In just five years, Uber has gone from a prefix meaning “supreme” to an international transportation juggernaut operating in more than 300 cities in 58 countries — all from a simple smartphone app. You sign up, you tap in where you are and where you want to go, Uber tells you exactly how much you’ll pay on your credit card and pretty soon a car shows up to take you there.
Health care, meanwhile, is still struggling to get out of the 20th century. It desperately needs to Uberize.
A story in Tuesday’s Wall Street Journal tells of how some start-ups are using technology to connect users with health care providers who make house calls. Why sit in a physician’s waiting room when there’s a physician or nurse who will come to you? It’s a forward-to-the-past idea that can revolutionize how people receive health care. But it’s just a start.
Imagine pulling your smartphone out of your pocket, opening up the “Uberhealth” app and arranging for transportation to a doctor who is connected to your health insurance network and can see you within the hour to treat a condition that requires immediate attention.
Imagine that, as you set up your appointment, the app also sends all your health information to the doctor, so that she knows how best to treat your condition. And then, when she writes a prescription, it is sent immediately to the pharmacy of your choice.
Then your claims for the office visit and the medication are automatically filed to your insurance company. And then the transportation service is waiting outside to take you home or back to work.
It’s utopian, but it’s hardly impossible. Many things have to come together to make it work in health care, however, because applying Uber-like technology to the American health care system will be much more challenging than moving people from point A to point B.
1. While there is an obvious demand among consumers, there is an issue with supply. The number of physicians, especially in primary care, available to meet the demand of appointments will be much lower than the number of people who feel they need immediate care, especially at certain times of the day and certain days of the week.
It’s not unlike what happens when the game ends and everyone pours out of the ballpark and calls Uber — but Uber knows how to deal with it: It adjusts prices to meet demand. Consumers seeking health care in an Uber-like scenario will have to be willing to pay different fees for the same services, depending on the availability of transportation and health professionals when they call. And, depending on their insurance plans, the added fee might have to be out-of-pocket. That’s also true in a scenario where the transportation service takes the health professional to the consumer. In addition, there could be licensing and regulatory issues for both the car and the doctor, especially if travel involves crossing state lines. There’s also the possibility that primary care physicians, facing competition from doctors making house calls, could see a decrease in their compensation.
2. Programmers will need to set up a powerful infrastructure to move and share data among numerous systems. Uber has a complex system that uses Google Maps, the Braintree payment system and a whole host of other applications just to meet the supply and demand of transporting individuals. Now consider what is needed for health care, in addition to the ride. There are myriad apps that provide data, whether it’s from a fitness device on your wrist to your complete medical record that’s been compiled from any number of physicians. Then there are your insurance and drug plans, and their billing systems. Much of this data involves privacy issues and company-specific information, but it all has to be in sync to deliver a satisfactory user experience.
3. The technology requires radical updating, and health care is already decades behind. Consider how quickly Uber knows how many cars are in which areas and how to adjust its rates to meet demand. The speed at which it assimilates all this information simply does not exist in health care today. If you need to see a doctor NOW, your physicians and your health insurance providers and your medical records company and their billing systems do not have the back-end systems in place to coordinate their data. You know what you want, you know what you need, and they can’t deliver.
4. There are regulatory issues that get in the way of progress. Even if all the technology were in place, the issue of privacy would remain a very high hurdle in health care. Even if all the data were available, the questions of who could access it and what might be shared would still be very complicated.
These are all serious obstacles to delivering the experience health care consumers want. But all they can do is slow progress; they won’t stop it. The health care industry needs to start emulating Google, Amazon, Facebook and Twitter — companies that have used big data and technology to create highly satisfying consumer experiences in near real time.
It will require combined talent and massive engineering, but we’ll get there.
There’s a bumpy road ahead — but it must be taken. Health care will be “Uberized.”
