I posted a previous note about some general aspects of the uberized economy with suggestions about how it might apply to staffing in pathology (see: Relevance of an "Uberized" Economy for Healthcare and Even Perhaps Pathology). I also posted a blog note more than five years ago about how software was causing disintermediation of multiple industries (see: Digital Self-Publishing Promoted by Amazon and Its Kindle e-Reader) A second key aspect of uberization, in addition to harnessing the shared labor market and the gig economy, is the substitution of software for human intermediaries in business processes. The software wrings both time and cost out of these processes, improves the consumer experience, and reduces costs. Consider how the sophisticated Uber software makes transportation in the city much more pleasant. This is all software-driven.
A recent article discussed the uberization of the banking industry with the deployment of new apps (see: The Uberization of Banking). For example, peer-to-peer lending can be accomplished more quickly and less expensively than applying for a bank loan. I want to take some of these same arguments and apply them to a discussion of the uberization of ambulatory care (see: The Uberization of Healthcare). My discussion in a note yesterday about how Walgreens is setting up a first-tier, ambulatory care system with complex software support (see: Walgreens Launches Major Effort to Generate Patient Health Information).
One of the basic pillars in the uberization of ambulatory care will be broader availability of physician virtual visits for low-intensity problems. In the case of the Walgreens business model and their walk-in Healthcare Clinics, the on-site professional is usually a nurse practitioner. By way of contrast, the Cleveland Clinic is now offering telemedicine visits using family practice physicians for $49 for all Ohio residents (see: Details of Cleveland Clinic's MyCare Online Virtual Telemedicine Visits).
Two powerful incentives are at work to stimulate expanded use of physician e-visits by hospitals even in those systems that are not particularly innovative. The first is that telemedicine visits do not require incremental investments in bricks-and-mortar in order to expand physician work effort. This is particularly important as the number of patients seeking care in the country expands under the ACA. I also believe that e-visits make more efficient use of physician time and effort, particularly as physicians become more comfortable with the technology. This is particularly important for participation by specialists like neurologists who are in short supply and for whom appointment wait-times can extend to many months.
At the present time, the range of services available during a physician e-visit beyond face-time are limited. One is the generation of e-prescriptions. Recall from the above discussion that we are only at an early stage in the deployment of software in support of the uberization of ambulatory care. Envision instead an e-visit that would include monitoring of patient vital signs using sensors attached to the patient's smart phone and the ability to order both lab tests and radiology studies for virtual patients.