Why Consumers
Are the New Patients


Meet Edith Stowe.

An 83-year-old resident of the District of Columbia, Ms. Stowe has made a routine out of her two to three monthly trips to MedStar Health, a Maryland-based nonprofit health system.

After all, her life literally depends on it. Ms. Stowe has chronic kidney failure, so her 5-mile trips to the hospital aren’t a luxury. She absolutely needs them.

Stowe doesn’t own a car, and taking the bus to get life-critical care isn’t always reliable–or even desirable for an aged patient with a chronic disease.

That’s how Uber enters the frame.

Beginning earlier this year, MedStar has integrated the ride-hailing giant into its platform, allowing patients to easily schedule rides to and from critical appointments. MedStar’s patient advocates will arrange rides for Medicaid patients who don’t have access to its website or app-capable smartphones.

MedStar’s partnership with Uber made headlines this August when The Atlantic originally told Ms. Stowe’s story.

That article’s takeaway was simple: The ride-hailing revolution pioneered by Uber and Lyft poses to give mobility—and hence access to care—to millions of home-bound Americans suffering from chronic disease.

That’s not an exaggeration.

After all, mobility and healthcare are intimately intertwined. Patients relying on public transit are more likely to be late for, or miss appointments entirely, than those with reliable access to a car, according to public studies. And those missed appointments add up. The Harvard Business Review points to one survey estimating that in 2006 Americans missed 900 million medical appointments at a cost of more than $150 billion. In the last decade, it’s doubtful those costs have gone anywhere but up, making the problem even more acute.

Importantly, many other health-focused startups and technology-minded hospitals have seized on the trend, promising to eat into a clear source of waste in the already-wasteful American health system.

Startups like Circulation have built their new business models around partnering with Uber to make it easier for patients just like Ms. Stowe to get to their doctors.

But I’d argue the healthcare trend posed by Uber and Lyft goes beyond merely logistics. Instead, the real transformation hitting medicine isn’t merely a transportation revolution but a broader revolution in consumer demand.

The on-demand economy, which Uber and Lyft have come to typify during this mobile-driven tech boom, has created a new breed of healthcare consumers who demand care with increasing disregard for place or time.

Put simply, they want their care where and when they want it. They also increasingly expect transparent prices, little to no wait times and mobile digital tools to make appointments, track their health and access care, according to a 2016 Deloitte survey of health care consumers.

Some healthcare players get it. Some still don’t.

One digital health startup that’s gotten the memo, in terms of user experience, is Oscar Health.

Oscar, which markets itself as “a new kind of health insurance company,” aims to transform people’s smartphones into hubs of their personal health. Currently operating in California, Texas and New York, Oscar uses an intuitive, accessible mobile app that allows a patient to enter a health problem—say your kid has a bad cough, or you need a physical—and get a callback from a doctor within 10 minutes, according to the company. One anonymous patient on the company’s website claims he or she received a prescription within 30 minutes of entering their malady using the app.

Another insurance startup, Clover Health, is hoping its data-driven approach it can rebuild healthcare for seniors from the ground up. Clover is trying to use data analysis and preventive care to improve healthcare for seniors and to give customers who use private versions of Medicare a cheaper option.

The company’s software is supposed to recognize when patients need medical treatment and then preventively intervene in their care. In fact, it can often even play “quarterback” for all the medical records and interventions a senior citizen has and help doctors make decisions. For example, it even notices when a patient doesn’t refill a prescription and makes the doctor aware that the patient may not be taking a medicine.

Then there’sOne Medical Group , a concierge medical practice that promises high-quality care at an affordable rate and reimagines the customer experience so that it’s so much more user-friendly.

The companyoversees a network of 250-plus primary care specialists in 40 US cities, enabling patients to book last-minute appointments on their phones, get certain prescriptions via the One Medical app, and access health records online. Itadded 80,000 new patients in 2015 and brought in a number of enterprise clients.

