Fairly or not, healthcare has long been considered among the most change-resistant global industries. Yes, it faces a degree of regulatory scrutiny that few others do, but at the same time there remains a surprising level of risk-aversion. As a result, many players have long subscribed to a wait-and-see mentality. “Until some people don’t just feel the heat, but feel it burning the hair on the back of their calves, they won’t change,” is the way Bill Drummy, founder and CEO of Heartbeat Ideas, puts it.
That’s why all the recent ground-shifting changes have the industry’s eminent thinkers borderline giddy about the next several years and the changes they’ll inevitably bring. “Over the last decade or two, we saw digital convergence in media, technology, travel, finance, you name it,” says Larry Mickelberg, partner, chief digital officer, Havas Health, and president, Havas Lynx US. “All the while, we were telling anyone who would listen that the impact of convergence on health would be just as significant or greater. Now, 20 years down the road, it’s finally our turn.”
Consider this, then, their call to arms: A series of predictions of not only what might be coming next, but what should come next. Here are their 10 game-changers, industry-reshapers or whatever other hyperbole you want to attach to them. Disregard them at your own peril.
1 The doctor/patient dialogue, deconstructed: Traditionally, communications between doctors and patients were physically confined to an office and temporally confined to two or three annual visits lasting maybe 10 minutes apiece. While there may have been the occasional phone contact, the type of on-call-when-I-want-you-to-be service desired by some patients wasn’t really possible until technology enabled it. Now, the doctor/patient dialogue is conducted via email, Skype chats, text messages and more; patients can snap a shot of their psoriasis with a phone and beam it over to their physicians in the time it takes to read this sentence.
As a result, the doctor/patient dialogue has evolved into something independent of the old constraints (office hours, limited availability windows, etc.). “I’m not sure I’d call it a ‘dialogue’ anymore. It’s now longitudinal. It’s multichannel,” says industry veteran Joe Shields. “Go into an exam room and you’ll see doctors and patients using their tablets together.” This interaction will continue to evolve as the remaining holdouts adopt smartphone and other new-ish technology—which, in turn, will force doctors, patients, marketers and everyone else in the pharma food chain to confront the problems that come with it: Are communications via unsecured text message a HIPPA headache waiting to happen? Who pays for a doctor/patient tele-visit? What liability concerns could arise from patients’ increasing inclination to record their conversations with their doctors?
2 Mind the non-doctor decision-makers: As the doctor/patient relationship morphs into something very different, marketers will realize that they have to pay more attention to others within the service and administrative loops: nurses, physician assistants, caregivers, social workers, managed-care decision makers and more. This will require a drastic shift in the orientation of their programs and a similarly drastic reapportionment of their marketing spend.
“You can’t take what you’re doing with doctors and throw it at somebody else,” says Drummy, who believes that certain constituencies, like nurse practitioners, have been “ignored forever, pretty much.” Given the increasing influence of nurses and others—as price pressures on doctors intensify, who do you think is going to be spending more and more time with patients?—Drummy believes there’s an opening for organizations who divert some marketing dollars in that direction.
“Because they’ve never been a target, you can reach them more easily and efficiently,” he says, advising marketers who are so inclined to “err on the side of more medical” as far as their communications are concerned, because “nurses don’t want to be perceived as unsophisticated medically.” As for communications with managed-care entities, Drummy suggests a funds-first approach: “They have a primarily economic orientation, obviously, so you’d say something like, ‘This is going to save your organization money because it will reduce the incidence of relapse.’”
3 Reverse orientation—from promotional to service: Expect pharma companies to start moving from “buy this” to “buy this and, hey, let us give you a hand with that.” Companies have realized that their traditional approach needs to be tweaked. “Reps can’t just go in [to those conversations], do their spiel and drop some samples. They should give some tools along with the promotion, which will strengthen the relationship to the benefit of the patient,” Drummy says. As an example, he points to a hypothetical recently diagnosed diabetes patient, who’s new to the regular injections of insulin. “At first, it’s traumatic. If the pharma company can make that easier—with some level of patient-friendly information, a download, an app, something—they’ll build trust and value with HCPs who are stressed.”
4 The digital nervous system: Healthcare is on the cusp of what might be called a sensor revolution. Thanks to wearable, embeddable or ingestible devices that beam data via Bluetooth to smartphones or other monitors, individuals are now capable of tracking their own crucial health info and are then able to share that data with their caregivers. “You become a living, breathing data set,” says Mickelberg.
There are concerns, ranging from the expected (comfort, pricing) to the slightly less mundane (whether the information from these sensors can be configured for use with existing technologies, whether physicians will be able to filter it efficiently). But think about the potential of a sensor that takes up residence in the stomach of a patient with nutritional or gastrointestinal issues. “It can directly measure what that patient has recently eaten, then signal to an iPhone or Google Glass, ‘Go have lunch right now, you’re low on protein, have at least three ounces.’ That sounds like a huge leap from where we currently are, but the individual pieces are already in place,” says Jay Goldman, senior vice president, innovation at Klick Health.
