NEJM August 29, 2012 published a perspective by Asch and Voipp titled: What Business Are we In? The Emergence of Health as the Business of Health. They present a cogent argument that healthcare today is similar to Eastman Kodak who after 131 years in business filed for Chapter 11 protection in the US. Kodak had an opportunity to create digital images and meet what customers wanted. Well they didn’t. Our healthcare system is in the similar throws of failing to read the handwriting on the wall. Are elements of our healthcare system behaving similar to Kodak, ignoring consumer wants and needs?
Our healthcare system largely focuses on producing healthcare, not health. Consumers want health and healthcare is a means to that end. It is the system we have in place, it is the fact of life and death in the US. Our system is designed around writing prescriptions, performing surgeries, and imaging. The authors rightly state this is how we get the health we want, through this system. They also go on to present the fact that our current system looks at health and disease as if it were entirely biologic and not in reality driven by social determinants, economics, personal behavior, social disparities, environmental influences, geography, etc.
Add to that the simple fact we are now in an age of outcomes. Never before have we had the ability to identify, measure, and report outcomes from entire systems and populations down to a single physician. We know what is working for whom and are making healthcare decisions based on that knowledge.
Finally the authors point to the fact our healthcare system is now testing costs and non-payment for preventable readmission or payment for bundled care. Outcomes and payments will be linked going forward.
In summary the authors state that unlike Kodak who were clueless about what their customer wanted successful physicians, hospitals, and provider systems will ‘shift their activities from delivering health services within their walls toward a broader range of approaches that deliver health’ They will in effect answer this question, ‘What do we need to do to move from a product-oriented industry to a customer-oriented one?’
Currently healthcare is about selling a product based on a response to a need, an illness an accident. It is a reactive model built less on customer’s needs and more on a situation. The system orders more tests, lowers costs, and drives utilization. It is like a broker churning your account. This strategy is inherently going to fail because of the changes listed above. The system is not looking at what customers want and where the puck is going to be but what is an immediate point of purchase behavior. The system is built on more use greater the revenue and ultimately profit.
The authors speak to the need for organizations and providers to look at wellness programs and other offerings that move the hospital away from being a provider of products to meeting customer needs.
In my opinion there are two additional factors that point to a direction that becomes a solution to the need to become customer oriented. We know the numbers. A larger portion of the adult population uses the Internet to search for health topics. To solve a health problem a greater number of patients and people are searching, chatting, joining, sharing, etc. online health questions, knowledge, information, etc. They are integrating this new knowledge into their healthcare corpus compendium. Some may be using it with their HCP but it is more likely their efforts are thwarted or fall on deaf ear. But they remain steadfast in their access of healthcare knowledge, data, and information.
Healthcare can get into a simple customer oriented business: information and knowledge transfer. Each hospital, each physicians office, each clinical department, etc. can become resources for knowledge, information, and data. Each and every one of these parts within healthcare can become a resource that customers (aka patients) can turn to, rely on, and trust.
Knowledge is power and that is not limited to who has the knowledge but, where that knowledge resides, how it is transferred, what its context, and how the receiver of that knowledge uses it and where. This model becomes the single most important connection driving exchange of knowledge and changing the dynamic from providing a product to providing a service based not on need but a relationship.
PS: A great analysis of content and publishing to support this idea from Digital Tonto.