[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/05/Medical-social-quadrant-box.jpg” thumb_width=”150″ /]Deceptively simple, the quadrant matrix can make sense out of actions and decisions.
As a management tool, it can help you prioritize what is most urgent and important, or how to vary your supervisory/coaching style based on the person’s skill and will levels.
Here we see the magic box used by Krishna Yeshwant, MD, a doctor and investor with GV, Alphabet’s venture firm, to sort out all those Next Revolutions in Health Care. The factors that Dr. Yeshwant uses pertain to the end user’s medical and social needs, often called social determinants of health (SDH). Both are meshed, whether in an active older veteran who lives alone in a rural area but manages his diabetes well, or in a homeless substance user in a city with multiple medical conditions.
Most non-medical entrepreneurs prefer to develop tech and services for people like them with low medical/low social needs, such as virtual doctor apps, concierge primary care, and wellness apps. It’s a crowded quadrant and perhaps is over-served. Those with a medical background appear to gravitate to the diagonal quadrant–high medical/high social needs, such as those targeted to the ‘underserved’ with diabetes or high-need care model management, such as Aledade and Iora Health. Where does the investment money go? Their money goes to companies which have developed high medical need therapeutics such as expensive treatments for cancer, neatly avoiding those complex social factors.
What is missing: innovation in low medical/high social needs. This group is at high risk to move into high medical needs due to their lack of organization and access to/willingness for primary care. This Editor agrees, but if another factor is observed–profitability–this is likely the least potential of the four. So if you want to get Dr. Y’s attention and maybe some moolah from Alphabet…. From his presentation at the HLTH meeting last week in Las Vegas. CNBC.
The GV Hot 7, especially the finally-acknowledged physician burnout. Google Ventures’ (GV) Dr. Krishna Yeshwant, a GV general partner leading the Life Sciences team, is interested in seven areas, according to his interview in Business Insider (UK):
- Physician burnout, which has become epidemic as doctors (and nurses) spend more and more time with their EHRs versus patients. This is Job #1 in this Editor’s opinion.
Dr. Yeshwant’s run-on question to be solved is: “Where are the places where we can intervene to continue getting the advantages of the electronic medical record while respecting the fact that there’s a human relationship that most people have gotten into this for that’s been eroded by the fact that there’s now a computer that’s a core part of the conversation.” (Your job–parse this sentence!–Ed.)
Let’s turn to Dr. Robert Wachter for a better statement of the problem. This Editor was present for his talk at the NYeC Digital Health Conference [TTA 19 Jan] and these are quoted from his slides: “Burnout is associated with computerized order entry use and perceived ‘clerical burden’ [of EHRs and other systems]”. He also cites the digital squeeze on physicians and the Productivity Paradox, noted by economist Robert Solow as “You can see the computer age everywhere except in the productivity statistics.” In other words, EHRs are a major thief of time. What needs to happen? “Improvements in the technology and reimagining the work itself.” Citing Mr. Solow again, the Productivity Paradox in healthcare will take 15-20 years to resolve. Dr. Wachter’s talk is here. (more…)