Editor's note: Claus Jensen is Teladoc Health's chief innovation officer
Until about 100 years ago, the village doctor was the primary and often only source of healthcare in the local community. They knew everyone, knew the history of your family good and bad, knew the disease patterns in the local community and were a ubiquitously trusted source of advice.
Fast forward to 2021. Healthcare has become much more capable. Biological and clinical science has brought us treatments that people could only dream about in the early 1900s. But at the same time, the system has become much more specialized and often disconnected, leaving many of us to navigate healthcare needs on our own.
The village doctor paradox is the structural challenge in healthcare for our generation. Is it possible to create a healthcare model that combines the intimacy, cohesion and convenience of the village doctor experience without losing the advanced capabilities of modern healthcare? We believe yes, this can be done via the fusion of clinical and digital science. But solving this generational challenge requires a dual paradigm shift.
The first paradigm shift has been removing the constraint of healthcare always happening in a brick-and-mortar setting. Virtual care is becoming mainstream as it can potentially provide a wide variety of services from acute episodic care to improved management of chronic disease. By giving people freedom of choice, we created convenience, but not yet intimacy and cohesion.
The second paradigm shift must address the need for good cohesive decisions over a lifetime, addressing whole health needs consistently over time and space. In today's healthcare ecosystem there is no real connective tissue equivalent to the village doctor, and even the best primary care physician is not involved in all aspects of someone’s journey of health and disease. Solving this second dimension of the village doctor paradox requires us to create something new, something built on four sets of interconnected and integrated capabilities:
- An intelligent technology platform that enables us to selectively deploy discrete solutions, yet creates synergy when more than one solution is used at the same time.
- Clinical programs with proven efficacy that address diverse health needs and drive patient engagement. Especially when it comes to mental health and chronic disease.
- Partnerships and support services that empower us to operate at the scale and complexity required to address the needs of a population rather than only the needs of a single individual.
- Amplifiers that make the healthcare ecosystem more effective rather than trying to replace it — that power up care providers, and enable people to interact with empathetic providers they trust.
The answer to the village doctor paradox does not lie in wholesale replacement of the current system, let alone a return to single clinician health service. Instead, we must disaggregate siloed solution towers and put the pieces back together better.
The next normal care model will be built on the right combination of people, software and hardware. It will have the ability to connect the dots across all points of care, including self-care. It will be based on a step care model where you have choice in what level of engagement to apply, ranging from digital self-service to expert advice. And it will provide you with your own personal "health navigator" that informs and guides choice and actions when you are sick and when you are not.
Imagine a world where the healthcare system is not focused on what, but rather on whom. Where integrated and purpose-built platforms serve holistically the distinct yet different needs of health consumers and clinicians. Where the health system is equitable and provides equal access to care for everyone. A world where we have filled out the white space currently existing above and around solution silos across health plans, health systems and community resources. Where we have not replaced these solutions, but rather transformed them through disaggregation and subsequent re-integration. Wouldn't that be worth striving for?
What if we could create the first stop for health advice, access and delivery? Effectively creating and managing that emotional connection to the system around you? That's the future, that's the next normal in healthcare. Healthcare is not a destination you go to a few times a year; it is a wrap-around experience that is there on your terms and in the palm of your hand every minute of every day.
Whole person care starts when a person isn't even looking for healthcare. We now have the technology to make healthcare ambient in our lives. It is time for the industry to deliver the next normal experience.