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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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I’ve always been fascinated by the convergence of technology, medicine, and business innovation. I love seeing how these new capabilities often will introduce new behaviors or manifest themselves in ways beyond the original innovators’ conception. There are countless examples, not just in our current era but throughout the history of technological progress.

As an example, just before World War 2, companies like NBC started experimenting with television. The first broadcasts were essentially people gathered around a microphone—a “radio program with pictures” as it was characterized at the time. Essentially, they took a known medium (radio) and then used the new technology to do it slightly better (sustaining innovation). It took some time for those involved to understand that this wasn’t just a better way to do radio; rather, this was an entirely new medium, completely new possibilities, and wholly new value creation (disruptive innovation). It wasn’t visual radio; they weren’t motion pictures with sound; ultimately, it was a totally new approach to entertainment and performance (that brought on the explosion in advertising) that was devised to capture the unique strengths of television (and, by the way, fundamentally altered our culture at the same time).

Another example comes from the Industrial Revolution era, when radical new factories produced standardized goods at unheard of scales, thanks to the steam engine. If you looked at a steam-powered factory around 1860 or so, all of the machines were effectively grouped around or closely connected to a steam engine, which used a line shaft and multiple pulleys to power all of the equipment. The first electrically-powered factories, starting roughly in the 1890s, followed this same grouped layout until people began to realize that electrical power was could be distributed, and there was no centralization constraint, which ultimately led to the even greater efficiency gains, and the birth of the modern assembly line.

Factory powered by Steam Engine and systems of pulleys. Circa ~1880’s.

There are plenty of examples in the modern era as well, of course. With the dawn of mobile devices, and in particular the launch of the iPhone (only!) 12 years ago, companies flocked to this new technology, seeing a different channel to push their messages. Yet the extremely personal nature of smartphones was less about passive consumption and more about interactive engagement and two-way conversations. It took years before organizations realized that the expectations and behaviors had changed, and you couldn’t simply “sell” in traditional ways. Nobody could have imagined Instagram or that its built-in storytelling was going to “sell” more sweaters when the photo sharing site was first created. In all of these examples, and hundreds more like them, the innovators were originally solving for a faster or more efficient way to do what they’d always been doing. But the reality was, that their innovations created new ways of doing things. The winners, whether it be Ford’s assembly line or Casper’s mattresses, are those who can see beyond performance changes and understand the opportunities for behavior changes.

So what will be the “aha” moment for digitally-enabled care that moves us beyond the “radio with pictures” limitations to see new behavioral possibilities?

In our Connected System of Health, we’re trying to anticipate the behavior change that digital health can enable. We hope to undermine the “tyranny of the visit” that is healthcare’s current, most prevalent, and ultimately flawed model. Can you imagine if the only communication allowed in your work environment were to call a physical, in-person meeting? No g-chat, no distributed calendar, no shared documents, no collaborative presentations, etc. We believe that our members should neither be faced—nor forced—with this choice. In fact, we see leveraging the power of our digital behavior so that remote and asynchronous communication is not only the desirable but the preferred engagement model.

Care begins online, every time. Digital first, then strategically in-person.

We believe this is an incredibly important paradigm shift. The impact of which extends far beyond convenient access, efficient care, or expanded panel sizes. As a result, we both expect and are anticipating fundamental changes to how we design, build, and staff our physical health centers in the future. We see them moving from exploratory to confirmatory; from meandering “online shopping” to more focused fulfillment or diagnostic destinations. We imagine that the time reclaimed by our clinicians via asynchronous virtual visits will redeployed into more consultatory or advisory/informational interactions, which will in turn result in more informed and empowered members. We think that, as our members become accustomed to having their entire care team in their pocket, they will start to think of healthcare as a continuously-on app, rather than a visit they need to schedule. We also anticipate a change in accountability—from being a passive patient to a true healthcare consumer to a true health citizen.

And, in due course, we see the arc of progress taking us well beyond seeing Digital First as just “radio with pictures,” instead it will send us into fundamentally new health behaviors, far exceeding current healthcare possibilities.

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