Healthcare "On Demand": Reform 2.0

Over the past few years, I have often spoken of a vision of a healthcare system available to patients, on their terms (not just those of the doctors or insurance companies), when they (patients) are available (not just when the clinic is open or the doctor is available) wherever they may be physically located (not just at a particular building or part of the country). I believe strongly that technology innovations in Public Health and Healthcare could significantly help us address racial and ethnic healthcare disparities. While some undoubtedly believed this to be the stuff of science fiction, we may in fact be much closer to this possibility than most realize. The New York Times is reporting in a December 20 piece by Claire Cain Miller that Americans could soon be able to see a doctor, whenever they want to, without getting out of bed, in a modern-day version of the house call that takes place over the Web. OptumHealth, a division of UnitedHealth Group, the nation’s largest health insurer, is planning a nation wide roll out of what they call NowClinic, a service that connects patients and doctors using video chat, nationwide next year. Soon any patient, any where, with or without insurance, can have a virtual visit with a doctor for $45. OptumHealth believes NowClinic will improve health care by ameliorating some of the stresses on the system today, like wasted time dealing with appointments and insurance claims, a shortage of primary care physicians and limited access to care for many patients. The potential implications of this one innovation are in some ways staggering should this technology become widely used across the country. Other technology mediated practice innovations as well as technology mediated patient/caregiver/consumer support tools (Consumer Health Informatics) could similarly prove not only popular but beneficial to patients enabling improvements such as better medication adherence, thereby leading to improved treatment outcomes. At a population level, the results could be substantial. Videoconferencing with providers will in no way fix all that ails healthcare, but it is one huge step forward towards the goal of making healthcare more patient centered, while helping to fundamentally change the very nature of healthcare and how it is practiced. You might even call a vision of "On Demand" healthcare, Reform 2.0.