Lots of health startups out there are trying to zero in on ideas that will improve the lives of patients with chronic conditions. And even though patients are the target audience of this technology, companies seem to be designing their products by first asking, “What will health care providers and and health insurers pay for?” It makes sense, assuming that these two groups will foot the entire bill for electronic health (e-Health) innovations. But it doesn’t make common sense. Why not design the tech for those who are going to use it in the end?
The discussion came up at the Digital Health Summit, a two day conference at the International Consumer Electronics Show. Health 2.0′s Matthew Holt moderated a segment called “Who’s Paying the Bill for e-Health?” When Holt asked a panel if consumers would be willing to pay, Senior Advisor of of the American Association of Retired Peoples Bill Walsh indicated that most AARP members would answer “no.”
“What they’re telling us about mobile health is, ‘Gee, this is interesting but why isn’t my insurance company paying for this? This is just another medical device,’” Walsh said.
A lot of insured people would probably answer the same way if asked, in general, if they’d pay an extra medical expense. On the other hand, if you asked patients about a specific product or service that would actually improve their quality of life ― they’d probably think about it …
Walsh said that the number one concern of AARP members as they age is staying independent. It’s such a priority that as many as eight out of 10 members are willing to pay for certain devices that help them live on their own longer, he said. But their interest came only after they were introduced to specific devices, for example, Vitality GlowCaps, a container cap that reminds patients to take their medications.
“What’s remarkable was the response we got from our people,” Walsh said. “They’re like, ‘Oh my God, I didn’t realize that existed. Is that out there?’”
“I think what maybe we all fail to realize is the low level awareness among the general population,” he said.
The lack of awareness is due to digital health not hitting the mainstream yet, and it’s one reason patients reject the idea of paying for the tech. Another reason can also be attributed to the reluctance to think about patients as consumers of health care. In a recent Harvard Business Review article, Augusta Meill and Gianna Ericson argue three main reasons why treating patients as consumers can be a problem:
Patients don’t want to be there: People don’t seek out healthcare without a reason. Something is wrong and patients want to solve it and get back to normal. When patients are required to be proactive decision-makers, the health care system is often casting a very reluctant hero into the role.
Patients aren’t equipped to be there: Even when patients are willing to be decision makers, they may not have the tools. At a time of unusual stress, the system asks them to absorb technical information and make difficult decisions that require specialized expertise.
Patients aren’t in it alone: To design for patients alone is to forget that they are part of a complex system and aren’t often independent decision-makers. Decisions are shaped by other stakeholders: friends and family who support the patient, the insurance company who foots the bill, practitioners who provide care and expert advice, the hospital administrators who inform system-level protocol, and so on.
All of this is true in many cases. There are medical services and devices that, especially during a time of medical crisis, should be covered by health insurance. But some health products are different. Take a specific group of patients and consider their common priority, and see how those three points are not true. An elderly person who wants to continue to live independently:
1. Does comes to the health care market willingly, and he’ll seek out a combination of products, like GlowCaps, that will facilitate him in living independently.
2. Will use certain devices that can equip him for a time of unusual stress. For example, if he takes a fall, a digital alert system will contact a loved one.
3. Isn’t in it alone in making medical decisions, so the systems he uses should be designed with his entire support network in mind.
AARP members are a part of just one consumer group. If innovators take the time to figure out the top needs of other patient populations, they can design products with the users in mind. Director of the Center for Connected Health of Partners Healthcare Dr. Joseph Kvedar, who was also on the CES panel, recently wrote a blog post about what patients really want in their health care products.
“Consider with me how we as innovators should best create the programs, technologies and services that chronically ill patients don’t know they want or need yet … How important is the patient perspective in the development of connected health programs and services?”
Very important. It’s OK to think of patients as consumers. They’re they ones who can tell innovators what they really want ― and even what they’ll be willing to pay for.