Moving up the health care value chain

Last week, I participated in a very cool live podcast with the ReadWriteWeb editor Richard Macmanus. While I am finishing up my commentary based on that experience, I did want to comment on another post by Richard who is one year into his diagnosis of Type I Diabetes. He mentioned that his favorite Health 2.0 application was MyMedLab.

In full disclosure, I serve as an advisor to
the company as well as a participant on the call that was conducted. I
became involved with MyMedLab while conducting my own survey of
promising Health 2.0 companies, tools, and technology. I was intrigued
by their Health 2.0 delivery model of leveraging the internet to remove
inefficiencies of time, location, and physician approval for routine
wellness laboratory testing.

I became convinced after using the service for myself. Since I
hadn’t ordered lab test since my medical school entrance physical exam,
and I was preparing for an upcoming physical, I ordered the baseline
wellness tests I knew my primary care provider would want (conveniently
organized by “profiles” – individual tests that are grouped together to
provide disease or organ system specific information
). I wanted to
maximize my time with my doctor and come prepared with as much
information to review during our appointment as I could.

MyMedLab helped me accomplish these objectives in a cost-effective,
convenient, and confidential way. It was a hassle free ordering process
and I had my results within 36 hours. I was able to fax this
information to my physician ahead of my appointment and to actually use
some of my time with him to review the data as opposed to discuss
ordering the test. I immediately saw the opportunity to extend this to
other appropriate settings, and other appropriate patient or physician
groups who have highly specialized laboratory testing needs (hormone health specialists, bariatric patients, and even diabetic patients).

A persistent question that comes up is the appropriateness of the direct to consumer model. I have to agree with John Sharp about the age of “paternalistic medicine” going bye-bye. I discuss this at some length in a previous article entitled, “The Millennial Patient
.The easiest analogy to understand this point is to review the
democratization of the financial services sector. 30 years ago, only
qualified financial advisors could provide financial advice, set up
accounts, trade stock, transfer funds, or manage a portfolio. Can you
imagine that being the case today? Consumers have the ability to read
financial information (now abundantly available), set up
accounts in minutes, buy/trade stocks with a click of the mouse, move
money across the globe between multiple accounts, and manage all their
accounts from single portals all without leaving their desks.

Does this obviate the need for financial advisors? For many smaller
or DIY investors, it has reduced the need by outsourcing these
functions to the consumer. However, the experience and knowledge of a
trusted financial advisor is still heavily relied upon for anyone
requiring professional assistance, complex trading, or needing higher
end service. They haven’t gone away, they have just had to adapt what
they do, how they provide their services, and who their customers are.
In essence, financial advisors have had to move up the value chain.

While this will sound heretical to some old school doctors, most
wellness laboratory exams don’t need to be interpreted by a physician.
In fact, most wellness exams don’t need to be performed by a physician.
It is pretty straightforward stuff: Cholesterol 250 = get on some
cholesterol lowering meds. This isn’t rocket science.

However, there clearly is a time and a place to call upon those
practiced both in the art and science of medicine. I assert that the
trusted physician advisor will be as meaningful, if not more
meaningful, to you in the future world of highly personalized medicine.
You might interact with her in new and exciting ways – chat, text,
videoconference – but she will continue to use her expertise,
knowledge, and experience to provide the advice you need on key health
issues, disease states, and medical treatment plans. Physicians aren’t
going away – they will just be practicing at a higher, more meaningful
level than they have in the past. Physicians, like other knowledge
workers, will have to move up the value chain in order to maintain their relevance in the future.

Most will. Some won’t. And for any of those clamoring that they are
the only ones authorized to read lab results, send them the this link along with an email saying you are looking for a new physician.

(Oh, they don’t do email? You should have left long ago!)

2 replies »

  1. I hope this time around we start looking at real prevention on the societal level. Fortunately, there’s good science that shows it works. Check out links research in New England Journal of Medicine and British Medical Journal at blog.jimgogek.com. Remember the stories about how obesity, smoking cessation and now happiness are contagious across networks? That has led to a new discipline labeled “Network Medicine”. Health and well-being can be spread across social networks. Instead of only treating the individual on the cellular level, we can treat him or her on the social network level, too.

  2. In principle, I really like the idea of accessibility. To have appropriate screening lab tests easily available makes sense.
    However, although not “rocket science”, there is science involved. A cholesterol of 250 does not always merit treatment when risks/benefits of treatment are considered.
    Buyer beware- the VAST majority of tests on this site are NOT indicated for screening purposes- to order a “general health” panel, or a panel of tumor markers and expect that it has some health care value is really, really bad medicine. Not only wasteful but potentially dangerous. Snake oil for sale.