Can you remember getting a shot in the bottom from your family doctor with an old-fashioned reusable needle and syringe?
I can (I think). The days of needles and syringes intended for reuse are long gone, at least in the U.S. So, too, does it seem that the family doctor is growing extinct. As more physicians choose higher-paying specialties, it’s harder to find family practitioners for primary care.
Instead of a family doctor, your kids probably see a pediatrician and you see an internist. People who have diabetes or cancer typically have a gang of specialists weighing in on their care, hopefully with some coordination. And for minor issues like a flu shot or a test for strep throat, you can bypass the doctor’s office entirely and go straight to a nurse practitioner at a pharmacy clinic. Who could have imagined that back in 1965?
Four Trends Transforming Healthcare
The healthcare user experience has changed dramatically over the past 50 years, for good and for ill. And it has the potential to change just as much over the next 50. Last fall I was invited to participate in a panel at the Human Factors & Ergonomics Society’s annual meeting. It was part of the annual “User Experience Day” and the panel session was titled “Future Visions of User Experience.” We did a thought experiment and traveled forward in time to 2065 to glimpse the future of healthcare. In my presentation, we followed four major trends to their logical conclusions:
Trend #1: Cost pressure is pushing healthcare into the hands of minimally trained patients and lay caregivers in the home environment. Whereas you used to have to go to the doctor’s office for an injection, now many injections can be done at home or on the go by the patient him- or herself. Prefilled syringes, auto injectors, and pen injectors are now quite common means of providing a variety of medications.
Trend #2: Major advances in technology for minimally invasive surgery. These techniques and technologies have drastically reduced the recovery time of many common surgeries. Out-patient surgery — which does not include an overnight stay in the hospital — has grown hugely since 1970, when the first ambulatory surgical clinic opened in Phoenix, Arizona, and out-patient procedures are now more common than those requiring hospital stays.
Trend #3: Big data. And drones. What, you can’t imagine what role drones will play in healthcare? Keep reading.
Trend #4: Doc-in-a-box clinics at pharmacies and large retailers. Companies at the point of sale within the healthcare industry are moving into health services. Drugstores now offer clinics to treat a limited range of illnesses and conditions and provide vaccinations. Walmart has taken this trend even further, recently opening primary care locations in stores in rural Texas and South Carolina. The company intends these clinics to be one-stop medical shops, providing chronic disease management as well as acute care services.
What Walmart and Comcast Have in Common
Who knew Walmart could become an important provider of healthcare? But the retailer’s long reach into rural communities, which often lack easy access to doctors and hospitals, has opened an opportunity. In some ways Walmart’s foray into healthcare echoes the cable wars, where the company with the most established relationship with the customers wins. Twenty years ago, we wouldn’t have thought a company that provides television signals via a cable would be providing telephone and internet service to our homes. But bundled telephone, internet, and television now dominate every market where they’re available.
We’re predicting that these trends — cost pressure moving care into the hands of patients; advances in minimally invasive surgery; technologies cross-pollinating into healthcare; and companies not previously thought of as healthcare providers — may play a surprising role in the future.
A Day in the Life of Your Healthcare 2065
If these trends continue at their current pace, here’s an example of where we could end up in 2065:
1 – Perhaps you’ll stop at Walmart on the way home from work to have a cardiac stent inserted by your Walmart surgeon.
2 – While you’re there, pick up a Samsung do-it-yourself kit for tumor biopsy to diagnose that lump on your head.
3 – When you get home, watch a YouTube video for detailed instructions on how to use that kit. Better yet, go to Twitch to find an experienced user broadcasting a live video feed as he uses it.
4 – Let’s say that lump on your head looks iffy enough that you opt for a ‘procedure’ (which is what anyone over age 50 calls ‘surgery’). No problem. Schedule the best surgeon — it doesn’t matter where he or she is, could be the other side of the globe — to perform the surgery remotely while you’re in the comfort of your own home.
Then order an appropriate surgical robot from Amazon. If it’s urgent, you can choose same-hour delivery by drone. (If the tumor biopsy determination was difficult enough, you might have had another drone fly the sample to a pathologist who could do some advanced testing. Or maybe you would have just snapped — or Snapchatted? — a picture with your phone and emailed it … but that’s so 2015.)
The Future Is Here
And speaking of your phone and 2015, did you notice the Apple Health app appear on your home screen after a recent iOS upgrade? It’s intended to be an “easy-to-read dashboard of your most recent health data,” according to Apple. You can track everything from your weight to your heart rate, the amount of calories you burned today to your current medications. And you can share that data with your doctor. IBM and Apple have partnered to make that big data sharing more secure.
Someday soon, your doctor may be able to anonymously compare your data with that of hundreds of thousands of similar people, and make educated guesses based on those other people’s outcomes about what you need to pay more attention to in order to remain in good health.
Even more futuristic medical services might be in the works. According to an article in the Wall Street Journal, Google’s latest search is detecting signs of cancer with tiny metal particles that “patrol the body for cancer.” Hopefully at some point they’ll train the nanobot patrol to destroy the cancer if they find it.
So thinking back to the cable wars analogy, what companies do you see providing healthcare in your future? It may not be Walmart, Amazon, or Google since the average lifetime of a Fortune 500 company is just 40-50 years. But we think these recent trends show that companies with the strongest connections to patients are moving beyond retailing healthcare products into providing healthcare as a service.
Taking a look at what the user experience could look like in healthcare fifty years from now can act like a shot in the bottom for those of us considering how to enhance user experience today. I had a lot of fun with this exercise — it’s not often that I can truly allow my imagination to run free from the varied, but inevitable, constraints inherent in all real-world design problems. I recommend such an exercise as a springboard for ideation sessions. If nothing else, it’s a good reminder that the future will be here sooner than we think.