Who will be your doctor in the future? When we think of “doctor,” we usually picture someone wearing a white coat and stethoscope speaking to us in an office. Doctors traditionally have also managed our healthcare data; they are the gatekeepers to our records, results, and diagnosis.
However, with the recent government announcement mandating improved healthcare data sharing, the answer of who may be your doctor may very well depend on who controls your data. The idea of bypassing the gatekeeper is a foreign one to current healthcare consumers and could even be dangerous. For example, most patient portals have time delays so that results may be given to us first by a doctor who is able to interpret the data in the context of the patient’s history. While it is likely that we will always need a doctor to aid us in interpreting our data, it is not likely that doctors will continue to be the gatekeepers of this data or even work in traditional settings, like a private practice.
While this concept of taking charge of own healthcare data may seem alarming, think of how quickly we were to trade traditional methods of doing business for Amazon, Google, Facebook, Uber, and Tesla. These are data companies. Their traditional competitors are not.
As patients, our data is still up for grabs. There are many visions of the future with the most traditional being that hospital systems will take the place of your traditional private practice doctor. Large healthcare systems are capitalizing on traditional expertise and investments in digital infrastructure and innovation in treating patients. You may have noticed urgent care networks in your region and even primary care practices purchased by large hospital systems. Hospitals want to build a relationship with patients before they need hospital-level care while offering enhanced benefits and easier access to diagnostic testing.
Another key holder of our healthcare data is insurance companies. Insurance companies already take a risk on patients and know a great deal about them. Could they become our doctor of the future? Some health systems (think University of Pittsburgh Medical Center) have tried to bring this vertically integrated model to life by being both a health system and an insurance provider. In this scenario, your doctor would be part of an insurance company. What remains to be seen is whether insurance companies that typically have been good at reigning in healthcare spending will also be good at effectively delivering care.
Drug sales constitute a massive percentage of this healthcare spending. Could they become our “doctors” of the future? Companies such as 23andMe, which provides personalized DNA analysis, are partnering with drug companies to offer insights that might someday bypass traditional healthcare. In this case, doctors wouldn’t work for hospitals – they would work for pharma companies. The benefit here is that pooling together so much patient data may develop pathways to new lifesaving insights. The challenge is that these companies may be held hostage by their own success. To implement a data first strategy, the companies might lose their dependable reimbursements for drugs and have to be measured by outcomes and performance.
The idea of hospital systems, pharmaceutical companies, and even insurance companies replacing the traditional physician image are different but not shocking. But, what if Google, Amazon, or Facebook became your doctor? All of these companies have developed massive storage infrastructures and the capability to mine data. We know that consumers are already used to sharing data with these companies in exchange for benefits. However, it is yet to be seen whether consumers feel that shopping for groceries is different than health care. Is it possible to monetize healthcare data and still provide effective care? Apple, Qualcomm or Fitbit may also become your doctor. These companies are pushing healthcare further away from sick care and towards wellness behaviors. They believe the best health care plan is to avoid illness. Will this translate into becoming our trusted advisor when we get sick?
Many of these pathways lead to you becoming your own doctor. This is potentially the most radical and transformative change. Consumers become more accountable for their care and the payment of it. Can individuals with more access, accountability, and data drive better outcomes? In entertainment and financial services, consumers bundle and unbundle services in a way no one could have imagined. Could it happen in healthcare? Would that finally bring price and quality transparency and competition, lowering costs, and improving results?
As we pursue all of these business models and more, the most intractable problems may well be policy questions about who owns data, who can benefit from it, and whether we are willing to trade-off privacy for cheaper and better care.