“Human contact is becoming a luxury good. As more screens appear in the lives of the poor, screens are disappearing from the lives of the rich. The richer you are, the more you spend to be offscreen.”
This quote, from a recent article in The New York Times, Human Contact Is Now a Luxury Good, caught my attention. To illustrate this point, the lead of the article discussed the use of Care.Coach-an online service that provides consumers with “24×7 psychosocial support” in the form of an avatar to help manage chronic health conditions. The program provides remote monitoring, appointment and activity reminders, health coaching, and companionship (see ABOUT care.coach). A non-profit health care program for older adults, Element Care, is providing the Care.Coach program for low-income seniors. The article’s author Nellie Bowles reaches the conclusion: “Such programs are proliferating. And not just for the elderly. Life for anyone but the very rich—the physical experience of learning, living and dying – is increasingly mediated by screens.”
I’m not so sure I agree with this conclusion. Is being “offscreen” really a luxury? Or it is a desired convenience? There are many sides to the issue.
First there is the dark side of technology—tech addiction, isolation, and even the possibility that extended screen time is changing the way we “think” and process information. Technology can decrease our attention spans, create greater distractions, and impair our social interactions (see 5 Ways Technology is Altering our Brains). As more information about these potential dangers comes to light, we’re seeing new efforts to address the dangers of overuse of technology (see A Dark Consensus About Screens and Kids Begins to Emerge in Silicon Valley; How Technology is Changing the Way Children Think and Focus; and Tech Used to Be for the Rich. Now They’re Paying to Avoid It).
On the flip side of these dangers is the desire for convenience. Technology creates value in our daily lives in many ways we no longer think about—online shopping and banking; the ability to communicate with each other 24/7; a tool to take photos and listen to music anywhere on one device; instant access to email, social media, and information. In trade for the convenience of 24/7 instant access through technology there is growing willingness to give up privacy. The reality of our current culture is that many people prefer interacting with a screen (my younger team members hate meetings and telephone calls). And this trend carries through in health care—many consumers prefer tech-enabled therapy services, largely for the convenience: 51% of consumers are so committed to convenience that it’s the most important factor driving their health care decisions, which makes them more convenience-oriented than quality of care-oriented (see 2019 Healthcare Consumer Trends Report). In addition, 79% of consumers will look for a new provider organization to receive an earlier appointment and 40% prefer to book appointments online (see Consumerism Is Changing How Patients Find Providers, According To New Patient Access Research).
But the ability to have this convenience depends on access to technology. And access to technology is often dependent on socioeconomic factors, with wealthy, educated Americans more likely to have access to a smartphone and the internet. Most Americans (95%) own a cellphone and most of those are smartphones (77%)—marking a 42% increase since 2011 (see Mobile Fact Sheet). While cellphone access is relatively steady across a variety of demographics, access to smartphones varies more widely. This includes the difference between consumers with less than a high-school education (57%) and a college degree (91%); consumers who earn less than $30,000 a year (67%) and those that earn $75,000 or more (93%); and rural (65%) and urban (83%). For consumers with internet access, the numbers also vary by the same above comparisons of education (65% vs. 97%), income (81% vs. 98%), and community (78% to 92%) (see Internet/Broadband Fact Sheet).
Then there is the health and human service delivery system issue. Only 18% of consumers report that they have used telehealth services (see Telehealth Gains Popularity, Telehealth Budgets Don’t). In December, work done by HealthAffairs augmented our understanding of the landscape and found that only 15.4% of physicians work in practices that use telehealth (see Physician Practice Use Of Telemedicine Varies By Specialty And Size). And work I’ve done in recent years found that less than half of provider organizations are using telehealth—about 44% of provider organizations over $25 million in revenue are using telehealth technologies and about 33% of organizations under $25 million are using telehealth technologies (see The Tech-Enabled Provider Organization: The 2017 OPEN MINDS Health & Human Services Technology Survey).
But this is likely to change. We’re working on projects now to make almost all mental health therapy “virtual”—whether synchronous (with a live person), or asynchronous (interacting with a virtual being), or creating rural hospital models where all physician care is provided on a screen (with only nursing staff in physical presence), to developing “virtual monitoring” that allows people with intellectual disabilities to live in their own apartments. I could go on and on. Here is our recent coverage of a few of these organizations:
- AbleTo Acquires App-Based Digital Therapy Company, Joyable
- Beacon Health Options Adds MDLIVE Behavioral Health Professionals To Its Provider Network
- Livongo Signs Definitive Agreement To Acquire myStrength To Address Behavioral Health Needs For People With Chronic Conditions
- Mental Health App Maker Mindstrong Health Raises $15 Million In Series B
- io Transforms From Mental Health Management Tech For Hospitals To Health Care Provider
- Mindoula Health Acquires Care At Hand Analytics Company
- OSF Healthcare Launches Telemedicine Program Amid Neurologist Shortage
- Crossover Health Expands Virtual Care Through Sherpaa Health Acquisition
- At UMass Memorial, Clinical Professionals Bring Virtual Care To Infants
- VirtualHealth Announces WellCare Health Plans Is Now Live On Helios Care Management Platform
We don’t yet know the full ramifications of our increasingly tech-driven life style, and I don’t know whether committing more fully to tech is a good or bad idea overall—though advantages and disadvantages are apparent on particular parameters. But consumer acceptance (and demand in some cases) is high, and if adoption can offer a return-on-investment, while simultaneously improving the quality of health care, we will no doubt see more of it.
For even more join me on June 6 in New Orleans, Louisiana for The 2019 OPEN MINDS Consumer Engagement Technologies Summit, featuring Andrea Auxier, Ph.D., Senior Vice President, Product Development, New Directions; Chris Thompson, Chief Operating Officer, Monarch; Davis Park, Executive Director, Front Porch Center for Innovation & Wellbeing; Larry Smith, Chief Operating Officer, Grand Lake Mental Health Center; and Neal A. Bowen, Ph.D., Chief Mental Health Officer, Hidalgo Medical Services.