The health network will see you now


On the face of it, Continuous Commerce™ in health care sounds like an oxymoron. Health care is needed when needed, not all the time, and it is not something that is, or should be, amenable to marketing to drive demand. Ostensibly, medical marketing today is done to educate patients and providers so they know how to use new products properly and can recognize conditions they already have, not to encourage them to imagine ones they don’t.

But if you examine the emerging context of health-care delivery, which is characterized by increasing numbers of medicines, protocols, guidelines, standards and, above all, accountability for outcomes, the ability to link data seamlessly becomes almost a moral imperative. Especially for chronic conditions like diabetes or unstable ones like congestive heart failure, remote monitoring and continuous assessments (of things like vital signs, patient adherence, and patient activity levels) will bring an unprecedented ability to make the best use of increasingly complex states of medical knowledge. But—and yes, there is a but—one implication of this continuous monitoring is that we need systems, not individuals, to track individual patients. This means our primary relationships will be with our health-delivery group—not our doctor.

Historically, health and health-care relationships have been essentially personal, occupying the lowest and most basic, and hence most fundamentally important, of the tiers in Maslow’s hierarchy. The relationship between provider and patient has been a near-holy one for more than 2,500 years in Western culture (since Hippocrates wrote his oath, and probably before)—a connection worthy of invocations, protections, and even a supplication that God will find you worthy to serve the needs of your patients.

Today, however, we are in the midst of a health-care revolution that is coinciding almost perfectly with the digital revolution, so that they’re dovetailing in very interesting ways. As we move away from provider-centric to patient-centric medicine, one of the least commented-upon effects of this shift is the loosening of the relationship between patient and individual provider, and the strengthening of the relationship between the patient and the health-care delivery system to which they belong. Ask someone who their doctor is, and they are just as likely to tell you the system they belong to as they are a specific physician (“Kaiser,” rather than “Dr. Jones”), in part because they don’t have very deep relationships with any one doctor. As health care becomes more consumer-driven, and large, integrated health systems become increasingly the norm for how we receive care, health-care brands are replacing health-providing individuals.

What does this mean for Continuous Commerce™? For one, if you take out the word “commerce” and instead call it “continuous health monitoring,” you’ll find an increasing number of systems that are integrated around tracking patient data and experiences. Few solo practitioners are in a position to take full advantage of electronic medical or health records, the cost of which are accelerating the demise of solo-practice physicians (which in turn is accelerating the shift to health-delivery systems). To ensure a seamless health experience, things like managing appointments, tracking prescriptions, and streamlining insurance and referral processes are all handled far more easily within a system environment. Gone are the days when a private physician can keep up with all of the coding, billing, and follow-ups required to make money in the current compensation model, let alone keep up with the more patient- and consumer-centric aspects of ensuring that wait times are minimized and patients receive not just good care, but a good consumer experience. Automated prescription refills and appointment reminders, along with integrated referral systems, make for a timelier, more patient-friendly interaction. If the appointment is shorter than it once was, at least the process by which you got there is much easier.

As increasing numbers of technological advances permit continuous monitoring of complex, chronic conditions, the ability of integrated systems to track patient behavior (like adherence) and status (like blood-glucose levels) will far outstrip the ability of the private health-care provider, and Continuous Commerce™ will meld with continuous health. This will also accelerate the trend toward patients becoming responsible for managing their own conditions, a natural consequence of “patient-centered medicine” and a development analogous to the personal management of 401(k) investments that were once the provenance of another group of professionals, the personal broker or investment analyst.

In other words, from a purely relational standpoint, Continuous Commerce™ has and will continue to be a driving force in the shift from personal to system-based health delivery. Efficiency and economy will be the benefit for providers, and patients will profit from a more organized, seamless experience. What will be lost, and sorely missed, are the days when your relationship with your doctor was a personal one. As with many things today, a brand experience is replacing a human one, with pluses and minuses on both sides.

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