Why healthcare business is getting a consumer-IT driven one.

2-to -4 % is the poor spending in global healthcare system today when it comes to prevention. Meanwhile, healthcare systems costs are massively increasing year to year: for example, in the US, in 1960 health care expenditures were 5% of the GDP, risen to 17% in 2016.

Demographics is, by far, not the only issue with the healthcare systems. Resistance (and excuses) to change, are now seriously challenging access and sustainability….meanwhile the future is knocking to healthcare doors, today much more insistently.

A reshuffle is happening at the healthcare dinner table: yesterday patients use to consume solutions prescribed by physicians and paid by payors…tomorrow….

In 2004, only 30% of Americans accessed health information online. By 2015, that percentage had surged to 72%. But interestingly, that does not mean that US health care consumers are relying less on their physicians for information. Back in 2004, 67% of them relied on their physicians for information; in 2015 this percentage had risen to 70%.

This trend is shared on a global basis, while single percentages and weight change, trend is confirmed. Consumers, or patients, it depends by which lens we want using watching them/us, are getting more and more into health topics and they are ager to gain an active role.

The healthcare business is changing into a consumer- IT driven one.

Succeeding in today’s healthcare world will require consumer-centric business models for providers and payers with superior expertise in listening and responding to the voice of the health care consumers.

Ten consumers demands are recurring in today’s healthcare markets:

-         I want to understand how to improve my health and live longer and better

-         I want to manage my health conditions

-         I want to make informed decision about health services and spending

-         I want coordinated, seamless health care

-         I want personal health information that I control

-         I want anytime, anywhere access to convenient care

-         I want health care tailored to me and my family

-         I want help with caregiving

-         I want to live independently

Answering these questions will transform the healthcare business in an information technology one.

We have already seen the proliferation and penetration of Electronic Health Record (EHRs) among acute and ambulatory providers with mixed success. While the major HER vendors focus on protecting their B2B models and proprietary systems, consumer health technologies are emerging for most of the needs identified above:

-         I want to understand how to improve my health and live longer and better- will be addressed by wellness apps, tools and biometric wearables

-         I want to manage my health conditions- will be addressed by condition and disease monitoring apps and tools

-         I want to make informed decision about health services and spending – will be addressed by navigation and transparency apps and tools

-         I want coordinated, seamless health care – will be addressed by smart care teams with interoperable electronic health records

-         I want personal health information that I control – will be addressed by personal health recors-electronic medical portals

-         I want to connect with people and patients like me – will be addressed by health crowdsourcing and social media

-         I want anytime, anywhere access to convenient care – will be addressed by virtual/remote diagnosis and treatment

-         I want health care tailored to me and my family – will be addressed by genetic testing and precision/personalized medicine, largely powered by AI

The structure of the healthcare industry will therefore radically change.

The shifting in the power distribution at the dinner for the 3Ps (payor-physician-patient) will drive major changes in the global healthcare industry, with clear winners and losers:

• Hospitals, the largest single expenditure category, will need to reinvent their business model and brands as ‘reform’ initiatives and the major trends migrated revenues to new provider models such as national specialty chains and retails clinics.
• Physicians will continue to consolidate and integrate to protect their independency. Public health organization will enjoy new appreciation (and hopefully funding) as population health and prevention become the norm.
• Payers will need to move from simply managing financial risk to becoming health managers and even health care providers.
• Healthcare Insurances will seriously need to review their business model, shifting into a 1:1 risk management solution.
• And finally new models will emerge from private equity and venture capital backed tech start-ups and unique health initiatives will come from the ‘frightful five’ (Google, Apple, Microsoft, Amazon, Facebook) and their partners. 

The key shift from passive to active health management will be further boosted by precision medicine:

• The science of medicine is exploding with new pharmaceuticals, diagnostic and device breakthrough happening weekly. One of the most impactful examples is the adoption of genetic testing as cost decline (1’000-2’000 Eur today, 100 Eur sooner then we expect).

The volume to value revolution, along with the solutions powered by the precision medicine, will set the stage for a major transformation in the global healthcare industry:

Today: reactive, transactional individual sick care

Tomorrow (sooner then we expect): preventive, interventionist population health management

Future is here, are we ready?