We’re a few weeks away from publishing our annual Trends Reports, but this doesn’t mean we aren’t already thinking about what our findings might mean for our clients and partners.
One of the key themes we’re seeing emerge is what we’re calling the shifting front door to healthcare.
You can see this in the closer integration between primary care physicians and pharmacists; you can see it in the direction that Amazon appears to be moving towards pharmacy services; and most of all – certainly from where myself and my team sit in our London office – you can see it in the rapid growth of smartphone-based telemedicine services.
For the last few months, users of London’s public transport have been targeted by heavy promotion of these next generation “push to call” alternatives to a traditional GP visit.
We’ve obviously seen services like this before, but what we’ve never seen before is serious advertising campaigns behind them. But now, just like London buses, after waiting for years, two come along at once.
First was the campaign for Push Doctor, promising access to a UK GP in six minutes and offering “Prescriptions. Fit Notes. Referrals. Amazing Customer Service.”
Then came the promotional blitz for Babylon Health.
Babylon’s “GP at hand” service goes one better than the others. If you’re prepared to de-register with your current GP and sign up with them, then you’ll get the service for free, paid for on the NHS.
This compares to approximately £20 a consultation with a service like Push Doctor.
For me personally, the prominence of these two campaigns marked the first time (after nearly a decade of working with digital health) that my friends and family have ever come to me with questions related to my work.
So, what do I tell them when they ask me about these services?
Well, I typically start by quoting historian Lynn White Jr. who noted back in the early 60s that “technology merely opens doors, it does not compel us to enter”.
Then I try to explain how the UK health system actually works, because while tech-savvy young consumers may be excited about a shiny new app, there’s something way more complex going on under the surface which surprisingly few of us actually grasp.
Due to way that GPs practices are funded – effectively paid according to their number of registered patients – critics say that services like Babylon’s could end up ‘cherry picking’ its customers.
Traditionally, GP practices are overfunded for the majority of their generally well patients, and under-funded for those who need care the most: the young and well support treatment for the older and ill.
If Babylon draws away the technically literate consumers who like the idea of getting signed off work without having to see a doctor, then there will be less money for ‘old fashioned’ practices to support the more vulnerable patients who remain.
Notably, these critics include the Royal College of General Practitioners.
It’s a concern that reflects yet another trend we’ll be covering in 2018: the increasing divide between the well-educated and technically literate, and the typically older and disadvantaged who may be far less comfortable approaching a front door to healthcare which requires a 4G enabled smartphone as its key.
None of this means, however, that increasing the number of doors, and routes, into healthcare isn’t A Good Thing. It’s just that, surely, it’s important that all of these doors lead to the same quality of care and outcomes.
Unequal distribution of education, technology and wealth shouldn’t turn healthcare into a gameshow where the smarter, smartphone-owning contestants unlock the prize behind a privileged Door One, while others settle for whatever’s behind Door Three.
This doesn’t mean that healthcare systems shouldn’t embrace, pilot and potentially adopt new approaches and systems. But what it does mean is that these systems should always be designed for inclusivity; and that they should always be on the side of the patient. Of all patients.
In our current age of accelerations, however, where developments in healthcare technology can seem to be moving faster than the speed of traditional clinical evidence, this is clearly more easily said than done.
Healthcare systems need to evolve, and to embrace technology, but not at the cost of equal access to quality care. Similarly, technology firms need to recognise that the Silicon Valley mantra of ‘move fast and break things’ doesn’t apply in a medical world of ‘move slowly and take care of people.
As a result, more than ever, understanding which of the many possible doors to move through requires more collaboration and more partnership between new and traditional stakeholders: physicians, industry, innovators, patients and their partners.
It requires us all to come together to shine a light to see how far – and how safely – we should go before evaluating further steps.
More than that, this light needs to generate enough heat and attention for the general public to understand the potential downsides of technology. To understand what may look attractive to the tech-savvy London commuter may also impact the quality of the care provided to those who need it most.
As the traditional door to healthcare shifts, and as new doors present themselves, we all need to adopt a new mantra: to ‘move together and shape things’.