How could health care be more like Uber? What could it learn from Airbnb? Sitting in the heart of Silicon Valley, Medicine X would hardly be complete without a panel mentioning such companies. Luckily, Jonathan Bush's Saturday morning keynote embraced the questions and discussed bringing "the network effect" to health care, with a rollicking sense of humor to boot.
Bush, founder and CEO of athenahealth, extolled the network as the principle by which supply and demand can be re-calibrated in real time, just like Uber does with auto transport and Airbnb does with temporary housing. Who is looking for what? Where, when, and at what price? What resources are sitting unused? By collecting this data via smart phones, and connecting such clients with providers who can meet their needs, health care could be immensely more efficient, responsive, and affordable, Bush argued.
With the proper tools, the internet is now capable of dividing up oceans of information into precisely what each person needs or wants to see at each moment, according to Bush. He said a good tool has three things: networked knowledge, administrative automation, and resource allocation. Such tools bypass much regulatory structure, which, he noted with a grin, often makes them quasi-legal or outright illegal. But with such enormous benefits to networked services, presumably the regulatory structures will catch up. In most cases, said Bush, elaborate regulation is not necessary. Many health concerns don't require doctors or prescriptions, but simply community, information, or care taking.
Bush gave examples of how this networked model is starting to be used in health care. Uber itself, as UberHEALTH, offered flu shots out of the backs of some drivers' SUVs and reached 17,000 people who would otherwise not have gotten one. Pager is an app connecting doctors (or nurses!) with people who have a health concern while they're at home or work. (So far, it only works in New York City.) Candescent Health does resource orchestration for radiology.
In his new book, Where Does It Hurt?, Bush explores health entrepreneurship in more detail. He wrapped up his talk with a few provocative ideas. "What if you could essentially create an illegal visit to do what needs to be done without all the certification and board approval?" What if you could "uber out" hospital beds when they're empty, for a totally different price point and a totally different client profile? Would this enable the democratization of health care?
"Maybe we could then afford what we consume," he wryly concluded.
Previously: Medicine X, the academic conference where "everyone is included," returns