The Future of Health Care is Human

The wonderful humans (and pets) at One Medical

Not long ago, my father-in-law was diagnosed with lung cancer, and the doctor said he needed surgery. The day of operation came and went. He didn’t go. Logically, this made no sense to me: clearly, the best course of action was to get treatment as soon as possible. Later, I learned that my father-in-law’s father died in a hospital. He was scared to end up in a hospital bed for the remainder of his life.

I work on software for primary care at One Medical, and we keep a close eye on the future of health care. The speed of innovation is incredible. Every day, it seems, we hear news of advancements in technology like personalized, 3D-printed drugs, artificial intelligence that automatically diagnoses diseases, clinical visits in virtual reality… Logically, it seems that health care might one day be completely replaced by machines.

Yet there is asymmetry in the future that is exciting to hear about versus the realities people experience in everyday life. When people talk about how to improve care, they say, “treat me like a person” and “help me make sense of it all.” When doctors describe their biggest pain points, they ask for “tools to foster patient connection” and “ways to reduce the endless documentation.”

I’ve come to learn that people are hungry for products and services that are empathetic and responsive. The more I see and hear, the more I realize that the future of health care is human.

Health is irrational and that’s okay

The more something matters emotionally, the harder it is to be rational. I recall a case of an elderly man with symptoms of dizziness and memory loss. From the physical exam and medical history, the provider knew that the cause was likely a stroke. Logically, the patient needed a stroke specialist, but he thought it was due to an unrelated surgery that he felt pressured into. So he asked for a referral to a new surgeon instead.

Technology could feasibly figure out the patient had a stroke. But could it convince him to follow through on the right care plan? Could it remember to call his wife to check in on him or comfort him as his vision disappeared day by day? Even if we knew what the exact issue was and what to do about it, care does not end at diagnosis.

Providers tell me the hardest part of care isn’t knowing what the issue is but convincing people of the life changes they need to make to improve it. Each person has a unique sense of what it means to be healthy. Some people, like my father-in-law, want more hospital-free days. Others are worried about leaving debt for loved ones and want to minimize financial impact. My favorite is a patient who simply said, “I want to enjoy a glass of wine every night for as long as I can.”

Humans are irrational and so is health care. It may be that people are best equipped to handle the messy, emotional areas where so much of health care happens.

20 percent of patients don’t follow up on referrals to specialists and 50 percent of chronic patients don’t take medications as prescribed.

The secret of medicine is relationships

Most people don’t want to be their own doctor. Data show that a majority of folks feel that juggling complex medical decisions is a burden. It’s a privilege to have someone who you trust to care for you. It’s also true that the relationship between care providers and patients has a significant impact on health outcomes.

80 percent of consumers would value a single, trusted source to help with their healthcare needs.
“Patients prioritize both the interpersonal attributes of their providers and their individual relationships with providers above all else.” — Harvard Business Review

To understand this perspective, let’s see how health care has shifted over the past hundred years. The top causes of death are no longer pneumonia, tuberculosis, and gastrointestinal diseases but chronic, slow-acting diseases that can be prevented or postponed through lifestyle behavior. Today, 88 percent of deaths in the US are caused by noncommunicable diseases. There is no pill for exercise, no vaccine to quit smoking, no surgery for over-drinking. Treatment is as simple (and hard) as people getting other people to change how they live.

More than new tech and meds, strong relationships with patients is the biggest opportunity in health care. I love how we define care at One Medical as “building a soulful connection with an unique individual.” We aim to build these bonds through longer appointments, quick access to a consistent primary care provider, comfortable environments for healing and conversation, and a powerful suite of tools for our care team.

“There’s no computer in the world that can look you in the eye and tell you to do chemotherapy. It’s the human expert who knows you and reflects your soul.” — Andrew Diamond, MD, PhD

Doctors deserve better tools

Care is provided by people, and the tools our care teams use are often poorly designed, optimized for billing and compliance instead of patient care. The next time you visit a health care professional, take a peek at the software they use. It is probably difficult to use, full of bugs, and looks like it’s from the ‘90s. This software determines the life and death of you and the people you love. That’s absolutely terrifying.

The rise of desktop medicine demonstrates the dark side of how technology has influenced healthcare. Electronic health records (EHRs) have given us searchable and shareable data, but they have also contributed to a reality where half the workers are burned out. Today, providers spend less time with patients and more time treating the computer screen.

More than half of US physicians experience professional burnout and physicians spend the same amount of time seeing patients as on desktop medicine.

But what if documenting clinical notes was as simple as using Evernote or Turbotax? What if your doctor could communicate with you and other health professionals as streamlined as on Slack or Zendesk? What if medical records were as transparent and shareable as Fitbit or Strava? The people who care for us deserve better tools that are patient-centered and allow them to fulfill their potential as givers of care.

At One Medical, we’re lucky to build the software our care team uses. We called it 1Life, and its goal is to allow our providers, admins, and phlebotomists to effectively provide quality care. We run experiments on the best ways to document visits, collaborate on team-based care, provide decision support, and automate the most manual parts of care. Software should free health care workers to focus on the most important thing: deeply caring for the patient.

“Our tools should not driven by fear and compliance but by a better patient experience.” — Terese Tatum, NP

Towards a better future

Sometimes technology and humans are treated like a binary system: better technology means replacing people, and focusing on people means no technology. But the goal for the future of health care shouldn’t be to match the quality of our existing health care system but to exceed it. Even if we could replace all the people, why should we? Imagine how great health care would be if we combined the powers of technology and people.

We are successful at One Medical because we double down on people and use technology to empower them to fulfill their potential. At the heart of it all, what is really going to be valuable and differentiating for any health care organization is their relationships with patients and how they support their care team. That’s why the future of health care is human.

Thanks to Kyle Munkittrick, Tamer Fakhouri, David Hoang, Mark Stuenkel, Ken Suzuki, Finn Howell, Jeff Ammons, and the entire One Medical tech team for their generous support! 😘

Also, we are hiring people who are passionate about health care! Apply to join our team.

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