Companies like mine, HealthEdge—a Burlington, Massachusetts-based healthcare payor-focused software company–saw this trend coming a decade ago, and we’ve been prepping our health insurer clients accordingly.

To be sure, healthcare is different animal from a lot of industries. The regulatory barriers to entry slow change, for better and worse, often insulating some healthcare players from the types of competitive pressures most companies face.

But private health players are not insulated from the market’s changing demands in the long-run.

Like every other sector of the economy already transformed by the on-demand revolution—from take-out and groceries to rental cars, used car buying, beauty, shaving, laundry and just retail in general—the market will reward the innovators who respond nimbly to consumer caprice.

The rest it’ll eventually send to join Blockbuster and Borders.

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3 replies »

  1. Telemedicine and remote monitoring has grown over the years to develop into a solid platform for consumers/patients. Obviously, the healthcare system have opened much more to general public, there is more transparency. This is certainly a good thing and I am hopeful that we see this continue to grow in the right direction. Here’s something I wrote regarding the growth and future of telemedicine – http://bit.ly/2jWA1fv

  2. am conflicted about this post.

    The techie side of me says YES! YES! YES!

    Cool! Gadgets! Widgets! Faster! Better! Bring it on!

    But I hate the word consumer.

    Frankly, I think it sucks.

    Not to pick on you, Ray. But people keep using it.

    I think it is fundamental and a potentially fatal mistake to think of patients as consumers.

    While in many ways patients behave in ways resembling traditional consumers – they look for answers – they compare prices – they get upset about bad customer service and dated waiting room decor – in many other key ways they are not consumers.

    This is one reason so many well-funded new technology companies that enter healthcare fail. And nobody gets quite why.

    After all, when you think about it – a patient is a consumer with a gun to their head.

    They are often confused. They are frightened.

    In many cases they are literally dying.

    If you treat them like consumers – and expect them to act like consumers – you run the risk of running into rather serious problems. They will not respond to the things you expect them to respond to. They will not be as happy as you expect them to be.

    Most importantly to you (presumably) as a business owner and entrepreneur, they may not be willing to do business with you because on a fundamental level they may not even be aware of at first – it will bother them that you are treating them like a customer. That thing about the Hippocratic oath?

    It applies to companies that do business in healthcare as well as doctors. The problem is many company’s don’t know that.
    Or if they know it, conveniently chose to forget it.

    And there are the questions of right and wrong and higher moral purpose.

    Is it right to treat a person with a gun to their head – or a case of stage four cancer – as you would a customer who wandered into the sporting goods aisle at Walmart?

    Of course it isn’t.

    I do not want to discourage you from entering this space. Quite the opposite. We need innovators. We need new ideas. And I am convinced that technology holds many of the answers. The other barriers you cite are real.

    But we collectively need to rethink some of this.

    • Thanks for the feedback, John. I think we need to be careful not to confuse the words ‘customer’ and ‘consumer’. I strongly agree that we are treating ‘patients,’ not ‘customers,’ but at the same time we are also helping to support a new generation of healthcare ‘consumer’ that is demanding access to real-time information and tools that will enable them to interact with their health plan in many of the same ways that they interact with their favorite organizations in other industries. We must make it easier for these healthcare consumers to quickly get access to the information they need, when they need it, using whichever tools will best meet their requirements.

      We must also, at the same time, make it easier for the people within the health plans to quickly and correctly answer member questions, respond to “what-if” inquiries in a way that will enable the patients to understand all of their options and alleviate any fears that they may have related to their financial responsibility, and offer meaningful advice based upon each patient’s specific situation that will enable these patients to live healthier and happier lives.

      Based upon current survey data, including data from a recent HealthEdge survey, it seems clear that people want and expect more from their health plans. As someone who has been in the industry for many years, I’m excited that we finally have the ability to make it easier for patients to navigate the complexities of the healthcare system and quickly get access to the types of information that will help them with their care.

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