Health Care Innovation Means Never Having To Say You’re Sorry (For Not Being One Specific Categorical Thing or Another)

….“Heal CEO and co-founder Nick Desai has previously spoken derisively about the limitations of the growing telemedicine model in building stronger patient-physician relationships.

So it might be somewhat surprising that the company is now unveiling Heal Telemedicine, a telehealth feature meant for the company’s returning patients….We believe the combination of real time monitoring, plus house calls, plus telemedicine is the real pathway to value based care.” (Why house call startup Heal is launching a new telemedicine service , 5/30/19 MedCity News)

It’s been clear for almost a decade that walk-in health treatment innovators like Heal, and Minute Clinic, RediClinic, and TakeCare Health (remember RediClinic and TakeCare Health?), were more emblematic of an assortment of material changes in the delivery of routine non-emergency health treatment than they were significant new forms of institutional treatment in and of themselves. MinuteClinic’s bold annual declarations that during the ensuing 12 months they’d grow total clinic locations by 50% have long since ceased being a silly industry in-joke; MinuteClinic doesn’t bother declaring it any longer, so nobody laughs anymore.

What Heal’s “news” signals is that people with brains & resources continue to tinker with the “form factor” of routine, non-emergency health treatment because, to paraphrase a label for instances of innovation popularized by Clay Christensen long ago, convenient routine non-emergency health treatment is a job people need to have done. Most people, most years, mostly don’t consume a whole lot of health treatment; 60% of the US population accounts for under 6% of total health treatment spending. The average spending in that 6% hovers around $300 for the year. But, however negligible that amount of spending may seem, people need that care. And somebody(s) going to try to provide it profitably.

And they need to have it done how they would prefer it to be done, rather than how the clinicians and conventional clinical support infrastructure and third-party payers would rather it be done.

And that means it will be done in ways that diminish the role of clinical experts, and amplifies the throughput of “make me feel better” clinical information (did you know that a lot of health treatment – a LOT – is essentially the exchange of information, rather than pills, bandaids, sutures, etc? Now you do — thanks Dr Topol!), through care technologies anticipated at least as long ago as the invention of the telephone, the exploitation of which as a health treatment device Paul Starr reminded us in his 1983’s Social Transformation of American Medicine was anticipated, if not by Alexander Graham Bell, then certainly by many of the enterprising telecommunications promoters who followed in his wake.

So Heal’s “pivot” really isn’t that. It’s inclusion of teleclinician care support isn’t even surprising. It’s paying attention to the job that people need to have done.

Does Heal have it right? It won’t be the firm’s management that decides. It will be people who need routine non-emergency care. They’re the ones who need a job done.