Healthcare is long overdue for major renovations. Learn how three companies are blazing the trails and what nurses can do to be part of the revolution.
By Dan Weberg, Ph.D., MHI, RN, FAAN
Many of us are familiar with the company Nokia which makes cell phones and other communication devices workers use daily. But did you know they used to make toilet paper? Nokia was founded in 1865 in Finland and was a paper company. Their mission was simple—connect people. So, they accomplished this by creating paper products used in organizations to communicate. Yet as we all know, communication evolved over the decades from paper to digital. Memos became obsolete, and email was the new tool. Nokia transformed along with its customer base while always keeping the mission statement of connecting people.
What does a paper product have to do with healthcare and nursing? Like the world’s evolution of communication from paper to digital, healthcare is experiencing change and disruption in how care is delivered from in-person to digital. The problem is that healthcare is very resistant to this change.
Culturally, healthcare honors traditions and legacy systems, which force it into the “slow to adopt change” category. One way to overcome this resistance to change is to look at other industries and how they have evolved to meet the needs of their core consumer, like Nokia.
Healthcare can also learn from the mistakes of other industries. Companies like Blockbuster Video provide insights into what happens when organizations double down on the past, focus on previous success metrics, and fail to invest in building the infrastructure for the changing world. An even more recent example is Southwest Airlines, which melted down over the holidays because of a lack of technology investment, staffing issues, and unthinkable events… Sound familiar? Cough cough…healthcare?
So, why do you need to learn about change and disruption as a clinical professional or leader?
It is simple. Healthcare is the last legacy industry to be completely disrupted by new entrants into its market share. Unless we evolve our organizations and practice, we will be disrupted or replaced. Uber disrupted transportation, Airbnb disrupted travel, and Amazon disrupted retail shopping. Healthcare is not immune to disruption.
There is an over $40 billion market share in healthcare that companies want a piece of, and it’s one of the industries that still needs to evolve to meet consumer demands. Hours of waiting at the pharmacy, months to get an appointment, and weeks to get a medical device are still the norm. In every other aspect of our lives, things arrive in minutes, hours, or days.
Still, we accept having a physician appointment at 9 a.m. but not getting seen until 10 a.m. as normal in healthcare.
Old organizational models and consumer frustrations have created a doorway for companies outside healthcare to enter and try and disrupt. Let’s focus on 3 of the big ones: Amazon, Google, and Apple.
Amazon has been dabbling in healthcare for several years with starts and stops. Please make no mistake, they are here to stay and disrupt but keep most of their operations quiet. Recently they dissolved Amazon Care and focused on their buy-out of One Medical. The goal is to become a telehealth marketplace where consumers can be matched to providers using Amazon’s technology. Amazon also owns PillPack, an online pharmacy, and provides durable medical equipment on the regular Amazon website. So, how will they disrupt healthcare?
You have not been feeling well; lately, you have a little fatigue, more urination than usual, and a little weight gain. You can only get into your primary care office three weeks from now, so you use your Amazon Prime perk of Amazon Health. You are immediately connected with a Nurse Practitioner who spends 30 minutes with you and orders labs you can draw at your local Walgreens. Within 24 hours, you are diagnosed with type 2 diabetes. Now the real magic starts.
You get a follow-up tele-visit from a nurse, and you are signed up for diabetic-friendly grocery delivery through Amazon-Whole Foods; your medication is shipped within two hours shipping through Amazon Pill Pack, and your glucose testing supplies are sent the following day through Amazon Shipping. Within 24 hours, you have everything you need and a care plan for your new diagnosis.
This scenario fundamentally disrupts every single aspect of legacy health systems. Amazon, if nothing else, will force systems to update, innovate, and evolve or choose to go the way of the Taxi.
Google is an exciting company, and they are the search and data leader in the world, so what would they do in healthcare? Well, Google has created something called Google Care Studio, which leverages the ease and accuracy of Google Search on top of a medical record for clinicians. Its effectiveness is still in question by many users. Still, the opportunity to change how we look at data and get information about patients is considerable.
One study found that nurses spend over 30% of their time hunting and gathering information. That is four hours of a typical 12-hour shift wasted in non-patient care activities.
By improving the workflow of clinicians as they navigate the multiple systems and massive amounts of data that drive their decision-making every day, Google has the potential to make clinical life easier. The real disruption this presents is more significant, though. Legacy health systems see Electronic Medical Records as the central system of records and data. Still, with a Google overlay, many systems could come together in a clinician-friendly way. For example, social determinants, weather, traffic, population data, transportation, and other data sources could be combined behind the scenes to provide a real-world and personalized view of our patients and systems. We could predict emergency department wait times months in advance, see patient housing and pollution data to support potential asthma diagnosis, or use the ease of Google search to find the data in the patient record that we need to make a treatment plan in one click instead of 30.
Apple has been in the health market for quite a while. The Apple Watch tracks fitness, detects Afib, and can now read sleep and SP02. Apple is also quietly innovating in the medical record department. Their brand has been focused on privacy for a long time, which is in stark contrast to Amazon and Google, which use data much more freely. Apple has created a way to import your medical record data into the health app and manage your medications, fitness, wellness, and other aspects of life in a single place. The more they partner and grow their medical record partners, the more they free the consumer to manage their health.
Several of the most successful health systems were built on the idea that your medical records were theirs to manage. In the past, you might go to an integrated system because they “knew you,” and you did not have to fax and share records every time you had a visit. But, with Apple tech, the consumer has full access to their medical records and can move their data around easily between systems, providers, and insurers. For example, if you need a hip replacement, you can seek out the best surgeon in the country and share your data quickly. Need your hypertension controlled? You could find the best cardiologist in the business and see them. Instead of being at the mercy of a single system or provider, patients could go anywhere and still have the new provider know their history without a single fax machine involved.
Amazon, Google, and Apple have firmly entered the healthcare space. Whether they stay and succeed long-term is yet to be seen. But one thing will remain—they will challenge our legacy systems and practice in ways that will force change. These companies also need more nurses on their teams to build this disrupted future to ensure it adds value, not just revenue. As nurses, we can look at these trends and start adapting our practice to include new data, workflows, and ways to deliver care beyond what we learned in nursing school. Our profession must adapt, and the best way to adjust is to be a part of building the disruption.