Can healthcare learn from Uber?

There is an increasing number of patrons of the transportation model provided by Uber, a US online network company that has grown by leaps and bounds since its foundation in 2009.

The Uber model functions on detailed information of cities – linking it with real-time data of prospective drivers, passengers and road conditions; simplifying decision-making; and presenting drivers with manageable options.

In short, it establishes, digitises and stores information that enables relationships to be established between prospective drivers and passengers.

The experience for Uber drivers and their passengers has generally been positive.

Passengers have found friendly drivers, reasonably clean vehicles, short waiting times and lower costs than the usual fares.

Drivers value the fact that they are the boss, the system’s flexibility and the low entry cost.

However, as with all things in life, there are downsides to Uber transportation.

There are potential safety risks to passengers that may be accentuated by drivers who drive irregularly.

There are also insurance and regulatory matters.

Notwithstanding these issues, Uber transportation continues to attract increasing patronage.

Healthcare also involves relationships: between patients and doctors, patients and healthcare facilities, as well as patients and payers.

image: http://www1.star2.com/wp-content/uploads/2016/12/sfit_fitmilton1812_ci_1.jpg

Uber works by compiling and analysing real-time data of prospective drivers, passengers and road conditions.

 A similar model could conceivably work in a healthcare app that delivers real-time medical expertise. 

Some of these relationships are long-term and strong, while others are transient.

The latter is particularly the case in the local setting where doctor-hopping is common.

So, can healthcare take a leaf from Uber’s book?

Uberhealth

Harvard Medical School Professor of Bioimedical Informatics Dr John Brownstein reported on a pilot project by Uberhealth, which is an outgrowth of his team’s Health-map Vaccine Finder tool and created in partnership with Uber, to deliver influenza vaccinations to people in the US cities of Boston, New York, Washington and Chicago one day in 2014.

Uber app and social media users in those cities were informed by e-mail that they could get influenza vaccines delivered to their home or office with the option of a nurse in an Uber vehicle to administer the vaccine.

Prof Brownstein stated that “substantial numbers of persons who are willing to be vaccinated against influenza, but are deterred by inconvenience will participate in a programme that provides vaccination when and where they want it”. (Source: Annals of Internal Medicine. Nov 17, 2015).

The pilot project was repeated in 2015, where residents in 35 US cities could request influenza vaccination through their Uber application, just like requesting for a ride.

There was an overwhelmingly positive response.

Uberhealth had reached thousands of people who would, otherwise, have not got influenza vaccinations.

image: http://www1.star2.com/wp-content/uploads/2016/12/flu-shot-1719334_640.jpg

Instead of requesting for a ride on Uber, people ask, via an app, for a health professional to stop by and give 

them a flu shot.

Prof Brownstein said: “The concept of bringing on-demand services… bringing physicians and nurses to people has so many opportunities.”

Uberhealth is not just about influenza vaccination, but is about an innovation, i.e. networked transactions, that many consider worthy of embracing in healthcare.

Mobile healthcare apps

Today, one can access with a smartphone or tablet, apps called Doctor on Demand (24-hour daily access to board-certified doctors in the US), Heal (an Uber-like app to call for a doctor in the US) and e-Nable (an app that matches people around the world who need prosthetic hands with those who build them with 3D printers).

There are also apps available on smartphones that enable patients to schedule appointments with their providers at a convenient time.

The number of such apps are increasing.

Other technology-driven changes have also impacted on healthcare.

Home blood glucose monitors have improved dramatically the management of diabetes; newer ones even provide advice and alerts.

These monitors have, more significantly, reduced the burden on healthcare providers and payers.

Wearable heart monitors continuously monitor parameters in patients discharged after a heart attack.

The information is transmitted by networks for interpretation and analysis.

Advice and alerts are then sent back to the patient, enabling potentially life-saving short-term interventions and long-term improvements in management.

Attending doctors can review data from many patients at a central location with reduced resource requirements, and more importantly, help patients to be in control of their own care.

Uberisation of healthcare?

After a ride on Uber, the passenger has an opportunity to provide feedback, which, if negative, will lead to an apology and a request for details.

Uber leaps at the opportunity to rectify passenger service gaps.

Compare that with the management of dissatisfaction in healthcare provision.

Waiting is the norm in the public healthcare sector, and to a considerably lesser extent, in the private sector.

Consider the situation when illness strikes while away from home or when one’s doctor is on leave.

The attending doctor would have no or limited access to the patient’s medical records.

Could the attending doctor, if he had Uber-like tools, provide the same care, or something close to it, as one’s own doctor?

A new dawn on healthcare delivery is appearing.

The Ubers of healthcare will shift some, but not all, of healthcare from relationships to transactions.

To be successful, they will have to do what Uber does, i.e. accumulate databases of population healthcare information; develop and improve real-time tracking; apply technology that discerns patterns of illness; focus on management options; and package this information for instant comprehension by patients and providers.

Success or failure will depend on the value the Ubers of healthcare provide to patients and their providers.

Needless to say, some healthcare cannot be delivered with Uber-like tools, and doctors and other healthcare providers will continue to be indispensable with their irreplaceable relationships with patients.

image: http://www1.star2.com/wp-content/uploads/2016/12/sfit_fitmilton1812_ci_2.jpg

At the end of the day, the relationship between a doctor and a patient cannot be replaced by an app, 

no matter how useful, as medicine is also an art. Photo: Filepic

The question is, how much of healthcare can be reduced to Uber-like algorithms.

Although the guesses of experts vary, the general consensus is substantial.

There is an increasing number of apps that connect patients and their providers.

What is needed are apps that make available medical expertise to the public.

However, the information technology used in healthcare requires radical updating, and regulatory issues will get in the way.

When useful apps, with networked knowledge, administrative automation and resource allocation, are widely available, healthcare can be Uberised.

The public would then find healthcare very convenient, quick, easy and relatively inexpensive.

More importantly, the relationship between patients and providers will be substantially better.

Although the road ride could be bumpy, the Uberisation of healthcare is not far away.