As I like to say, what’s the biggest pain point available? Dying. What’s the greatest value prop possible? Not dying.
There’s a reason technologists are getting into heathcare in droves, private capital fast on their heels. Because of our work in this area, and because this is where I started my career more than a decade ago, I’m often asked what’s big in healthcare right now.
This is how I typically respond.
Healthcare is increasingly performance-based.
Healthcare’s business model is changing. Because of certain provisions in the Affordable Healthcare Act, as well as broader changes in opinion by payers laden with spiraling costs, performance-based health care has finally arrived, after much discussion.
Providers are starting to be paid on outcomes, no matter how many visits or how much testing it took to achieve those outcomes. How it actually goes down in practice is more complex than I address here, but imagine that your doctor, hospital, or clinic of choice gets a flat fee for treating a given illness or disease state. It’s kind of like an advertiser moving from a CPM to a CPA model.
This is in theory a good thing for everyone. Unnecessary testing is curbed, costs get under control, more emphasis is put towards wellness and preventative care, and more money is invested in innovation.
Whether these effects will prove out is grounds for another post entirely.
Demand for healthcare services is growing.
We’re onboarding millions of new people into our healthcare system, many of them with pre-existing conditions, and many of them under-treated. There is already an acute doctor and nurse shortage. If you’re thinking through career options, nursing school is in my opinion a much better bet than the coding dojo equivalent.
Talent is only one part of how we’ll cope with new demand. For a long time the healthcare establishment was standoffish to change, and careful to preserve control. Healthcare is still a sensitive industry (as it should be) when it comes to ethics, confidentiality, and compliance.
Nonetheless, growing demand has brought down more than a few walls. If you introduce new efficiencies help address the demand problem, you’re far more likely these days to get a meeting, and a deal.
It is easier than ever to end-around the system.
Concierge healthcare and medical tourism are trending.
Concierge healthcare is a cottage industry that has traditionally catered to wealthy individuals and families who can afford to pay outright for increased access and the very best doctors. These people usually buy supplemental insurance to cover catastrophic issues, but for primary and secondary care they are generally able to eschew the system as the rest of us know it.
If you take away the fact that concierge healthcare carries an elitist connotation, it actually makes a lot of sense. Is it so crazy to think that we would pay for healthcare the way we pay for any other service, and that we’d only buy insurance to do just that — insure us against unlikely events? Have you ever found it weird that you buy insurance for things like annual visits, which are certain to happen?
What’s most interesting is that the costs of concierge healthcare are coming down significantly, as concierge practices grow more ambitious. What’s exciting is that concierge practices typically differentiate on pedigree, convenience, and innovation. Those last two in particular mean that a concierge doctor is far more likely to text with you, and far more likely to try new apps, services, tests and technologies.
Medical tourism is exactly what you think it is — Americans traveling outside of the US to avail themselves of alternative care and significantly lower prices, often in a luxury resort wrapper. Think: more Four Seasons than a seedy trip to Tijuana. Star athletes like Adrian Peterson and Kobe Bryant have made this kind of activity cool, much to the chagrin of mainstream physicians, who recognize the (very real) risks. Still, I think the risk issue is long-term solvable.
What people often overlook however is medical tourism inside of the US, which is just as popular. Regardless, the big change here is the removal of geography as a reasonable constraint for care, and that’s a gigantic change.
Genomics, proteomics, biomics.
“Omics” is the future.
This is the area I’m most excited about, and there’s enough here for dozens of blog posts. The reason “omics” matters is because of personalization.
For example, we’ve already cured cancer…in a few cases. The methodology these days goes something like this. Your cancer is not my cancer, even if it’s the same cancer in a petri dish. How cancer interacts with each of us is unique, owing to our DNA, and any mutations thereof. The trick to curing cancer has everything to do with understanding the unique way in which each individual interacts with each form of cancer.
But “omics” applies to far more than cancer. “Omics” is about a personalized understanding of your past, present, and future body. That understanding might be achieved through testing done in consultation with a doctor, or it might be achieved on your own.
“Omics” looks like Silicon Valley 10 years ago — the hardware is expensive, data is piling up, and consumer interfaces are found wanting. I should be able to manage my health the way I do my wealth. My doctor shouldn’t know more about my body than I do (we should know the same in my opinion). And we shouldn’t only inquire about our bodies when we are sick.