Opinion: Reflections of a health consumer with greater expectations

I am 52 years old and a little on the portly side due to an aversion to strenuous exercise and a (in)famous inability to walk past a nice dumpling, pizza, burrito, stir fry or glass of red wine. I have gout, which I am told is genetic, but then again I haven’t met too many skinny, teetotal gout sufferers over my time.

I am starting to feel the first signs of arthritis in my wrist, knees and ankles and I have collected the odd more exotic disease along the way, in my case Gilbert’s Syndrome. I am not sure who the original Gilbert was but it is quite nice to know we at least have something in common.

In short, I am starting to feel my age and – more than a fraction belatedly as my family regularly points out – my health is starting to become more important to me.

I am also an early (read old) Gen X with a technology consulting background and three millennial children who have a different way of connecting and thinking about the world (although they still seem to highly value access to their parents’ bank accounts so some things clearly never change). Some of this experience and thinking are important influences as I now contemplate how I want to manage my health from this point on.

As I consider this topic, I can’t help but reflect that healthcare might well be the least consumer-centric industry of them all, the last bastion of a time when your service providers knew best and your job was to obey and (literally) take your medicine.

In many ways, the business of healthcare for a consumer hasn’t fundamentally changed over the past century: you get sick, you see a doctor for a diagnosis, you unquestioningly take some form of treatment or you visit hospital for some more intrusive procedure, and then you repeat this cycle periodically. Along the way you book face-to-face appointments around the schedules of service providers, you fill out paper forms, you repeat your details multiple times, and you have your medical details scattered throughout the health system.

It is somewhat bewildering as to why this is still widely considered acceptable in a society where we can order goods online and have them delivered to our homes in 24 hours, we are able to withdraw money from anywhere in the world and maintain an accurate and up-to-date record of our financial transactions, we can livestream events from around the globe to our mobile phones, or we can find out very definitively what a dumpling restaurant in Shanghai is like – a favourite search of mine – from the comfort of our own couch.

As an ageing, reasonably tech-savvy consumer – although my children might disagree – here are a few personal healthcare expectations that are both technologically possible and well within the expectations we would have as consumers interacting with virtually any other service sector:

  1. I want access to a complete, secure and up-to-date electronic record of my health conditions and interactions with the health sector
  2. I want to own and share this dataset, not have parts of it hidden from me by my service providers
  3. I want to have my key health indicators proactively and remotely monitored and I want to be alerted when there is a discrepancy that needs attention
  4. I want to access first-level diagnosis electronically from my home at a time that is convenient to me (and this is rarely during normal working hours)
  5. I want my drug prescriptions to be automatically fulfilled and delivered to my home
  6. I want to have transparent access to consumer ratings of doctors, drugs, treatments and clinical facilities (i.e. a ’tripadvisor’ for health)
  7. I want to book all of my healthcare appointments online
  8. I never want to fill out another paper form again or repeat my details as I navigate the health system
  9. I want access to reputable, best practice healthcare information
  10. I want periodic, tailored, full-service health check-ups – if it is good enough for my car, it should be good enough for me.

As a country we are spending an increasingly significant proportion of our state and federal budgets on healthcare, but while we have seen some initial moves towards electronic health records and some excellent technological advances in clinical treatment methods, at the end of the day this money is overwhelmingly focused on maintaining and supporting the status quo method of consumer healthcare delivery.

This is neither a smart nor sustainable approach as the status quo is characterised by sharply increasing healthcare demand and costs in response to factors such as an ageing population, the increasing incidence of chronic disease, and the availability of more technologically advanced and costly medical treatments.

None of the expectations I have listed are unreasonable or rocket science, but, as has been the case for over 100 years, the way we fund and deliver healthcare is very health administrator- and care provider-centric. It is now time to do things differently, to tap into a millennial mindset, to properly unlock the power of technology and, at long last, to really put the consumer at the centre of our healthcare system. I would be happy to raise a dumpling and a glass of good red to that.

About the author

Adam Powick is a senior partner at Deloitte and is one of the old stagers of the national eHealth agenda. He was the lead author of the 2008 National eHealth Strategy and has worked across most parts of the health sector over the years. With the onset of middle age he is now taking a more personal interest in how well our health system really supports consumer needs.

Comments  

# Queensland Health staff member 2018-01-19 09:28
Plug me into a diagnostic center, where you answer a stack of health questions on all aspects of your body, so you have a more thorough work up before talking to the doctor.
# Nepean Blue Mountains PHN staff member 2018-01-19 09:34
Although humorous, much of what Adam says is plausible. What is left out is the paranoia felt by governments if a change is made in the way health services are delivered and, heaven forbid, someone dies and the family blames the government. The 1.8% of Australians who will opt out of My Health Record when it goes National later this year, unfortunately have a disproportionat e effect on health policy.
# Healthscope staff member 2018-01-19 09:54
Very well articulated article which provides a factual account of the Health Care System.
All Australian should have a My Health Record and would if they seen the realities of the system. Medication errors due to providers relying on patients to repeat their details and provide lists of current medications which they have no understanding of.
# Darryl Carr 2018-01-19 11:40
Great article Adam. Thanks for taking the time to share your thoughts and vision. I identify very strongly with your circumstance, having almost the same situation myself. I have to say that ALL of your expectations can be met with current technologies, and there are some new services entering the market that will hopefully deliver on some of the points. The inefficiencies you speak of are also present in many aspects of society, but I agree that healthcare is indeed taking longer than most to make the much needed changes. I believe there are still technical challenges to achieve what you're after, but I also think that 80% of the issues holding us back are centred around human behaviour and the need to let go of established power bases.
I like to quote an old saying in these circumstances: "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.". :-)
Darryl Carr.
# Lynne Everett 2018-01-19 12:29
I'd just like to point out that the MyHR is only a partial answer to expectation number one, and only number one -- currently it's not even a solution to the issue of current medications for many people. But I would like to live in the world that addressed these issues.

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