5 Hub hubbub: Now that EHRs have started to take hold in physician’s offices across the land (at least in theory, anyway), all aspects of an individual’s medical history will be unified electronically (ditto). But since things can never really be quite that simple, health technologists are currently grappling with a related question: Is it going to be possible to merge data from extant devices (which includes everything from glucose monitors to pedometers) and ones to come (the wearable/ingestible sensors that are referenced above) into EHRs, in order to give physicians and nurses an even more complete portrait of an individual’s well-being?
To frame the issue in broader terms: What, if anything, will emerge as the so-called “health hub” for consumers? As resource-filled as the best ones of them might be, insurance companies’ websites have for the most part been ignored by consumers. Clearly, then, the opportunity is there for someone to come in and fill the void. “You manage all your banking with one bank. Why wouldn’t you manage all your care in a single central place?” asks Monique Levy, vice president, research at Manhattan Research.
6 Quantify thyself: The “Quantified Self” movement, through which individuals take it upon themsevles to measure and compile data gathered from every aspect of their daily existence, has come in for its share of mockery. “The people who do it, they’re almost making a statement about how healthy they are. They’re flaunting awareness of themselves,” says Shields. Nonetheless, more and more Americans have jumped on the bandwagon, believing that they can never truly have enough information about, say, the timing and volume of their daily Nutella intake. “The idea is, ‘If I count everything I do—every calorie I ingest, every step I walk—it will help me change for the better,’” says Rich Patterson, vice president/strategist at Evolution Road.
If the Quantified Self movement catches on, it will mean more consumers in the market for information-gathering devices of all kinds. The questions: How will consumers filter the myriad data they accumulate—and how will their HCPs, who will ostensibly be asked to help make sense of it, find useful patterns within it? “If the physician doesn’t have a reliable algorithm for teasing out what all the data means, I’m not sure it’s aiding treatment,” Shields says.
7 Bluetooth-enabled forks! Cars that monitor your cardio!: The breakout product at this year’s Consumer Electronics Show wasn’t a 100-inch television or the next Blu-ray iteration. No, it was a fork—HAPILABS’ HAPIfork, a Bluetooth-enabled fork designed to monitor and track eating habits. Then there’s Ford’s research arm, which worked with Medtronic on a car seat that monitors the driver’s cardiac activity. Any number of similar health-tech innovations are soon to follow, including “smart” supermarket carts that help shoppers make better (read: more health-conscious) decisions as they roll through the store.
And the healthier home isn’t too far behind. We’re not talking about splinter-resistant beams or double-padded staircases here so much as superfunctional medicine cabinets, ones that can share a weather forecast and, based on what it knows about the user, beam a don’t-forget-your-allergy-medication reminder to his phone. As currently envisioned, the “smart” medical cabinet will be able to check, via RFID tags, whether a prescription may be close to expiring; its mirror could, conceivably, stay on the lookout for bags underneath the eyes or unusual marks on the skin. “It sounds science-fiction-y— ‘a medicine cabinet that talks to your phone,’” says Mickelberg. “But it plays into the notion of active aging. Homes will be smarter and more health-conscious, because people want to age in place. They don’t want to go to retirement homes.”
8 Into the looking glasses: Healthcare experts see vastly different things when they peer into the proverbial crystal ball, but they are uniform in their enthusiasm for the potential of Google Glass. While it is billed in nerd-speak as an “augmented reality wearable computer,” Google Glass is actually better and more colloquially described as being futuristic superglasses that can do it all—think a hands-free, camera-enabled, voice-recognizing, non-invasive smartphone for, like, your face. For physicians and other HCPs, they could prove a godsend. Google Glass will allow them to access a patient’s medical records or the results of a lab test while examining them. They should also provide great support for doctors faced with a challenging diagnosis, who can virtually convene a Google Hangout to analyze a particularly vexing symptom.
9 Trial recruitment, digital-style: According to Goldman, there’s a reason that digital marketing tactics haven’t been deployed in clinical trial recruitment. “Nobody saw any upside,” he shrugs. But he believes that’s about to change. “Higher participation in clinical trials, particularly in rarer disease states, are such a critical part in getting products to market faster. And anything that shows even a little promise in getting products to market faster is worth experimenting with.” So far, the most successful efforts have involved highly targeted, mobile-enabled microsites that prompt visitors for the necessary data.
10 Who’s that knocking on the door?: Imminent changes have lured major players to invest in the space. One prime example: IBM, which is trying to help data newbies parse their piles of information. Throw in a lot of private-equity money and the traditional players have some formidable competitors. “Companies outside the industry, who have never played in healthcare before, are entering the market in droves,” Levy says.
Of course, industry pundits who predict this infusion of corporate blood say they have no idea how or when it will play out. All they know is that unlike few other major industries in the US right now, healthcare is rife with opportunity. “Affordable Care and all the reforms and all the technology is changing the trajectory of what we consider to be modern healthcare,” Mickelberg says. “And that’s the whole point of reform: To force everyone’s hand, to prompt innovators to problem-solve. It’s time.”