Our expectations over the last 10 to 15 years have completely changed in terms of how we actually interface with the digital world around us.”
Q & A with Drew Schiller
When you think of digital health, what comes to mind?
The definition can be pretty wide-ranging and all-encompassing. Personally, when I think of digital health, I see it through the lens of the consumerization of health. It speaks to the consumerization of how healthcare is accessed by patients, but it’s also the consumerization of how healthcare providers and practitioners interface with technology. It’s important to remember that practitioners are also daily consumers of technology. And so, our expectations over the last 10 to 15 years have completely changed in terms of how we actually interface with the digital world around us.
Think back to 20 years ago when the paradigm of listening to music was to go to the record store and buy a piece of plastic, then put that piece of plastic into a player that was designed specifically to play that thing. Even though it was digital music, it was very analog in terms of how that process actually worked.
Whereas today, when you want to listen to music, all you have to do is Google it, listen on YouTube, or even ask your Amazon Echo to play the song. It’s all at your fingertips. Any piece of music that you want to listen to in the world right now is readily accessible to you. I think that’s the general expectation people have for how they interface with technology in general, right? When you want to speak with somebody — one of your friends, for example — you can text, call, FaceTime, message them on Facebook, or tweet at them. You can use myriad different messaging tools in order to reach out to peers or friends.
I think we’re seeing a similar expectation — that consumer expectation of always being connected, always on, with multi-faceted domains for communication — being applied to healthcare, which is still today a very static industry focused on singular channels that are embedded in the system. And, that’s why digital health is a concept that’s so disruptive. I mean, we’re going from electronic health record systems that were designed to be digital filing cabinets, with improved billing and some improved data aggregation services, to a world where patients are expecting to not only be able to pay their hospital bills from their phone, but to schedule appointments, reach out to their doctors, and be educated on a condition. In addition, we also have new expectations around how our data is used in all aspects of our lives.
So how will we measure that digital health is improving people’s lives and making people more healthy, or making people recover faster?
We’re already starting to see measurable improvements. What we’re missing is the integration of technical and operational components in such a way that clinicians and care managers can interface with the data the way they expect as digital consumers. For clinicians and care managers, this means the data are in their workflow in a way that’s seamless and expected. Oftentimes in healthcare, we forget the care team members themselves are consumers of this data. It’s not just the patients that are consumers. So, we need to develop technology and user experiences for both sides that enable patients and care managers to take the data, make meaning of it, and take action on it.
How do changing demographics impact digital health progress?
As digital natives enter high school and college, millennials begin to age, and baby boomers approach retirement, healthcare is shifting toward having a more technologically-savvy consumer base. That is universally true. I don’t think it’s specific to any one particular age profile. I mean, I just FaceTimed with my 87-year-old grandparents on my grandfather’s iPhone the other day. My grandmother refuses to touch an iPhone. She says that she’s kind of a little bit of a technophobe. She does do email pretty well, but she’s a little bit of a technophobe.
But my grandfather, he’s a technophile, right? I mean, they’re both 87, and he’s totally fine with FaceTime; he loves it, he gets it, he texts. So, I think it’s a little bit individualistic as well. One truth that is often lost in healthcare is that technology is not supposed to be a burden. Think about the internal combustion engine of a car. If it was more of a pain to drive a car than it was to ride a horse, we never would have shifted toward pretty much exclusively driving cars, right? If it was easier to continue using a typewriter than it was to use a computer, we would have never switched to using computers. And early on, it was easier to use a typewriter than a computer, right?
We need to make digital health technology so easy to use and so seamless in terms of how we interface with it in our daily lives, that it’s easier than any alternative. We should be able to do this pretty easily by applying very simple, straight-forward design thinking to how we implement and integrate the technology.
What are the hurdles that we still have to navigate?
Candidly, one of the biggest hurdles is the payment models inside healthcare.
Fundamentally speaking, the folks who are actually paying for healthcare are not directly the patients or the providers. It’s generally the employers who are paying on behalf of the patients, or it’s the payers who are operating as the third-party benefit administrators.
With some of the new payment mechanisms, like alternative payment models (APMs), we’re starting to see providers take on more risk. Because they have financial incentives and are actually seeing improved outcomes, we’re going to see providers put in place streamlined, efficient, easy to use, and well-communicative technology.
What is digital health going to look like five or ten years from now?
Some of the core principles will remain the same; we will still have a largely decentralized healthcare system that is slightly more consolidated but still varied across the country. In other words, we’ll still have thousands of health systems, dozens of payers, dozens of pharmaceutical companies, and a siloed electronic health record system. I think all those things will still probably be true in ten years, but I think the big difference will be the data. There will be incentives for each of those stakeholders to make the patient experience such that data will flow much more efficiently within those systems.
In other words, a patient within a particular provider network will have a more holistic and cohesive experience with their provider. Communication will be easier. Data, whether it’s their wearable or sensors on their phone or from devices that they’re using in the home, will be able to flow freely between disparate systems. And, there won’t be a marked difference between data that I’m collecting on my blood pressure monitor at home or my wearable on my wrist, versus data that is collected from the blood pressure cuff when I’m in the doctor for my annual physical.
The sharing of data is going to be vastly improved. Any data that I collect pertaining to my health, whether it’s psychological data, phenotypic data, potentially environmental data, as well as medical data, lab data, etc., will all go into a centralized repository where my clinicians and physicians can access it at the ready. This is the future of healthcare.