Empowering you to manage your Health

The Urgent Need to Change Healthcare’s Service Innovation Inertia


If you rely on the NHS or most Western health services for your healthcare you are treated routinely to a customer service experience that will take you back well into the last century.

The world wide wait

You know the sort of thing. Re-dialling endlessly first thing in the morning to get an appointment with a GP at a time that doesn’t suit you, rather than wait for weeks for one that might.  Travelling to appointments which never happen on time for a conversation that could have been had remotely.  Receiving confirmation and diary letters by post and then having to take pieces of paper to referred appointments that you spend hours on the phone trying to arrange.

Then having to trek back to GP surgeries to pick up repeat paper prescriptions and take them to pharmacies where you have to hang around for prescriptions to be filled. The list goes on. If you attempt to bypass some of this time wasting with private health provision you then take on a complex and time consuming and usually paper-based task of managing the process of finding and paying for care.

Putting your life on hold

Basically, the way health services are currently delivered requires you to put your life on hold for the convenience of the service provider. This approach and related ways of working started to disappear in other businesses decades ago, so having to do this in any other aspect of your life would be totally unacceptable. That’s because, in the modern world, you expect services to come to you and be designed for your convenience

First world problems, of course. If you happen to live in the third world things are much nastier. If, for reasons of cost, provision or distance, you can’t access services delivered via this model at all then your quality of life is severely reduced and your life expectancy cut short.

Smartphones place the patient at the centre of care systems

The need for fundamental change is urgent. And one of the answers is – literally – to hand. In a world where all healthcare provision is under severe stress from a global ageing population, growing affluence, a rise in chronic diseases and a better-informed patient population pitted against spiralling costs and limited resources, the everyday smartphone can be at the centre, along with the engaged patient, of creating systems that fundamentally increase the efficiency, effectiveness and availability of healthcare.

After all, systems that take advantage of the revolutionary changes and associated investments that have been taking place in enabling technology and the economy outside of healthcare have already re-shaped and vastly improved the people’s lives.  They’ve created a global economy of previously un-heard of opportunity, changing power balances and taking millions out of poverty in the process.

Yet healthcare systems around the world are stuck in a timewarp, almost unique in exhibiting a common and curious innovation inertia when it comes to serving their customers – the patients. The customer-centric on-demand world that the rest of us live in seems to have passed them by.

Luddite self interest

But why is this? In the developed world, at least, there is a toxic cocktail of excuses stymieing change that is routinely trotted out by the neo-luddite, self-interested professional and administrative groups.

Concern over confidentiality, the `special` nature of physician-patient relationships, safety and, in some systems, the constant fear of legal action – all tied  to lumpen bureaucracy, of course –  appear to inhibit the change that would benefit billions of the rest of us.

Bitter irony

It’s a bitter irony that half the world’s population don’t have access to the very basic healthcare that they need, yet a substantial proportion of those people will have access to a smartphone.

People in substantial parts of Africa and other emerging economies’ previously excluded rural communities now have access to state-of-the-art banking facilities and new lending models.  Why? Because the mobile infrastructure transcended cost and distance.  There was an opportunity and a will to provide the service and improves people’s lives. And, of course, no vested interests or existing systems to get in the way of change.

I suspect too that considerations of the niceties of relationship and confidentially won’t much matter to those in counties where the ability to access adequate medical care is a matter of life and death.  Anyway, what we define as a personal relationship has vastly changed with the arrival of social media – and, yes, that too is mostly these days globally accessed via the smartphone.

Bigger issues at stake

But the potential impact of the smartphone in the West or emerging economies is not just predicated on consumers paying for any one of the tens of thousands healthcare apps already on the market that allow them to bypass the increasing treatment queues, monitor their fitness or other such sometimes eye-catching or media-pleasing lifestyle enhancement.

Although this is a good start, it is a mere glimmer compared to what could be achieved. And there are much, much bigger issues at stake.

It’s not just about apps it’s about using the smartphone as an integral part of platforms that put the patient at the centre of healthcare provision and take the `friction` out of the business of accessing and providing medical care for patient and practitioner alike.  That friction, allied with the enablement of the individual, has been removed in countless industries by companies from Airbnb to Uber and so should it be in healthcare.

A global market and better investment impact

Self-evidently, a few self-appointed vested interests should not be allowed to continually fuel lack of service innovation on the basis of healthcare being a `special case`. But, of course, heathcare is special in one particular way – the addressable market is the whole world.   Every person in the world.  They’re going to need healthcare, they require healthcare or they’ll benefit from healthcare.  And that number is growing by the second.

And from an investment or funding perspective, using existing mobile devices and infrastructure enabled by new platforms linking current technologies such as CRM and clinical research systems to improve healthcare is great value.  It’s not anything like as capital-intensive or requires as much investment overall as improving healthcare by building life-sciences businesses or a pharmaceutical companies, worthy causes though they may be.

That’s because much of the enabling investment has already been made.  So I’m certain the potential impact for every pound or dollar invested is many times greater.  After all, this is about improving innovation in medical service provision, not in medicine per se.

But, as the US economy found when decades of applying IT had barely increased national productivity until comprehensive commercial re-structuring started to happen in the 1980s, simply putting IT systems on top of existing medical practice won’t solve the problem.  For instance, practice management systems that badly automate existing procedures and further anchor-in archaic ways of working do nothing to increase productivity and effectiveness – they just swallow more precious budget and lead to more frustration.

Avoiding healthcare collapse or underservice

This damaging culture of inertia in healthcare service innovation cannot be allowed to continue.  To do so would be madness.  After all, the definition of madness is doing the same thing over and over again and expecting the result to be any different.  Healthcare delivery systems have to change fundamentally or they will collapse or never have a chance of coming close to providing a decent standard of care to the under-served.

For the good of us all, patients and practitioners are going to have to be offered and embrace new ways of accessing and delivering medical services – as they have other services in the rest of their lives.

Just as it is impossible to imagine the post-war formality, hierarchy, typing pools and communicating by envelope being appropriate to today’s businesses, so it should be axiomatic that the health service cultures and structures that were appropriate for 1947 are not those that are able to meet today’s healthcare demands.

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