What Healthcare Could Learn from Amazon

We take for granted that UPS will track and send an e-mail alert about a package’s delivery status. Or when Visa lets us know when we’ve hit our credit limit.

So, when a family member — we’ll call him P.F. — was hospitalized in Connecticut for a medical emergency last week, I got a reality check on the state of customer care online in healthcare. It doesn’t really exist.

It may not seem fair to compare caring for our health to managing a retirement account, buying and financing a home, or arranging a trip to an international destination. After all, the healthcare system involves people, processes, technologies, and all sorts of institutions — doctors’ offices, hospitals, pharmacies, and labs.

Still, marketing executives from all sectors are reminded countless times: Because the Internet empowers consumers, businesses must respond accordingly. Shouldn’t that message be making its way to the healthcare community?

“Patients should have access to any information about them,” said Dr. Ted Eytan, a family physician and a consultant for the California HealthCare Foundation, a research organization. He points to other sectors, such as retail, where consumers can track an order on Amazon or elsewhere.

In recent years, I had thought it would be nice — but not essential — to dash off an e-mail to my physician if I had a question about a minor medical condition like a sore throat.

Escalate the medical condition — whether it’s an emergency or chronic care — and you begin understand why it becomes important for the many pieces of the unconnected medical community to get better connected.

A doctor’s follow up communications with a patient — though not exactly marketing — are all part of a customer feedback loop that can help keep a patient and her family informed to make better choices about continuing care.

Take P.F.’s case. He went to a gastroenterologist’s office for a routine colonoscopy. One in 1,700 people who undergo this procedure reportedly encounter complications — or so I read somewhere on the Internet. P.F. suffered internal bleeding, requiring a two-day hospital stay before he was cleared to head home to convalesce. Back home, it would have been far more reassuring if he could easily get test results from his hospital physician or e-mail her to clarify post-hospital care instructions.

To look into the state of online health-care information and marketing, I turned to a half-dozen experts in the medical and marketing worlds — and learned about the challenges that exist to digitally connect patients to healthcare providers. I also got to meet (virtually) some of the people and organizations, such as the Markle Foundation’s Connecting for Health, that are working to bring about change.

Old Habits Die Hard

One healthcare marketing professional who asked not to be identified, speculated that many physicians and healthcare organizations deliberately want to avoid sharing too much information. “The overriding fear in healthcare for doctors and hospitals — the terror is malpractice lawsuits,” he said. “The concept of a customer-centric service has not reached the healthcare industry. It’s not there yet.”

Dr. Eytan has other theories. As long as consumers don’t directly pay for healthcare, they don’t always see a direct connection to the service they get. Plus, the medical community’s business remains opaque. “As doctors, we still use Latin,” he said.

Determining the Right Place, Right Time

While consumers are flocking to the Web for health information, health-related organizations, including pharmaceutical companies, haven’t kept pace. Pharma companies plow billions of dollars into television and print ads, but only three percent of the sector’s ad dollars end up online, according to one estimate.

ValueClick, for one, is trying to change that, by establishing AdRx, a vertical network for health and wellness advertisers. According to Denise Zaraya, director, AdRx Media, the network aims to provide great reach for brands and ensure that ads don’t show up adjacent to unsuitable content, such as an article discussing the use of a drug for purposes not approved by the Food and Drug Administration.

Where There’s Google and Microsoft …

Champions of digital personal health records are keeping an eye on Google Health and Microsoft HealthVault, both online registries for people to store personal health information. “That’s encouraging…two customer-centric companies applying their knowledge relative to healthcare,” Dr. Eytan said.

There’s a benefit not only for patients, but for partners, too. For instance, a HealthVault directory prominently features companies that make devices to track health and wellness, such as blood pressure or heart-rate monitors. Results from these devices can be uploaded to a personal health record and tracked over time.

“They are trying to do what doctors should be doing, but haven’t,” said Dr. Matt Handley, associate medical director for quality and informatics, at Group Health Cooperative, a Seattle-based managed care organization that gives patients the ability to e-mail physicians with healthcare questions.

How E-Visits Can Work

At Group Health Cooperative, patients were first given the opportunity to contact physicians by e-mail about eight years ago. Since that time, nearly all of the organization’s 850 physicians communicate with patients online; physicians respond to 97 percent of the queries by or before the next day, according to Dr. Handley.

“First and foremost, this is to take better care of patients,” he said. “It saves a patient in-person visits. It leaves a record for patients to access, and it indirectly improves access [to a physician],” he said. If minor inquiries can be addressed through an e-visit, that leaves more time for a physician to see other patients in person.

What about privacy concerns? “It’s much safer than paper records,” he said, echoing a position taken by other advocates of personal digital health records.

Once patients realized the benefits of e-visits, Group Health Cooperative promoted the initiative in advertisements.

But, Group Health patients won’t find any ads popping up in the clinical messages they receive from physicians. “There is no spamming, no promotional messages to patients through our electronic medical records,” Dr. Handley said.

Group Health professionals say the retention rate was 6.5 percent higher for enrollees who used the digital health record system than those who didn’t. “Two-thirds of the patients say this is a very important thing to them when they think about where to get their healthcare,” Dr. Handley said. “It’s hard to give this up.”