Institute For The Future

Interview Summary--Jay Parkinson

HC2020 Interview Summary—Jay Parkinson:

(Note: It was a bit tricky to keep Parkinson on track with the interview guide, so not everything follows the script/summary directly.)  

 

1.    His/her work—Hello Health. “we’re creating a platform for the outside world and not trying to integrate it into the current infrastructure”—They’re working on mimicking Facbeook/Etsy, etc. in terms of functionality; will also enable communication between physicians to interact and communicate and get rid of middlemen. Doctors list prices online to encourage market transparency.

 

TRENDS/CHALLENGES

 

2.    How optimistic about future of health/healthcare in 2020?

Not super optimistic (he sort of talked around this—started by saying he wasn’t optimistic and that we were behind the curve, then sort of said he had some optimism for disruptive technologies, but then again, he didn’t.) See additional notes below.

 

3-4. Biggest trends or challenges & responses

1)    Physician training/specialty mix. “We’re 15 to 20 years behind the curve in terms of encouraging a strong primary care backbone… and rightly so, they get paid so little and their lifestyle sucks so badly.” Suggests that pay reforms for primary care will be needed to encourage doctors to go into primary care rather than specialty care. “if you don’t have money and you don’t lifestyle, it’s a killer… until we change those very very basic principles, then nothing’s going to change.” In response to a follow-up question on nurse practitioners and retail clinics, he said he thinks it makes sense for retail clinics to be solution shops to simple problems, for primary care physicians to be solution shops to more complex problems, and for the two to be integrated (so that retail clinics have immediate, real-time access to doctors as needed.)

2)    Cites the book “The Innovator’s Prescription” (http://innovatorsprescription.com/) which outlines three kinds of business models (not sure I have the terminology exactly right):

a.    The Solution Shop—Thinkers who get paid at an hourly rate (like an ad agency)

b.    Value-add specialists—like orthopedists, who do the same task repeatedly at an exceptional level of quality

c.    Distributed network—like eBay

An individual health system (such as a doctor’s office) might combine all three of these elements in one office, which doesn’t make practical sense. A potential suggestion here would be to create businesses that focus on one of these things; for example, cardiac care hospitals.

3)    “I’m not familiar with a highly profitable industry that ever disrupted itself.” He argues, in a broad sense, that a large number of entrenched interests and regulations inhibit innovation because to innovate would effectively mean foregoing some profit. “that’s one of the main problems with our current system, is that there are so many vested interests that try to kill anything… any innovation has to go through 10 years of trials, if any doctor tries to innovate, the insurance board runs after them… that’s an important part of where we are now—the leaders are recognizing that something needs to change, and if it doesn’t change, it’s going to essentially tank  the economy.”

4)    Payment and delivery structures, generally need to function in tandem. For Hello Health, a patient can adds a physician to his team (or several, including specialists) and then interact with them online and doctors can share information/discuss information with each other. “I can share this visit with my colleague, and ask him what he thinks… he can comment, etc. that’s a solution shop style business model, he’d get paid a certain amount per hour to talk to me about that… the ability for patients to network with one another” Patients also pay a fee “I mean, our platform is asking people to pay on a regular basis for health care, which is essentially a dollar a day, and basically that allows us to keep you out of our office and use communication instead of therapy… a lot of visits are communication-seeking activities and that doesn’t work for anybody”

 

5.    Have these trends surfaced before?

“I’m not familiar with a highly profitable industry that’s ever disrupted itself… it’s just, circuit city—it didn’t invent the internet to destroy itself… the key players are going to be startups like ourselves who are going to be innovating on how care is delivered… there has to be deregulation on both payment and delivery… to me, the deregulation, you can’t criminalize new business models…” (Point here being: Look to other industries to see how technology adoption will disrupt trends in health care.)

 

6.    Challenges/responses not on radar now?

 

He seems to be largely focused on/interested in disruptive forces and suggests that they’ll come from startups and other arenas rather than from large organizations. Not surprisingly, he thinks Hello Health has the potential to be disruptive.

 

Also, notes that physicians have the opportunity to learn a lot from patient communities and from listening to patients in general.

FUTURE SCENARIOS

 

7.    Most preferable scenario

The best case scenario where up to 10% of income is spent on health care and beyond that, the government takes over… and that would be for everybody except for Medicaid level… if you’re obese and a smoker, you feel the financial pain of your decision… and that’s what killing America, hopefully those behaviors are going to change… “the correlation of behavior and cost needs to happen…” “That would be the best care scenario—a situation where people start caring about how much they’re paying, and then the flipside of that, doctors are paid to deliver the right care because they’re split up into solution shops and value-added shops.”

 

8.    Most plausible scenario

 

“I think what we’ll happen is I hope there’s going to be some deregulation for innovation in health care. I think it’s going to look like what we’re seeing in the retail market right now…” Hello Health and other groups will drive older community hospitals out of business—he expects this process to take about twenty years; in a decade, we’d be somewhere in the middle of it.

 

9.    Most negative scenario

“Worst-case is that we continue what to do with a single payer system… paying doctors for procedures and visits—our population is getting older and sicker, so we’ll just spend more and more… single payer—doctors… socialized medicine would be the worst case scenario… I think people need to have their foot in the game.”

 

10.    Wrap-up

 

Check out the following:

People to talk to: Jeff Goldsmith—health care futurist, writes for the Harvard business review

 

Book: The Innovator’s Prescription (see above)

 

Other: Acor.org