Moving up the health care value chain

By Scott Shreeve

Last week, I participated in a very cool live podcast with the ReadWriteWeb editor Richard Macmanus. While I am finishing up my commentary based on that experience, I did want to comment on another post by Richard who is one year into his diagnosis of Type I Diabetes. He mentioned that his favorite Health 2.0 application was MyMedLab.

In full disclosure, I serve as an advisor to the company as well as a participant on the call that was conducted. I became involved with MyMedLab while conducting my own survey of promising Health 2.0 companies, tools, and technology. I was intrigued by their Health 2.0 delivery model of leveraging the internet to remove inefficiencies of time, location, and physician approval for routine wellness laboratory testing.

I became convinced after using the service for myself. Since I hadn’t ordered lab test since my medical school entrance physical exam, and I was preparing for an upcoming physical, I ordered the baseline wellness tests I knew my primary care provider would want (conveniently organized by “profiles” - individual tests that are grouped together to provide disease or organ system specific information). I wanted to maximize my time with my doctor and come prepared with as much information to review during our appointment as I could.

MyMedLab helped me accomplish these objectives in a cost-effective, convenient, and confidential way. It was a hassle free ordering process and I had my results within 36 hours. I was able to fax this information to my physician ahead of my appointment and to actually use some of my time with him to review the data as opposed to discuss ordering the test. I immediately saw the opportunity to extend this to other appropriate settings, and other appropriate patient or physician groups who have highly specialized laboratory testing needs (hormone health specialists, bariatric patients, and even diabetic patients).

A persistent question that comes up is the appropriateness of the direct to consumer model. I have to agree with John Sharp about the age of “paternalistic medicine” going bye-bye. I discuss this at some length in a previous article entitled, “The Millennial Patient” .The easiest analogy to understand this point is to review the democratization of the financial services sector. 30 years ago, only qualified financial advisors could provide financial advice, set up accounts, trade stock, transfer funds, or manage a portfolio. Can you imagine that being the case today? Consumers have the ability to read financial information (now abundantly available), set up accounts in minutes, buy/trade stocks with a click of the mouse, move money across the globe between multiple accounts, and manage all their accounts from single portals all without leaving their desks.

Does this obviate the need for financial advisors? For many smaller or DIY investors, it has reduced the need by outsourcing these functions to the consumer. However, the experience and knowledge of a trusted financial advisor is still heavily relied upon for anyone requiring professional assistance, complex trading, or needing higher end service. They haven’t gone away, they have just had to adapt what they do, how they provide their services, and who their customers are. In essence, financial advisors have had to move up the value chain.

While this will sound heretical to some old school doctors, most wellness laboratory exams don’t need to be interpreted by a physician. In fact, most wellness exams don’t need to be performed by a physician. It is pretty straightforward stuff: Cholesterol 250 = get on some cholesterol lowering meds. This isn’t rocket science.

However, there clearly is a time and a place to call upon those practiced both in the art and science of medicine. I assert that the trusted physician advisor will be as meaningful, if not more meaningful, to you in the future world of highly personalized medicine. You might interact with her in new and exciting ways - chat, text, videoconference - but she will continue to use her expertise, knowledge, and experience to provide the advice you need on key health issues, disease states, and medical treatment plans. Physicians aren’t going away - they will just be practicing at a higher, more meaningful level than they have in the past. Physicians, like other knowledge workers, will have to move up the value chain in order to maintain their relevance in the future.

Most will. Some won’t. And for any of those clamoring that they are the only ones authorized to read lab results, send them the this link along with an email saying you are looking for a new physician.

(Oh, they don’t do email? You should have left long ago!)