Redefining the Future of Healthcare With Patient Intelligence

By Cole Sirucek, CEO and Co-Founder of Docdoc

Cole Sirucek, CEO and Co-Founder of Docdoc

A patient-centric approach to delivering healthcare should be the primary focus of the healthcare industry today. However, this is often not the case. In reality, improving healthcare quality and access is difficult. Difficult problems often become deprioritized, not because of their lack of importance, but because there are other easier and more straight forward problems that can be addressed.

There is a lot that can be learned from other industries, which if applied to healthcare, would go a long way in improving healthcare quality by empowering consumers to take charge of their own healthcare.

A brief history of the Internet.
What do Airbnb, Uber, and Amazon have in common? They are all category-defining companies. They are also worth hundreds of billions of dollars because they have each created a platform that radically simplified the consumer journey. They did this in remarkably similar ways. In fact, when analyzing the Internet’s most successful businesses, a common pattern emerges.

Great internet companies tend to do three things well for consumers: they provide discovery functionality, relevant curation, and transaction capabilities. In essence, they have lots of relevant inventory that is easy to find and pay for.

Despite the common-sense simplicity found in this framework, a cursory analysis of the healthcare industry makes the old axiom that there is nothing common about common sense abundantly clear.

In short, patients suffer from a lack of empowerment because they lack the information needed to allow them to make informed decisions about their care.

This represents a failure on the part of the healthcare industry, and an exceptional opportunity for the entrepreneurs who step in to solve this problem. There is nothing inherent in healthcare which prevents the creation of a consumer-friendly journey.

In the same way that Amazon defined ecommerce, and Airbnb and Uber the sharing economy, the company that defines patient intelligence will reap the benefits of teaching consumers how to consume healthcare.

The issue is not one of technology. The technology to create category-defining companies was not invented by today’s leaders. Today’s leaders defined their categories because they built a highly functional ecosystem that worked for consumers.

In the Asia-Pacific, the healthcare technology industry has grown to become the second largest in the world, only behind the United States. Just last year, the region’s industry attracted a staggering US$6.3 billion in investments.

Much of these investments have gone into digital technologies which acquire data through devices such as the Internet-of-Things (IoT), or process data more efficiently and effectively through artificial intelligence (AI), or in delivering care remotely through telemedicine.

But how exactly do these investments create a patient-centric approach to the consumption of healthcare?

What is the role of insurance companies, large employers, and governments in shaping the patient’s journey? These groups, collectively referred to as payers, represent the patient in today’s healthcare ecosystem as they pay the bulk of medical bills.

If the Internet has taught us anything, it has shown us that empowering consumers with the information they need to make informed decisions improves the overall efficiency of the market and is a good business opportunity for the first mover.

From this perspective, the missing ingredient in creating a consumer-centric healthcare system is a deeper understanding of the problems consumers face in the consumption of healthcare by the payers. When payers begin to demand and pay for better customer service, the market will respond accordingly.

Patients need access to relevant medical information and nonpartial medical professionals to help them understand the decisions they face and to navigate the medical landscape

There are four main pathways payers should begin exploring how they can empower patients to gain greater control over their health and healthcare:-.

1. Empower patients by bridging the information asymmetry in healthcare
At any point in time, individuals can find themselves in a situation where they need to make important medical decisions for themselves or their loved ones. However, making such informed decisions often becomes challenging without access to crucial information packaged in a way that is easily comprehensible by the healthcare consumer.

This translates to massive information asymmetry in healthcare, where doctors know much more about their expertise than patients and patients often do not have enough information to make an informed decision about their own healthcare.

Patients need access to relevant medical information at a procedure and condition level of granularity. They also need access to non-partial medical professionals to help them understand the decisions they face and to navigate the medical landscape.

At DocDoc, for example, we collect information about doctors that are most closely linked to quality, cost, and patient experience. This includes the information that is not available anywhere else, such as the number of times each procedure is performed a year, legal actions against a physician, credentials for a given procedure, and pricing. We then verify information wherever possible with legal bodies, certification boards, and government agencies to assure that our understanding of physicians' strengths and weaknesses is as accurate as possible. We then take this one step further by leveraging computer intelligence to compare each doctor’s unique strengths and match them with the patient’s unique needs, thereby empowering patients to find the right doctor at the right time based on verified information.

2. Personalization of care
Consumers today are demanding personalization across all aspects of their customer journey, and it is no different when it comes to their health and healthcare services.

To get this, many are turning to wearables and mobile applications to track their health and get recommendations based on their habits. Healthcare providers and payers can leverage this invaluable data gathered across channels to analyze patient behaviors and offer personalized suggestions to improve the patient’s health.

There is also a vast opportunity to provide recommendations on healthcare services and treatments based on an individual’s profile. For example, a female in her 20s, who needs her Anterior Cruciate Ligament repaired, needs a different orthopedic surgeon than a 70-year-old male who needs a knee replacement. This requires understanding each patient’s particular needs and applying AI to a well-structured database to create personalized doctor recommendations for each patient.

To provide the best-personalized care for patients, AI capabilities must be coupled with the expertise and contextual knowledge of a healthcare practitioner. And to provide the best support and guidance for patients, there have to be online and offline touchpoints to medical professionals throughout the continuum of care, from discovering the right doctor through making the first consultation appointment to finding alternative care options if required.

3. Better access to care through telehealth
New technology solutions, such as telehealth or telemedicine, where doctors and patients can connect remotely through mobile devices and video conferencing, are moving care out of healthcare facilities and into the patient’s home.

With these features, telehealth can help address one of the key healthcare issues in Asia Pacific which is access to care. Not only can it provide healthcare services to remote, rural areas– but also free up healthcare facilities by allowing patients to recover or get consultations from the comfort of their own home. Telehealth is especially useful in primary care consultations and can offer patients convenience and time savings.

However, it also has a set of limitations. For example, many symptoms are difficult to diagnose over a video consultation, and a number of critical illnesses cannot be treated virtually. To follow the patient through the continuum of care, we need to combine telehealth with AI-powered platforms that can provide personalized doctor recommendations for in-person visits.

4. Seamless insurance claims through cashless settlements
When it comes to making insurance claims, we would often link it back to the manual process of claim forms and lengthy reimbursement process. Through AI, insurers can simplify this process by automating claims management through smart contracts and cashless payments.

With the rise of tech-savvy consumers in Asia, AI-powered customer service can add value and help insurers differentiate their service delivery to discerning consumers. Furthermore, consumers will be able to enjoy a seamless claim procedure and a better end-to-end healthcare journey.

The road ahead
As patients become more involved with their own health management and better understand their needs, healthcare providers and payers must ensure that they are taking proactive steps to deliver superior healthcare experiences where and when patients need them. Technology has and will continue to support this, improving experiences for both healthcare practitioners and patients.

The inbuilt capabilities of health technology platforms will make a significant difference for enhancing the patient journey, and with a sophisticated AI-powered tool, organizations and patients will be able to unlock immense opportunities to patient intelligence.