By Reenita Das
Partner and Senior Vice President
Frost & Sullivan
New model can save time and money when treating chronic care patients
Much has been written on the “Uberization” of healthcare and the potential benefits this model could provide in terms of cost reduction, improvement in efficiency of care, and judicious use of both manpower and resources. The prevalent consensus thus far is the Uberization of healthcare will be one of the defining healthcare trends of the 21st century.
The core objective of this model is widely assumed to be the facilitation of primary care physician home visits. These home visits expect to benefit patients who are not ambulatory because of a disability or ailment. With two-thirds of the American population using a smartphone, coupled with network connectivity and high rate of Internet penetration, healthcare providers can target this large home care market. Patients can access custom apps allowing them to view doctors in the area, select a visit from a particular general physician (GP) and make an appointment.
However, use of the Uber model for primary care home visits is debatable. A survey conducted by the American Academy of Family Physicians in 2013 shows home care visits declined from 19% a week in 2010 to 13% in 2013. This trend indicates patient mobility may not play as large a role in home visits as previously thought.
Another major issue limiting Uberization of primary care is the current physician shortage in the U.S. Despite the number of primary care physicians increasing over the past five years, the number of primary care visits a year is a staggering 1 billion annually, making an average of 3,000 patient visits per physician. Conservative estimates expect the primary care physician shortage to go as high as 12,000 by 2025, with other estimates projecting a shortage of 31,000. The most acute shortages are currently seen in rural areas, with a current deficit of 4,000 primary care physicians. Only 10% of primary care physicians in the U.S. practice in rural areas, home to one-fifth of America’s population.
With an existing primary care physician shortage expected to widen over the next decade, using physicians for house calls would adversely impact time between consultations and make a poor case for smart utilization of primary care physicians.
Virtualization – Healthcare’s New White Knight?
While Uberization of primary care through use of smartphone technology does not seem viable, the same technology can be leveraged toward virtual health services. A survey conducted by the American Hospital Association two years ago shows 76% of responders prioritized access to care over the need for human contact with providers. This survey showcases strong potential for growth in virtual healthcare.
An international survey conducted in the U.S. shows only 29% of physicians indicated their practices made arrangements for ensuring after-hours care for patients, other than automated phone referral to the emergency department. Only 30% of patients in this survey described getting care on nights and weekends as “very” or “somewhat” easy.
In another national parent survey conducted by Joseph S. Zickafoose, only 47% of patients reported access to their child’s primary care office on the weekend, 23% reported access to primary care after 5 p.m., and only 13% reported access to primary care physicians via email. Creation of virtual platforms enables patients to contact primary care physicians over video calls 24 hours a day will ensure greater real-time access to physicians.
Virtual care could also reduce cost per consultation to about $40 to $50 over time and eliminate doctor visits. This would benefit insurers looking to reduce costs and improve efficiency of care provision. Primary care physicians could see more patients on a daily basis, as well as manage patients more effectively.
For example, patients who are scheduled to see physicians for regular check-ups can do so over a virtual video call, while more serious patients can visit the doctor’s office in person. This practice allows primary care physicians to allocate more time and effort on patients requiring in-person care to improve health outcomes.
This, of course, does not mean virtualization will completely replace the Uberization of healthcare. Virtualization can work with Uberization to create comprehensive patient management solutions, which will greatly benefit chronic care patients.
Virtualization and Uberization of Healthcare – A Hybrid Solution to Patient Management in the 21st Century
Chronic care management is perhaps the most critical component in the U.S. health system. Chronic diseases are on the rise and expect to kill approximately 64 million people each year in the U.S. Four-fifths of healthcare spending is driven by chronic conditions, most of which are lifestyle diseases. Chronic care requires continuous patient management as opposed to one-off surgical or medical intervention. Currently, 71% of chronic patients are managed through face-to-face meetings with primary care physicians and specialists, while 50% of chronic patients are also supported by home visits.
To facilitate efficient patient management, it is essential to monitor patient health in real time and share this information along the care continuum. While wearable technology is currently used to monitor and share a range of health parameters such as blood pressure, heart rate, oxygen saturation, etc., without requiring a doctor or caregiver to be physically present, monitoring for some chronic conditions will require high-end imaging solutions.
In such a scenario, Uberization of health can create an extension model of care provision. In this model, specially trained diagnosticians can partner with ride-sharing services to bring portable imaging services to the patient’s home. Portable ultrasound, MRI and CT devices can be leveraged to improve efficiency of diagnosis, with results transmitted via encrypted networks to doctors and patients post-analysis. Doctors can then make an appointment with the patient either in person or virtually, based on the results.
The Tricoder – From Star Trek to Med Tech
For fans of the Star Trek series, the Tricoder needs no introduction. For the uninitiated, the Tricoder is a handheld device used to record, store and analyze data. To this end, there has been interest in creating a medical Tricoder allowing patients to self-diagnose, store and analyze health data. While there has been resistance to the idea of patient self-diagnosis, including from the FDA, there is tremendous potential for medical Tricoder adoption among care providers.
Care providers can work with device firms to create Tricoders that capture multiple parameters of health data and store for later analysis. Diagnosticians can partner with ride-sharing services to reach patients who are unable to visit the diagnostic lab. Tricoders can be used to record health data not already captured by wearable technology. Data on these devices can then be transmitted to cloud-based servers for analysis and then to the doctor.
Virtualization of health has and will continue to revolutionize the way care is provided. However, physical human presence will remain the backbone of the care provision spectrum. To this end, Uberization will have a huge role in connecting caregivers and patients outside of doctor’s offices, hospitals and diagnostic labs.
With a shift in focus from intervention to patient management, aggressive monitoring without putting a strain on already limited resources and manpower is necessary. To achieve this goal of aggressive monitoring, it is essential caregivers utilize both virtualization and Uberization to create hybrid solutions to meet current and future demand.
This article was written with contribution from Sowmya Rajagopalan, Research Manager with Frost & Sullivan’s Transformation Health Program.