What Health Care Can Learn From Amazon
My kids love movies, and like all kids, they go through phases on what they love. There was the “My Little Pony” phase, the “Transformers” phase, Disney’s “Frozen” phase and, dovetailing with the holidays, the “Ice Age” phase. Like many Americans, I buy my DVDs on Amazon.com. In fact, I buy everything on Amazon.com, the most cutting-edge company in retail. It’s a marvel of consumer engineering and experience.
As COO and past CTO of an IT company focused on making health care work as it should, it hasn’t escaped me how much better Amazon’s consumer experience is compared to that of health care. A doctor rarely praises an electronic-health record system for being easy to use or improving care. A patient easily coordinating the transfer of health information is a rarity. In sum, health care delivers consistently disappointing experiences.
So why does health care provide a lackluster experience? Perhaps there’s not a captive audience? Or the market is too small?
This isn’t the case. We all access health care, and according to the Bureau of Economic Analysis, all the money spent on consumer goods — $2.5 trillion per year on things like movies, electronics, clothes and cars — amounts to less than the $2.7 trillion spent on health care. So why is health care failing? Today, as I stand before health information technology’s largest annual confab, at HIMSS 2014, it occurs to me that, in following Amazon-inspired philosophies, we can connect health care and its key audiences like never before.
Put the customer first, every time
Above everything else, putting the customer first is why Amazon has emerged as one of the most admired companies in the world. Most companies that deliver a seamless customer experience are tenaciously customer-focused companies that view technology not as an end, but a means. This is embodied in Amazon, an organization that has built service upon service — online retail, e-reading devices, cloud data storage — on the back of multiple technologies, to the end of delivering value to customers. However cool, whether Web servers, warehouses, robots or drones, these are all simply enablers to a better customer experience.
The health care industry has been behind the tech curve as it relates to putting the consumer at the center of care. We’ve been building, buying and installing tools and software stacks that keep the hospital at the center of the health care universe — a center that must shift to the patient — philosophically and practically. We need to empower CIOs at leading health systems and hospitals to step out of and away from their siloed data centers — filled with servers, firewalls, backup tapes and lots of blinking lights — to embrace and plug in to open networks that can enable information to follow the patient anywhere. With the advent of accountable care organizations and the spirit of pay-for-performance, finally it seems there are emerging business models/efforts to put the patient at the center of care. The next step is to align our technology strategy with our new patient-centric mentality.
Use big data more effectively, and enable data through better technology
In health care, everyone talks about Big Data. But petabytes of data is only as good as your ability to operate on it. Amazon is a master at using big data. Amazon has a global network of
more than 100 96 fulfillment centers, the positioning of which are informed by analyzing and optimizing with data. Every day, Amazon monitors its network and decides where to open centers. It also analyzes consumer preferences and creates algorithms that stock popular items at different areas of the warehouse, making staff members more efficient.
Today, a more massive, virtual treasure trove of big data exists in pockets throughout health care. While driving action and insight from data is the nirvana, step one in health care needs to be making better use of data in silos. (AthenaHealth alone has more than 40 million patient records.) We are a long way in health care from Amazon-like recommendations for patients (around which physicians patients might choose based on a preference for a past physician) or for doctors (that suggest if you found treatment X effective for disease Y, you might appreciate treatment W for disease U), though such tools are not beyond the reach of the data the industry collects.
The concept of blending data pools sounds like a big job, but has been done in countless other industries. Just think about Mint.com. It’s a simple interface that pulls together disparate and complex data on individuals’ finances; it gathers different types of institutions’ data, including detail on savings and checking accounts, credit cards, mortgage bills, securities, 401k, etc., into one consolidated view. This same data integration can be done in health care. If we’re okay with big-data tools being applied to our financial information, why do some squirm at the idea of similar applications being brought to health care?
While such data insights are a right-minded goal, Amazon has recognized that you need the right technologies to make data actionable. In Silicon Valley, startups and major companies alike rely on Amazon’s cloud storage and platform to power essential processes; increasingly, leading companies are getting hip to the cloud. In health care, however, onsite servers still dominate the landscape, even as cloud technology seems built for exactly the dynamism health delivery will demand for an era of change, unpredictability and population health management.
Cooperate and compete
As an extension of its maniacal focus on pleasing the customer, Amazon shares screen real estate with competing retailers. It rents out its big-data-enabled distribution network, too. Fulfillment by Amazon has fundamentally changed the way that other companies reach consumers. Amazon does this because it is in the best interest of its customers. In fact, 30 percent of products sold on Amazon are sold by third parties. Separately, Amazon Web Services rents out its core technology infrastructure to run the websites of others — major online players, including Dropbox, Netflix, IMDb and others operate off of Amazon’s core technology infrastructure.
Netflix, as an example — one of AWS’s largest customers — has almost all of its information technology services running on Amazon, from the software that runs its internal operations to everything customers see. At the same time, the two companies compete fiercely in the on-demand video market. In health care, by contrast, sharing and collaboration are the exception. Data famously exists in silos because health care provider organizations aren’t incented financially to share patient information, and therefore HIT companies haven’t propagated open solutions to make information flow in meaningful and consistent ways.
Pioneer new paths
Amazon emerged by taking on the status quo. Many thought CEO Jeff Bezos was nuts to compete with the brick-and-mortar powerhouse Barnes & Noble. The company has continued to take side steps — introducing the Kindle, exploring with drones, providing businesses with Web services, allowing competitors to sell within its online store, etc. This company is pioneering narrow passages and disrupting itself, as Bezos described in a 2012 letter to shareholders, even though some efforts turn out to be blind alleys. In health care, we can learn from this pioneering mentality.
We must embrace change at a time when it has never been clearer that the old way of doing things will no longer work. We are seeing some companies on the edges of health care reinvent themselves. We have seen Walgreens and CVS transition to being health care companies through clinics and other efforts. Most recently, CVS furthered that journey, announcing their intent to stop selling cigarettes. Similarly, more progressive health systems are forming partnerships with alternative care centers. Still others — whether pharma with new business models around sales teams or collaborations, or insurers that are creating their own health delivery networks — are thinking bigger and broader.
Emulating Amazon is no small feat, and health care is hardly the only industry that need take notice — just perhaps the most critical one to take notice. In health care, we are beginning to see some openness toward incorporating many of the philosophies that have made Amazon so successful — customer-first, “coopetition,” gaining insight from data, and pioneering new paths — albeit at too slow a pace. With more of this (much more), I believe both the business and experience of health care can change. Through inspiration and applications from these philosophies, we can breathe life and humanity into the process of care delivery — that’s a mission worth undertaking.
Ed Park, chief operating officer at AthenaHealth, a thought leader on the application of innovation to health care’s largest problems. He will present this talk on Feb. 26 at the HIMSS 2014 conference in Orlando. Reach him @athenahealth.