Electronic Health Reporter

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.

Dr. Noriaki Kano, the astute Japanese student of Dr. Ishikawa, was the man who developed the model to address the various ways in which Six Sigma practitioners could prioritize customer needs. These practitioners would become the impetus behind the quality-based revolution and six sigma practices in the USA. Kano talked about three separate levels of quality. First, there is the quality without which you shouldn’t even consider going to market. The second is the quality which is designed to put into service through products based on your understanding of what people want. Finally, there is the “quality surprise,” which occurs when if asked about a product or service, you realize you would have never requested it on your own, but desire it following an unanticipated encounter.

Perhaps I never understood the idea of turning pain points into bliss points quite as well until the other day when I was on my visit to Chicago. I didn’t expect rain, so I had not brought an umbrella. When it was time to leave, I needed to get to the airport. The taxi routine would have me headed outside into the rain to flag down a taxi with low odds of success. I’d get into the first available cab, regardless of its condition, to go on a trip where I was unsure of correct directions, to finally worry whether they accepted credit cards or needed cash.

With Uber, I could summon a car in advance, track its progress it to me; send a link to my colleague who could track my progress to the airport on his cell phone; follow the route and progress on my cell phone; know that the payment and tip were already negotiated, and travel in a vehicle and with a driver where I knew ahead of time the quality of the vehicle and the way that the person driving would interact with me because they were already set by Uber’s standards. In addition, the vehicle could automatically link my music to the radio in the car.

Modernization is something different. Modernization means that the majority of taxis now accept credit cards. Uber understands that you can make the necessity of transport into an experience; you can take the routine and the mundane and not just take away the pain points but also create bliss points.

Technology, particularly the combination of smartphones and ubiquitous sensors are creating capabilities in healthcare that are trying to lift sickness from pain and distress to a new focus on health and self-actualization, and controlling illness as a separate part of life to an integrated one in regards to helping make chronic care simpler. We have come a long way from the nightmares of “Bedlam” and the insane asylum to a world of online cognitive therapy and positive psychology and therapists on demand; and activities to maximize neurogenesis and synaptogenesis (otherwise known as brain games).

Technology is an enabler, but just as is important is design. Perhaps more important is a real understanding of designing for patient happiness and satisfaction. For me, we are watching the advent of the “uberization” of healthcare. Have no doubt it is coming, driven by creativity, ingenuity, vision, and dreaming; powered by iterative design and redesign, created by engineers and artists redesigned and repurposed by people with real lives, real dreams and a real understanding of the issues. As for me, I cannot wait.