Over the last year I have been thinking a lot about the opportunities that digital can bring to the healthcare realm, specifically in terms of improving patient outcomes. At Extractable we have a number of healthcare clients on both the service delivery side (hospitals and healthcare organizations) and the payer side (insurers), which has given us the opportunity to undertake in-depth research with all types of healthcare consumers and learn the nuances and challenges of healthcare delivery.
There are a couple of major trends in the use of digital channels and technology we are seeing. The first, that was everywhere in the last year, is the use of wearable and other technology to help gather data and feed that back to our medical teams to help with the treatment of chronic conditions, such as blood-sugar monitors for diabetics or smartphone-enabled heart monitors for cardiovascular patients.
More closely to the experience strategy and design services Extractable provides for our clients, we are seeing a strong push to drive improved wellness in patient communities through the use of targeted digital content (articles, tools, quizzes, etc.). Yet, outside of providing electronic medical records (EMR) to patients, specifically driven by the meaningful use provisions of the Affordable Care Act (ACA), we are not seeing much in the way of online tools being used as part of treatment itself.
While clearly online tools are not a replacement for the appropriate drug or medical procedure, there may be a large opportunity to improve patient outcomes through readily available digital tools and techniques - through using digital to close the loop in healthcare provision.
Stepping back, there were two stories I came across in the last year that helped set the stage for identifying the challenge and opportunity I see ahead. Neither is pleasant to read (for different reasons), but the lessons are worth drawing from here.
The USA and UK are a good comparison for healthcare purposes. The populations are similar in terms of wealth, education, technology adoption and general health patterns. However, the systems are very different with the USA insurance / private model and the UK's National Health Service (NHS) single payer (state) model. Having grown up in the UK and now living in the USA, I’ve experienced some of the pros and cons of each model very personally, but this post is not about which is better, but what we can learn from the contrast.
In 2010, for every 100,000 people in the USA, 6.1 died of HIV/AIDS. In the UK, that rate was just 0.5 out of 100,000.
So, what can we learn from this shocking statistic?
From the New Republic article:
"In the United Kingdom and Germany, if you test positive for HIV, you'll immediately be referred to an HIV clinic for tests to measure how much of the virus is in your blood and how well your immune system is holding up. Three-quarters of Brits diagnosed with HIV get to this next stage of care within two weeks, and 97 percent make it within three months.
In the United States, only 65 percent of people with HIV get linked to a hospital or clinic within three months."
The basic premise of the argument is that when there is a positive loop of continuous care, the patient does not 'fall between the gaps' and it requires much less pro-active effort on their part to lead to the best outcome.
The other, unrelated article that triggered my interest was by the BBC related to the growth in DIY fecal transplants! While an unpleasant topic (don't read the article if you are having lunch!) for most of us to think about, there are multiple cases of people with untreatable conditions that have found a cure through the power of Google and online self-help communities.
From the article:
"My colorectal surgeon said: ‘The easiest thing would be to just take your colon out.’ And my question was: ‘Easier for whom?’”
…They started the process at 16:00 in the afternoon. By 22:00 that night she felt almost completely better. “And I had been literally dying the day before,” she says. “I was going into renal failure – I was dying.”
The lesson I took from this was that the core premise of the internet truly delivered in this case – that of empowerment – the ability to connect a normal person to detailed information that they may not have ever been able to reach before.
So, we have two connected ideas. Firstly, that digital channels can connect and empower people like never before. And, secondly that people fall between the gaps in the healthcare system to the detriment of their health.
So, what can we do about this?
I believe there is a strong opportunity for digital tools and techniques to be integrated into the healthcare process to close these gaps and hence aid in people's health outcomes.
Today we have many digital technologies designed to close gaps in marketing and sales. If we visit a shoe website we see re-targeted ads the next day when we are on Facebook aimed to persuade us to buy those shoes. At Extractable, we use powerful personalization tools in CMS systems like Sitecore, tied with marketing automation tools like Marketo or Eloqua and integrated with CRM systems like Salesforce to track and nurture every potential customer / lead. These tools allow us to create a highly personalized and relevant experience for each prospect as they hit our client's digital properties over potentially long sales cycles.
And, it works, with these experiences increasing conversion rates by orders of magnitude.
So my proposition is that we should, in effect, treat patients like an e-commerce customer or lead - tenaciously providing personalized relevant content and tools throughout each cycle of treatment and driving wellness throughout their life.
While I'm not suggesting we use re-targeting to promote broccoli after you visit a bacon orientated website, there are many ways in which messaging and content could be embedded within our day-to-day digital life. And, as importantly, in the same way we can report a prospect's progress to the allocated sales person at our client, we can integrate the data back to the patient's medical team to continue the positive cycle of care.
Of course, this will not solve all the challenges of the healthcare system, but we don't have to do that. Just changing some of these health outcomes by a few percent (or less) can mean thousands of lives saved.
And, for me, that is the opportunity.