The Uberization of Healthcare

Dr David Whitehouse
Dr David Whitehouse

Guest post by Dr. David Whitehouse, chief medical officer, UST Global.

“The Uberization of healthcare” has recently shown up as an expression in blogs and articles. However, each time it seems to possess a different meaning. For some, this phrase summarizes the transformation that happens when there is a deep understanding of the real hopes and needs of consumers, operationalizing them effectively. Facilitated by the latest technologies this concept is making life simpler and happier.

This concept of “uberization” keeps the comfort and concerns of consumers at heart. For others, it hints to a democratization minimizing competency, regulation, and oversight – essential ingredients to maintaining healthcare quality and standards. Some fear that this consumer empowerment will lead to people self-diagnosing, leading to the ultimate detriment of patient health with minimal support or evidence. This also raises major concerns regarding the maintenance of patient privacy. An example is when someone catches an Uber and something bad happening because the driver lacked experience.

What does all of this mean to me? Earlier this year at HIMSS in Chicago, I was looking out over the million dollar booths. I wondered how many of the vendors would remain as powerful or relevant 15 years from now. I also considered the transformation of health delivery where ACOs, PCMHs and new versions of retail health are growing. New approaches to healthcare payment and transparency are forging into the mainstream, enabling consumer empowerment, personalized medicine and cultural sensitivity. It’s all creating new levels of individuation; where we continue to struggle with effective models of behavioral change. Here is where the digitized self is beginning to show the first moves in the health field. From exercise enthusiasts to empowered consumers managing chronic illness, digestibles are being added to wearables to increase the panoply of both individualized and physiologically dynamic data, where social networking and gaming have coupled with crowd sourcing solutions and new insights to create new paths for data to create insights and action.

I was reminded that we occasionally overestimate the cognitive and logical aspects of our humanity with insufficient thought to emotional impact. Sometimes we set the bar too high for the impact disease management could have when patients are classified more specifically, bringing each individual evidence-based advice to alter their behaviors and change that path coupled with an enthusiastic coach. What we had missed was that people have messy, complicated lives with different resources practically and emotionally available both permanently and on a day-to-day basis. People who had emotional lives complicated with depression, anxiety and stress with goals for each day were not necessarily maximizing control of their chronic illness, but rather looking for moments of relief, happiness, and excitement.

I think the true power of Uber is genius. Its power partly goes beyond the world of satisfaction, which is now a major concern in medicine since it directly relates to revenue. Much of the Uber concept comes down to bliss, going beyond the typical expectations that we articulate. Satisfaction manifests when we match experiences to expectations. It goes beyond creating opportunities for moments of joy – it takes away pain points we do not even think about until they occur.

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The Quantified Self: A Vain Hope, or an Impending Reality?

Dr David Whitehouse
Dr. David Whitehouse

Guest post by Dr. David Whitehouse, chief medical officer, UST Global.

Technology innovation is changing many fields dramatically but unevenly, and that is especially the case with the medical field. When I get into my car each morning and look at the dashboard, I know more about the health of my car than myself.

When it comes to health, we live our lives directed by our beliefs about health and symptoms. Beliefs drive us to strategically invest in aspects of our physical selves, from diet to exercise, to immunizations. What causes us to go to the doctors, for the most part, are symptoms: aches, rashes, pain, and general losses of function. Once we see a doctor, specifics about our health are further defined by numbers (temperature, blood pressure, cholesterol).

For the most part, I am aware of my symptoms, but not my numbers. Some with a chronic illness like diabetes use numbers to help pinpoint the ups and downs of their health. The majority of us do not keep track, because internally, automatic sensors measure and assay everything – glucose levels to direct the secretion of insulin, and blood pressure changes to alter our heart rate.

Homeostasis takes place unconsciously, as conscious knowledge of all these internal processes would be information overload. Certain manifestations like fainting, blushing, and dizziness, remain on the macro level to warn us that the system was in trouble.

Modernity has shifted the need for conscious measurement of our internal processes. The diseases that are killing us – obesity, metabolic disease, type 2 diabetes, hypertension, and heart disease – are ones for which our control systems are poorly evolved. These types of diseases do their damage silently and over long periods of time. Unable to correct imbalances well, these problems tax us physiologically but send us no symptomatic warning until it is too late and the damage is well on its way.

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