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Does Health Care Need an Uberization?

Bruce_Broussard_MEDIres.jpg WIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — Does Health Care Need an Uberization? — is reprinted below. To see all of his blog posts, click here.



It’s always interesting to hear the strong opinions people have about Uber. Some like to say they have not taken a cab since they started using Uber while others enjoy how easy it is to rate your driver thanks to the mobile app service.

If you’ve had any kind of business trip in the last few years, chances are you’ve heard some variation of these comments from a colleague. And if you’re in an industry where everyone is looking to disrupt, you’ve heard of “Uberization.”

It’s fascinating to see how deciding whether to use Uber leads to a conversation about the power of disrupting an industry. We’ve all seen how the “Uberization” of transportation has begun to unfold. So it leads to a simple question: what industry is next for disruption?

Some say the finance industry is going to experience Uberization. In a very insightful column, “The Uberization of Money” by Zachary Karabell, which ran in The Wall Street Journal, Karabell examines how “the Uberization of finance” will lead to new banking models. In his column, Karabell explores how the process of buying a house could evolve:
•“Imagine instead a simple online interface that could generate a tailored credit score for you, taking into account your future earning potential based on your education and location. It would connect you to lenders ranging from banks and credit unions to pools of individuals who want to lend privately at a negotiated rate for whatever duration you agree on.”

Karabell’s commentary is about connecting people based on their interests. He goes on to state that Uber is a “high-tech middleman that is making the intermediaries of the past obsolete. The financial world is one of the most mediated industries on the planet, and that is precisely what is about to change. Uberization also means using vast amounts of data to make those connections feasible.”

So, Uber is about connecting people with a driver, leaving the dispatcher out of the picture. The financial industry is about connecting people seeking loans directly to the people who can loan them money.

Could this happen in health care? Here’s a hint: it already has.

It Starts with Connectivity

In the health care industry, we’ve all interconnected ourselves, but not directly to each other; that’s led to a fragmented system.

A specialist, or two, serves the same patient, but the patient probably knows that his or her primary care physicians, and these specialists, are not connected to each other. If you go to receive physical therapy, or get scripts from drug stores, there’s a good chance that your primary care physician is not directly connected with all of these different entities.

The challenge of interoperability has been facing the health care system for quite some time. While progress is being made – “In 2014, 38% of survey respondents indicated they had been offered access to their online medical records, but that was up from 28% the year before” – there is still work to be done.

Earlier this year, I wrote that interoperability is more of a cultural problem as opposed to a technical problem. What’s holding it back in health care is that the information is siloed, which means there is no infrastructure that can support the sharing of information among physicians.

Without a business incentive to do so, the connectivity necessary to bring patients and physicians closer together will not become reality.

Making it Happen

When I think about the financial system, I think about the system that’s built around the consumer. It’s about the ability to connect and create views that are agnostic to the process and the ability to fulfill the needs of the specific person. When it comes to health care, it’s more complicated because the person who is coordinating the care, the caregiver, is trying to basically manage someone else’s “portfolio.”

And there is no shortage of challenges: When is their next appointment? What are the results of a recent check-up or visit? What kind of maintenance or therapy are they in? What time of day do they need to take each of their 12 pills?

We need to create this connectivity for the physician, the caregiver, the specialist, and the patient. Rather than going to eight sources to get this perspective, connectivity will enable us to see the holistic aspect of the health care delivery system. Because it’s about the health care journey the person is on.

When you have this connectivity, you will enable the primary care physician to see where a person is on their health journey in a complete fashion. He or she will see when they buy drugs, when they go to a therapist or specialist, when they go to the hospital. The physician will see details about all this. It also allows people to see details to make decisions; the caregiver understands what’s going on, or the provider or specialist can make a decision.

When it comes to the disintermediation of health care, it’s not about companies. It’s about the ability to connect. And to achieve this interconnectivity in health care, you need to have the free flow of information, supported by consumer and clinical analytics.

Sharing Information through Connectivity

When you start to turn on the flow of information, you will drive connectivity and present physicians, and consumers, with data they can analyze to improve a person’s health. Physicians need the power of data analytics in order to take a holistic approach to care; and that’s necessary to achieve the best health. By progressing to value-based reimbursement — where physicians are rewarded for the health of their patients, not the number of services they provide — we can foster holistic care that is dependent on information.

In addition, by allowing information to flow freely through the system, physicians, caretakers, consumers and others will benefit because they can have access to information that enables them to make more informed decisions for the most effective care. In a value-based reimbursement model, it’s not just about the data; it’s about being able to analyze the data to act in a moment of influence.

Physicians, and the people they serve, need an easy-to-use interface that is relevant and delivers personalized information that enables consumers to take action or to motivate them to do so. It must have an easy-to-use interface, similar to an Android or iOS application. It must also display relevant, personalized information to all parties – caregivers, primary care physicians, specialists, etc. Enabling the connectivity among these key users will be the foundation for this experience.

So who controls the connectivity? You, the user, will control the connectivity. If you think about a physician, he or she can connect to a specialist without having to go through a hospital or a health plan. Physicians can create their own health care systems because there is not an institution serving the beds. So what’s the result? It’s a self-created health care system. Providers and patients will get closer and closer, wrapped around the health needs of the individual.

Connectivity will ultimately drive down health care costs, enable better decisions, reduce administrative costs and simplify the consumer health care experience. Connectivity among physicians and patients will also create further venture capital funding for connecting the information to create business models for analytics and devices for individuals to make informed decisions.

If someone is going to take responsibility for someone’s care, he or she needs connectivity to have a holistic view of the person they love. Access points, from telemedicine to local retail health clinics, will only increase. Today, the connectivity is now through economic and legal structures. The system of tomorrow will allow physicians and patients to do this on their own. And the value-based reimbursement model will create a business model to do this.

Results in Action

At Humana, we’ve seen the transformational power of the value-based reimbursement model lead to improvements in health, quality and cost when it comes to serving Humana Medicare Advantage members being treated by physicians in value-based models.

When you have providers in value-based models, they are responsible for the entire health of the patient, not just transactional services. In order to harness the power of the value-based reimbursement model, the health care industry needs to evolve from a fragmented system to an interconnected system that enables connectivity between the physician and the patient.

The move toward value-based care and population health will continue to spur investment in clinical analytics and consumer analytics, providing deeper insight for doctors and consumers about health and leading to better outcomes. Value-based care will also enable physicians and consumers, not institutions, to have real time transparent information for their health care decisions and build stronger relationships among physicians and consumers.

It’s About Relationships

Once we achieve the necessary connectivity, it will stimulate innovation and additional funding because there is a business model that supports the integration of the value-based reimbursement model. Second, it will reduce barriers to entry into the system. As in a fragmented system, size is what determines connectivity.

Uber revolutionized the taxi industry by cutting out the middleman – the dispatcher – and connecting the passenger and the driver who will get them to their destination. The financial industry has already started to move in this direction. Other industries are soon to follow.

So what’s in store for health care? It’s about to undergo its own version of Uberization. By facilitating a transaction between a person and the people who serve them (primary care physicians, specialists, caretakers), we can usher in a new era of disruption in health care. And the time has come to take it up a notch.

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