Why Hasn't Technology Saved Healthcare

Griffin Mulcahey April 5, 2018
Why Hasn't Technology Saved Healthcare

A whispered quote by an anonymous executive of a national telemedicine company at recent HealthTech conference…

“Great doctors are the real scarcity for our industry.”

This is a harsh reality the technology focused digital health industry has avoided acknowledging. The reality mirrored by our national health system facing a projected shortage of 80,000 physicians over the next decade.

Digital Health companies have failed to engage the best and brightest experts in the medical field. Companies often find great physicians to work as medical directors or serve on advisory boards, but when it comes to delivering care they haven’t engaged with high caliber candidates to the same extent as their brick and mortar health system counterparts.

Where are the Outcomes?

Every advancement in healthcare is measured by the triple aim: 1) improve access, 2) lower cost, and 3) improve outcomes.

The silicon valley companies shifting from social consumer products into healthcare over the last decade have focused on what they know how to control and measure - improving access in the form of consumer engagement. And, the ‘price” per visit seems to lower costs when compared side by side to traditional healthcare.

However, the early research is muddled as best on the (3) improving outcomes, which in the end is the key to lowering cost.

A 2017 Rand study analyzed 300,000 telemedicine visits from 2011-2013. The study found “Like some other new patient care models that promise to cut costs and reduce the hassle of receiving medical care, it appears that in some cases, direct-to-consumer Telehealth may increase spending rather than trim costs.”

The problem - consumers are using telemedicine and digital health services without getting healthier outcomes. Which, eventually leads them to spend more money on additional healthcare.

The Rand group’s solution? Make telehealth more expensive so people use it less. This seems counterintuitive for actually making people healthier.

Another study, 2016 Scripps Wired for Health, followed a patient cohort using digital health tools to self-monitor their own health for 6 months. The study found, “no clinical or economic benefit from digital health monitoring,” Ouch.

But this shouldn’t be a surprise at all. Human nature, we’re not great self-monitors. We need help, nudges from experts, and an engaging experience to drive change.

“There are a few possible explanations for the failure of digital health devices to impact outcomes or costs in this trial… Another is that this study more or less tested the effect of monitoring itself, although there were nurses and coaches made available to participants.”

Technology without people helping to implement it fails again.

It’s a people problem, stupid

The anonymous telehealth executive hinted at the real truth - technology focused digital health companies need better clinicians to deliver care, not just better technology.

We’ve all experienced it in any walk of life - a technology product eventually stops working or disappoints. You try customer service in hopes of talking to a person who can actually help. If that fails, you move on to another product and start the process over. Spending money for the same services, again. The only way to break that cycle is hands on human accountability.

Medical care is this magnified 1000x. The person on the other end of the line in healthcare has 12 years of expert clinical training! Technology can help increase access, and AI can even streamline diagnosis, but in the end a highly skilled creative clinical mind must be on the other end of the medical treatment.

Great medical outcomes - whether for urgent care or a specialist issue, requires a great medical mind in concert with the best technology.

From 2011 to 2017, HealthTech companies have operated with the hubris that the tech will solve the problem. They have treated medical professionals like Uber drivers, as if interchangeable to get the patient from point A to point B of their product experience.

Many technology companies have failed to actively recruit, train and implement their products alongside of the medical professionals who ultimately implement their products.

In 2018, a handful of forward thinking executives have seen ahead of the curve to active find the best clinical experts. They realize all the tech tools can’t solve this people problem.