The following is a guest article by Jeff Wells, MD, CEO and Co-founder of Marathon Health.
COVID thrust telemedicine into the spotlight, but its beginnings date back to the 1950s when the Nebraska Psychiatric Institute first used video conferencing technology to check on patients at the Norfolk State Hospital 112 miles away and more famously in the 1960s when NASA used a form of telemedicine to check the vitals of our astronauts. And while big players like Teladoc, Live Health Online, and Doctor on Demand have been refining the technology for many years, it wasn’t until COVID made it a must-have that average consumers really started to notice – with adoption rates jumping from .3% in 2019 to 23.6% in 2020.
Consumer and provider willingness to adopt telemedicine as a viable care delivery channel is a big win for the US healthcare system – but it’s not a silver bullet. In order for us to turn the corner, aka reduce spend and improve outcomes, we need an omnichannel care delivery model that’s rooted in patient-provider relationships. While some view Amazon Care’s entrance into the healthcare market as overrated and others see it as a silver bullet, there’s little doubt that the blended delivery model they are adopting is the right approach.
However, mastering this blended approach is just one piece of the puzzle. Investing smartly in primary care is the first major step in solving the US healthcare crisis.
Primary care providers used to be the heroes of our healthcare system. I bet you can still picture the doctor going door to door with a black bag. In the 1970s we started to move away from primary care being the quarterback. That was accelerated in the ‘80s and ‘90s as big hospital systems gobbled up all the independent offices in an effort to design a built-in feeder system to the more lucrative specialties like imaging, cardiovascular and orthopedics.
Layer on the Affordable Care Act, which doubled down on an already broken system and made it worse by perpetuating a fee-for-service model. That model failed to increase affordability and included the unintended consequence of rewarding action instead of outcomes.
Now we’re left with generations of talented primary care providers who are unfulfilled and dispirited by a system that doesn’t allow them to impact their patient’s lives meaningfully. Couple that reality with a decline in medical students electing primary care (and who can blame them?). And the trifecta is hundreds of millions of consumers who are frustrated, sick and missing that personal touch.
The future of healthcare needs to be focused on value, not volume. A model anchored on tangible outcomes – reduced risk through better education and management of chronic disease, a focus on prevention and lower costs.
An Omnichannel Healthcare Approach Starts with Patient Relationships
To deliver those outcomes, we need an omnichannel delivery model that’s rooted in trusted relationships. Achieving that starts with more convenient access. Face it, some issues don’t require an in-person visit, and telemedicine is perfect for those. Sick visits, lab reviews, medication checks – the transactional stuff that fills the gaps between the real change.
If we’re going to bet the house on primary care being the solution, partnering virtual access with in-person is critical. Chronic conditions like diabetes and hypertension, among others, drive 75% of our total healthcare spend today. You can’t bend the curve on that via a video screen. Providers need to spend real time with a patient to uncover the root causes of those diseases and then build trust so that the patient will take ownership for driving real behavior changes that will result in reduced or eliminated risk.
Our focus in the coming months and years need to be about recommending the best channel depending on the patient’s needs. We should strike a good balance between consumer choice and clinical best practices. Let’s not make this one more thing for a consumer to figure out on their own.
Empowering Patients and Providers, not Payers
We have to shift our focus from treating disease to preventing it. Let’s incent healthcare providers to deliver outcomes, not volume. Thirty percent of all procedures are unnecessary. It’s expensive, wasteful, adds friction to the patient experience and doesn’t lead to improved health.
Let’s allow primary care providers to be the quarterbacks of a patient’s healthcare journey; to simplify the care plans, help navigate the world of specialists and procedures and to be the confidant for an otherwise confused, sometimes scared and disheartened patient.
To reimagine healthcare, we have to reimagine our approach. Improved care happens when an integrated care team is empowered to meet the patient where they are and can invest time to build trusted relationships. Ultimately the difference between a great outcome and lower costs and the inverse, is a single patient decision made in a moment.
Let’s empower patients by putting them at the center, listening and including them in decision-making. Let’s leverage integrated care teams who are trained to identify roadblocks and guide patients to meaningful change. By focusing on the relationship, spending more time with patients, we’re delivering value, building trust and making a true impact on patient lives.
Modern healthcare requires a level of accountability throughout the entire patient journey. We have a chance to transform individuals and fundamentally improve their quality of life. It’s often said that the most expensive tool in our healthcare toolbox is the provider’s pen. Let’s wield that powerful tool more effectively.
