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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me

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Telehealth. Virtual Care. Remote Medicine. Do we really need to make these distinctions anymore? I guess in healthcare people still do. But we shouldn’t.

In the last decade, we’ve all started to move from the idea of digital-only, or bricks vs clicks, or other such phrases to the point where all of it—the mobile experience, the web experience, the physical experience—just is. It never should have been “either / or,” but rather “and” from the beginning. They are just channels after all, or delivery mechanisms, to help us achieve a broader objective – whether it’s buying clothes, ordering mattresses, banking, or travel – and the more seamless and integrated the experience, the more the omni-channel network effect becomes the norm.

Some were surprised when Warby Parker, the original online purveyors of glasses, started opening physical locations a couple of years back. Or when Amazon purchased Whole Foods as their platform to learn the grocery business while they simultaneously reinvented it with their AmazonGo stores. In both of these cases, these retailers recognized that building and maintaining the relationships they had with customers depended on being available in whatever “channel” their customer wanted to access the “service.” They also understood that people would not only want the best selection of high quality items, but they want their choice of channels as well. The best retailers intuitively got that while removing channel “friction” is important, it’s blurring the channel “distinction” that makes the service experience exceptional.

AmazonGo.jpeg

Now Open. Amazon Go stores not only do they remove channel “friction”, they are also blurring channel “distinction” between physical and digital services.

As usual, healthcare is a decade or so behind the rest of the world. I see over and over where my industry is treating “virtual care” as a discrete category, a different initiative, or an alternative care strategy to bolt onto the care model du jour.Telemedicine” is a case in point. I just returned from a large employer conferences with multiple sessions about “What’s your telemedicine strategy?” or “How to achieve an ROI with Virtual Care.” The prevailing wisdom is that we solve the “access” problem by making more physicians available for video visits (this is the classic misstep of digitizing a physical process without rethinking the new possibilities enabled by digital). However, as we look around at life in the 21st century, digital is enabling the movement of nearly everything into a asynchronous future when services can be consumed on your own timeline, personalized for your own tastes (asynchronous creates space between “consumer action – service reaction” for an entirely new world of possibilities to be created), and consumed in your preferred way through your preferred channel.

Life in the 21st Century. Going digital means going asynchronous as well.

So how is the healthcare industry implementing the virtual strategy? Famously, of course!

I would argue that the proliferation of health apps is also a symptom of healthcare’s slow acceptance of the digital+physical world. Providers see these tools as distractions at best, and at worst irritating competitors for patients’ mind share (yet another thing to try to integrate into the 10-minute office visit). While there is so much potential, there is no time nor reimbursement to meaningfully incorporate any of these tools into the day to day practice of care in any way that would be rational, convenient, or logically linked to how providers actually work. This is unfortunate because prescribing apps as part of a care plan would go a long way to breaking down the cognitive dissonance between a traditional office visit and the possibilities of an integrated and coordinated app-driven digital experience.

How do we get to the point where healthcare just is, whatever the medium? The arguments that healthcare is like no other business, that it’s far more complex, that regulations complicate even the simplest of initiatives, just don’t hold water. The experience of healthcare is complex and fragmented because it’s in the narrow self-interests of most in the industry to keep it that way. It is certainly not in the interest of the patients, who want timely and straightforward answers and moreover, a seamless experience that feels tailored to them. In person, online, and anytime—no friction, no distinction.

During the last 12 months, we have fundamentally pivoted Crossover Health in recognition of this new reality. We’re developing communication tools and software infrastructure to allow our member patients to engage with us whenever or however they need. It’s much more than simply enabling digital access and communications, however. The goal is to convince our members that the digital is not an adjunct to the “real” visit, not second-class, and that our front door is actually in their pocket, not at a physical health center. With the right data in hand, we are able to guide them to the peace of mind they seek through whatever channel makes sense—for them as well as us—at any particular point in time.

To make this experience seem seamless and obvious to a member, we have to do a lot of heavy lifting in the background. We looked at the overall delivery workflow, identified areas that caused friction (such as referrals and follow-up communication), and solve to make these more integrated and seamless. We are building the systems and data to identify where immediate (synchronous) communication is required and where responses can be timely but not immediate (asynchronous). We need to ensure the payment mechanisms are in place so the choice of channel is not predicated on reimbursement potential, but instead on our members’ needs. We’re vetting apps to see which can actually add value to the entire healthcare experience. And, we’re focused on the training that will help our providers be comfortable building relationships and providing counsel in any medium.

We do not anticipate the change in behaviors and attitudes will be immediate. However, we believe the communication and relationships that fall out of a natural digital+physical model will lead to greater engagement, and that our members will gravitate towards not only the convenience of a primarily online experience but also take on more health ownership and self-management while feeling more connected to our team. We are convinced that over time our members will see “virtual” (synchronous and asynchronous) as virtuous and as valuable as an in-person visit. In fact, the goal is that they don’t make the distinction between virtual and real at all.

It’s healthcare, that just is.

4 comments on “Healthcare that just IS

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