Recently, I posted an article on my blog entitled, “What
You Know Just Ain’t So,” which discussed things we believe to be true but
when tested over time and with deeper questioning, just don’t hold up. That
type of critical thinking is necessary in order for us to accurately look at
our reality – to see things as they are and not as we might want them to
be.
Yet, an analysis that shows the flaws in our thinking,
doesn’t, by itself, help guide us down the correct path. After all,
highlighting all the closed roads on a map won’t get us to our destination. To
choose the best path for our journey, we need to know the roads that will be
open when we need them. In other words, to set the right course, we must know
the things that won’t change with time.
Jeff Bezos, the CEO of Amazon, eloquently makes this point.
He noted that people are always asking him about what’s going to change in the
next 10 years, but they never ask him about what’s not going to change in the
next 10 years. He says, “…the second question is actually more important of the
two because you can build a strategy around the things that are stable in
time.” Because Mercy is going through a strategic planning process, that
statement made me think about what won’t change in health care over the next 10
years.
The best way to come up with such a list is to take the
perspective of our patients, since they’re the ones who will ultimately choose
what has real value over time. It’s hard to imagine a future where a patient
would prefer to wait longer to talk to a provider or obtain test results, have
less confidence in their quality of care, have more unanswered questions about
what treatment plan they should choose, pay more or have more hassles about
paying their bills. In short, the best future for Mercy will be one where we
seek the opportunity to be faster, more convenient, more trans- parent, higher
quality and less costly. No problem, right?
Think about that challenge for a moment. What do we need to
do to realize a more “customer friendly” future? To start, we’ll need to care
for people where they are as patients, not necessarily where we are as
providers. That will mean being accessible online and in person, on phones and
tablets, at their home or work, days and nights, week- ends, holidays and
vacations. When patients want information or answers, they’ll expect it to be
immediately avail- able, just like the products and services they’re used to
getting on demand today. When they get a test or image, they’ll expect it to be
interpreted and explained in the moment, that they’ll be billed the amount they
were promised up front, that the results will be easily interpreted and a plan
of care established quickly. If referrals are made, the expectation will be
that they’ll happen promptly and if they have problems with a service, there
will be someone to listen to them and take action quickly. When a procedure or
surgery is necessary, it will be scheduled promptly, performed expertly and
with the least amount of discomfort possible. If it can be done in an office
without anesthesia, that would be preferable but always with minimal pain,
invasiveness and time away from home or work. They’ll expect to be treated with
respect and in a manner that befits an organization that wants to retain their
loyalty.
Perhaps that seems like a tall order for our organization,
but before writing it off as fantasy, consider this...If you’ve ever tried the
Uber transportation service, you may have been as impressed as I was on its
simplicity, transparency and responsiveness. Through the Uber phone app, you
input where you are, where you want to go, select a driver who has already been
vetted by Uber, rated by prior passengers and is close to your location. Both
you and the driver can see each others’ pictures and locations via GPS to know
the time of arrival. Typically, within a few minutes, the driver pulls up, you
travel to your destination, pay through the app, rate the driver, the driver
rates you as a passenger (warning: don’t act like a jerk), and voila’ – done!
It works brilliantly.
But after my last Uber experience, I was struck by one
question. Why is it that suddenly, in the era of Uber, there are all these drivers
just waiting to take me wherever I want? Before Uber, if you needed a taxi and
were waiting at any place other than a high-traffic area, it was a hassle. Most
likely you called a taxi dispatch that sent a message to a cab that may or may
not be available at that moment. There was no feedback on where they were or
when they’d get to you and you didn’t know what exactly to look for, nor did
they. What changed?
I would submit there are two things that made Uber possible
and popular. The first is technology. Uber cannot happen without GPS. With GPS,
nearly anyone with a driver’s license can become an Uber driver. In the taxi
era, one of the driver’s valued skills was knowledge of where places were and
how to get there. Today, those skills are less valued as one doesn’t need local
road knowledge to follow the directions of GPS. The passenger says where they
want to go and the software takes care of the rest.
Of course the next step on this path is to eliminate the
human driver all together. With self-driving cars as envisioned by Ford, Apple,
Tesla, Google and others, the long-term need for drivers of any type – Uber,
passenger, truck or otherwise – is questionable. But while the driver may be
optional in the future, it’s the second component that makes Uber itself
irreplaceable. Uber makes the experience feel safe. By showing pictures of
drivers and passengers, providing feed- back on locations and time of arrival,
secure method of payment, rating their past Uber experiences, tracking
locations with GPS and recording all that data, the Uber experience feels safer
than any taxi experience I can remember. That sense of safety is key to making
Uber valuable to travelers and gives it staying power in the market.
Think about how the technology behind Uber and its
popularity apply to health care. In that same blog article on “What You Know
Just Ain’t So,” I discussed a company called Ayasdi that’s helping Mercy put
together care paths for about 80 different illnesses, based on real data from
our own patients. These are not care paths put together by wise men stroking
their chins while extolling the virtues of what they believe to be best
practice, but actual data. The end result of that work will be care paths that
provide the best evidence on how to care for a particular disease that achieves
the best outcome at the lowest cost.
Now, pause for a minute and think about this... do you need
to be a physician to follow a care path? How about a physician’s assistant or
nurse practitioner? How about a nurse? Nurse’s aide? If the diagnosis is
correct and the care path instructions are clear, outside of an acute care
setting, what’s the need for any of those traditional providers? Why wouldn’t a
patient just follow the care path on their own until they ran into a problem
they couldn’t solve themselves? While Uber and GPS put power in the hands of
the passenger, why wouldn’t patients want and utilize that same type of power
by having state-of-the-art care paths to guide them through management of their
illnesses?
If, like me, you’re a provider and that last statement makes
you fear for the security of your professional future, go back and think about
the second part of what makes Uber successful. They make it feel safe. Managing
your health when you aren’t terribly sick is not that difficult if you’re armed
with adequate information and a plan. But when good health fades and more
complicated illnesses loom, managing your health can be both scary and
difficult. In those moments, patients want to know they’re safe and not alone.
Is my health care team behind me? Can I talk to them quickly when I have
questions? Will they provide good advice to me when I need to make a tough
decision? When I need more than just advice, will the hospital, experts and all
the technology I need be there for me?
As it always has been, Mercy’s answer to all those will be
“yes.” That’s the service we’ll provide, the feeling of safety we’ll give, and
the sense of value for which we’re known. That’s why we, as providers, will
remain vital and why Mercy, as an organization, will thrive for generations to
come.
Certainly health care has more complicated problems than
that posed by an antiquated taxi system, and it’s always dangerous to apply
simple solutions to complicated problems. Still, as we look to the future and
contemplate what will not change, it’s sometimes the simple lessons taught by
the experience of others that resonate the most. Let us vow to build a future
at Mercy that serves our patients by making it something they want and are
thankful to have when they need it the most. It’s an honor to be on this
journey with you.
What do you think? Email me at Alan.Scarrow@mercy.net or on
Twitter @DrScarrow.
