The Internet lets people bypass traditional channels of service. Hospitals need to keep up.
For decades, we’ve talked about doing a better job of involving patients in their health care decisions and treatment. As important as that goal is, it’s only an incremental step away from the traditional roles of the controlling provider and the dependent patient. And incremental steps aren’t enough for consumers in the Internet economy.
The Internet has provided rocket fuel for people to take control away from traditional structures. Just ask record companies, taxi companies or newspapers. Progress has been slower in health care, with its entrenched traditions, complexities and regulations. However, we are starting to see significant examples of people using the Internet and related technology to completely bypass physicians and legacy health care systems.
A great example is the Nightscout Project, described in a recent Journal of the American Medical Association article. The parents of a 4-year-old boy with Type 1 diabetes found that they could not access readings from their son’s regular glucose monitor while he was in school. The boy’s father, a software programmer, created a program to send glucose readings from the device into the cloud, where the parents could access them from anywhere via their smartphones.
A tweet about his achievement led to inquiries from caregivers and patients with technical expertise, and ultimately to the Nightscout Project online collaborative. The group developed mobile solutions for diabetes monitoring, including smartphone apps that provide alerts for abnormal glucose levels, and a web application and wearable device to display glucose readings. The project has a Facebook group with more than 15,000 members in the United States and 4,000 members in other countries and a website where anyone can download the open code and set up their own system.
Here is a breakthrough that was developed by a parent, makes use of wearable and cloud technology and is shared through social media. No health care professionals are involved.
This is not an isolated example. A 15-year-old invented a sensor that alerts his family via smartphone when his grandfather, who has Alzheimer’s disease and is prone to wandering, gets out of bed at night. His project was recognized at the Google Science Fair and spawned a popular TED Talk.
Startup companies are also helping people bypass the traditional health system. WellnessFX offers direct-to-consumer blood tests by connecting patients with local labs, delivering easy-to-understand results to personal accounts on its website and offering a virtual physician consultation about the results. The company Any Lab Test Now, which has more than 150 locations, provides direct consumer access to clinical lab tests, including providing a doctor’s order for patients who do not have one; results go to the consumer rather than to the physician.
A handful of forward-looking legacy health systems have taken steps toward giving more power to patients. For example, Kaiser Permanente Northwest has allowed women to self-refer for mammograms since 1991. However, startups are clearly taking the lead, and funders see great promise, with venture-capital investment in on-demand health care companies estimated to reach more than $1 billion by 2017.
The movement toward patient-powered health care is causing plenty of consternation from legacy entities about lack of care coordination and regulatory compliance, the possible increase in utilization and therefore costs and the need for physician oversight. These concerns are valid, but they do not change the basic fact: In the Internet economy, patients can and will take control of their health care. Legacy health care entities cannot stop this trend any more than newspaper publishers can persuade people to put down their smartphones.
Today, people don’t have to stand in the rain fruitlessly searching for a taxi. They don’t have to wait for the next day’s newspaper to get the news. And increasingly they don’t have to wait for a traditional provider to grant permission to access care or health information. In the Internet economy, people no longer have to accept things they cannot change; instead, they change things they cannot accept. That same attitude needs to become a core belief of traditional health care providers.