communities, research, access to complementary and alternative practitioners, community support and more. A far more dimensional experience than the communications tools hospitals and physician practices use today.
Compliance, insurance, HIPAA regulations, and pesky things like, ‘who owns your healthcare data’ are still obstacles to achieving that vision, but at some point, hopefully in the not so distant future, this integration will hold a key to healthcare transformation.
If one day we all will be a patient, how do we create a patient universe that works well for us all — one that takes a giant leap forward from healthcare to well care?
The answer is co-creation. Its crowdsourced ideas, new technologies, multi-disciplinary design thinking, small victories that accumulate and work towards solving complex problems in envisioning and delivering healthcare— one step at a time.