For years now, the prevailing healthcare delivery model has been that patients come to the healthcare providers. But that model is quickly shifting to providers coming to the patients. We see this happening in a number of different ways already, but you can expect this trend to continue and grow.
It behooves traditional healthcare providers to leverage this change now. Use big data to predict new developments along this line and to manage healthcare data from a variety of new sources associated with this trend.
The rise of clinics in retail stores
While the concept of independent and satellite clinics is not new, the development of grocery stores and pharmacies as healthcare delivery vehicles is—at least it is in the U.S. Many of the larger chains deliver discount drug plans; some free drugs, mostly antibiotics; and vaccinations. The newest trend is to also provide clinician care within these establishments. Retail giant Walmart with its Clinic at Walmart offering, and major drug store chain CVS’ Minute Clinics are examples of this new rise in in-store health clinics.
While such developments ease the burden of excessive demand on traditional providers and increases healthcare access for the masses, they also increase pricing and transparency pressures on traditional providers. The in-store clinics clearly post pricing for services online, which are also typically cheaper than most traditional providers. In markets where for-profit healthcare exists, this potentially presents a competitive challenge.
But even these new models are not free from competitive pressures. The trend to take healthcare to the patient goes beyond the convenience of a clinic in a neighborhood store.
For example, Uber, a mobile app that enables users to quickly summon a ride, has launched UberHEALTH, an app which enables users to summon flu vaccinations to come to them. One to 10 shots can be thus delivered onsite for the app user. It is likely that UberHEALTH will deliver more than flu shots once they work out the kinks in the new service. You can also expect more competitive entities to arise that specialize in delivering healthcare to the patient’s physical doorstep soon.
Telemedicine spreads to drones and mainstream use
Telemedicine is also stretching beyond its early goal of providing healthcare to remote places where doctors in general and specialists in particular are scarce. Now telemedicine is becoming a personalized, virtual service available to almost anyone on almost any device.
For example, Google recently launched a telehealth pilot program wherein people searching Google about a particular symptom are offered a “talk with a doctor” option. At the moment, the resulting online chat with a physician via Google Hangouts is free. It is unclear whether the service will remain free over time.
Wide scale availability of telemedicine coupled with mobile apps capable of health metrics from blood testing to vitals and fitness measures will radically change how healthcare is delivered at least in non-emergency and triage situations.
Yet another example of medical care going to the patient is the advent of ambulance drones. Already a drone has been developed in the Netherlands for rapid response defibrillator delivery to heart attack victims. There are plans to greatly expand the drone’s capabilities to address a wide assortment of medical emergencies. The drone can arrive faster than the traditional ambulance since it flies rather than travels in traffic.
“It is essential that the right medical care is provided within the first few minutes of a cardiac arrest," said Alec Momont, the drone’s creator, in an article in CNET. “If we can get to an emergency scene faster, we can save many lives and facilitate the recovery of many patients. This especially applies to emergencies such as heart failure, drownings, traumas and respiratory problems, and it has become possible because life-saving technologies, such as a defibrillator, can now be designed small enough to be transported by a drone."
For overwhelmed healthcare systems these new healthcare delivery models will come as welcomed relief. For for-profit systems, this is yet another challenge since the drone is planned to include a telemedicine component connecting patients to physicians located anywhere in the world.
It is also conceivable that drones will one day transport patients to hospitals. It has yet to be calculated how this is likely to affect current ambulance and ER operational models. This may also affect future facility planning to accommodate incoming drones carrying patients.
Ebola spurs a rethink in healthcare delivery during a public health crisis
However, this take-healthcare-to-the-patient shift in healthcare delivery is no longer solely attributable to new technologies and the possibilities they bring. The recent Ebola epidemic is spurring a rethink of the existing centralized healthcare delivery model for purely practical reasons.
An emergency medicine physician penned an interesting piece and posted it on LinkedIn wherein he underscores a major but often overlooked potential problem in delivering centralized healthcare during an epidemic. To that point, Dr. Louis M. Profeta said in his LinkedIn post:
“Now imagine that huge numbers of hospital staff – from doctors to housekeepers, from food services to registration, from security and parking to transportation will decide not show up. They will call in sick or simply just say: ‘No, I’m not coming to work today.’ In just a few days, human waste, debris, soiled linens, the sick, the dying and the bodies will pile up. We will be overwhelmed and unable to offer much in the way of assistance because the labor-intensive protocols that allow us to safely care for even one patient are just too exhausting. These procedures are barely repeatable more than once or twice of day, and fraught with so many steps and potential for mistake that it becomes too physically and emotionally taxing for the staff to do…so they simply won’t show up. And I am not sure I will, either.”
Further he went on to say:
“So we drill and we prepare and we post placards and do screening but no one is asking why in the hell are they coming to us in the first place? Fluids and rest can be provided anywhere: an empty warehouse or a huge tent in the middle of farmland. Why would we not just take the care to them in the form of special traveling Ebola-mobiles that triage and treat the patients at home? Why can we deliver the mail, pickup the garbage and recyclables at damn near every house in America, but we can’t pull up a retrofitted UPS van, drop off a mid-level provider in a hazmat gown, let them do an assessment, draw some blood, drop off cans of rehydrating formula to their doors, clean linen, biohazard bags, gowns and gloves for family members, slap a warning sticker on the front door, tell them you will stop by tomorrow and move on to some other location? I know I sound crass, perhaps like I don’t really have sympathy for these very ill patients. This could not be further from the truth. I’m just kind of angry. I know there is a better way than risking the infrastructure of a medical center for the sake of a few patients that will either do OK at home with simple supportive care or die no matter what care I provide.”
Having the means for remote patient care can make all the difference in how well an epidemic of any type is handled and how well other patients are cared for too. And as this doctor pointed out, remote medical care also protects our healthcare infrastructures. No one wants to see healthcare facilities, or the entire infrastructure, collapse under epidemic borne pressures.
What this all means to providers
Healthcare is rapidly changing in myriad ways and mostly for the good, particularly in terms of patient outcome and outreach. But our current healthcare models will also need to be modified in order to adapt and adopt such changes to maximum benefit. This means big data projects should not be aimed exclusively at improving current operations and treatment methods but should also be aimed at exploring and discovering emerging trends and changes that can then be leveraged by providers to maximum effect for patient and provider alike.
These changes also mean patient data can become increasingly siloed if we are not careful about how the data is gathered and shared among providers and public health agencies. Increasingly healthcare data will come from sources outside traditional healthcare circles and our collection efforts must grow to encompass that.
These are exciting times bringing arguably the most rapid and dramatic advancements in healthcare that mankind has experienced so far. But they do not come without challenges.
Successful providers will be those who master big data to proactively and strategically harness change. Make sure your big data projects are balanced with some looking inward to improve operations and patient care and some looking up and out to discover and respond to emerging opportunities and threats.
Pam Baker is a regular nuviun contributor, the editor of FierceBigData and author of Data Divination: Big Data Strategies. For more expert insights from Pam, follow her on Twitter @bakercom1 and at FierceBigData.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.