Am-I-Care: Healthcare Version Of Amazon???

Tuesday’s #HCLDR dialogue asked some very good questions. As always, I tend to take some notes, review the transcripts (here), and begin to think of the topics that I want to address in follow up.

#HCLDR 1st question

The first question really makes us think. If we had a system of care, and the users of that care were really engaged, than what would it resemble?

Everyone had good inputs, thoughts, and goals.

But it made me think more about the essence of the question. If we designed a system to care for people, what would it look like? Would it look anything like healthcare as we know it today?

So I made a bold statement:

In which one of my favorite virtual mentors commented:

Which made me stop and think. Who would get prime? What would prime look like? What could that framework facilitate? What would it impact?

I Have A Need:

No matter the time of day or where I am, as long as I have access to the internet, and a device to access the internet, I can make a purchase on Amazon.


In the “Am-I-Care” model (my hypothetical name for the healthcare version of Amazon), when we have a symptom, a pain, an ache, or we are curious about something, we just go to the web. Instantly we can access care.

Maybe it is 2:30am and my child woke up crying. They are burning up. I go to the site and for $50 I get instant access to a clinician that walks me through several steps to alleviate the fever, get some pain relief, and follow up.

If I know how to do the majority of the workup, maybe I select a different service that only costs $20 because I just want to make sure I am not overdosing my child.

If I am really worried, maybe I selected a $150 service for someone to make a house call and check out my child in the next 3 hours. In the meantime, they walked me through how to alleviate the pain, reduce fever, and monitor my child until the clinician arrives.

For an additional $50, now a total of $200, maybe I can get quicker service, say in less than an hour.

Comparison Shopping:

We need an operation that is not life threatening or emergent. We can go online and compare all of the surgeons we have access to within a specific plan and geographic area. We can see reviews and comments from other patients. I get to pose questions in an open forum. Previous patients have the ability to comment or respond if they feel comfortable. I get to see other ratings such as number of surgeries, number of specific types of surgeries, number of complications, average number of hospital days by surgery, the cost of the surgery, and a list of common side effects.

Maybe there is a series of videos to walk me through pre-surgical preparation at home, arriving at the hospital, pre-operation, the surgical procedure itself, and post surgical care, discharge, and at home recovery. For each video I watch, there are a set of tools and guides to help me.

For each video and tool I use during my surgical experience, I get a refund of 5%. The more I engage, the more I save. If I do not do anything, I pay an additional fee of 5%.

If I decide I want to go to a different doctor, I have the option, and there is a cost associated with that selection. It may be that I have to travel further, but if I engage more, I end up saving just as much in the long run.

Am-I-Care Prime:

The model of Prime would be for those users that already have a diagnosis. Users that have moved beyond a single treatment or intervention. The healthcare version of Prime are for those patients that have a diagnosis of cancer, congestive heart failure, diabetes, dementia, or one of the many other diagnosis that need frequent trips, follow ups, or care.

The prime version allows for on demand access to a care provider to answer questions as they come up. It allows for instant help when it comes to caring for a loved one. Maybe you need help cleaning a port, or changing a dressing, and instantaneously a care provider pops up and walks you through the process. If more help is needed, one will be at your home in moments.

Hospitals and Distribution:

In this new model, hospitals and clinics do not become the place where everyone goes for care. It is the place where care teams work on developing new models, tools, and right sizing teams. The focus becomes on how to embed the teams, models, and tools into the community. So that at any point in time, depending on need, that the care is accessed where the user is, and does not have to drive to a “warehouse” and try to find the care they need amongst millions of options.

Only when care cannot be delivered closer to the user, or it is a major intervention, does the user need to drive to the hospital for care. When they arrive, they are seamlessly directed from parking lot, to check in, to meeting with the care team, setting expectations, and moving to treatment.

No need for more forms and paperwork.

I can envision a framework that allows the masses to get answers when they want them, on their terms, and in an environment that is truly transparent. Costs, access, and quality are all open, in one system, and easy for me to understand and research. Comments are transparent, and since they are made by other users, they are in the context and language that is meaningful to me. No acronyms, no big fancy words, no medical jargon.

I envision a system that understands my anxiety grows between the time I notice something is wrong and being told what it is that is wrong with me.

The diagnosis period.

The shorter you make that time, the more you share with me, and the quicker you get me the right answer, the more willing I am to participate.

Treatment is important, but it is what everyone focuses on. It is more tangible. It is easier for leaders to focus on because it ties to revenue.

The secret, in my experience, is that the sooner you engage a user of healthcare in the “what is wrong with me” phase, the diagnosis, the more willing that patient is to engage, participate, and use all of the available tools that impact the revenue and costs in healthcare.

Much like Amazon. I know I want something, I go to one place to find it. I can see reviews, prices, and I can weight my options. If I like it, I buy it.

Am-I-Care allows me to notice something is wrong. I want an answer. I go to one place to find the answer. I can see reviews, prices, and I can weigh if I want that answer tonight, tomorrow, at home, in person, or at a healthcare distribution center.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek