Trust me, I'm a digital doctor! The importance of trust in delivering connected health

The past couple of years have inevitably made all of us even more aware of the importance of the healthcare sector and the criticality of having systems in place that optimize operational efficiency and effectiveness.

That said, from a technology perspective, the progress of healthcare transformation has advanced at varying rates around the world and with varying degrees of success. The UK government’s ill-fated multi-billion pound disaster that was the NHS National Programme for IT (NPfIT) still stands as painful testimony to that.

But there’s little doubt of the potential for digital transformation in the health industry. The pandemic has seen the rise of the ‘virtual doctor’s appointment’ as face-to-face surgery consultations were replaced by Zoom sessions, for better or worse.

From a tech vendor perspective, healthcare is a hugely lucrative opportunity, as recognized by Oracle CTO Larry Ellison recently, shortly before his firm mounted its $28.3 billion bid to acquire Cerner in December. That move was widely predicted to lead to similar transactions as other tech giants seek to shore up their own interests in the sector. Just this week, IBM is reported to be attempting to sell off its Watson Health arm for around $1 billion.

All of this drew my attention back to a study released by Salesforce at the end of last year, its latest Connected Health Consumer Report - registration required - which looked at a hugely important aspect of healthcare transformation, namely how far we, as patients, trust new systems and ways of operating.

This has always been a vital consideration - or should have been at any rate. Just because something can be digitally transformed doesn’t necessarily mean it should be. Going back to the UK’s NPfIT fiasco, there was much talk at the time - the Tony Blair years - of people accessing digital medical consultations in supermarkets or public libraries. That was the theory, but one that ignored the basic practicalities of whether people were ready to tap into a kiosk surrounded by their shopping bags rather than visiting their doctor’s office.

As noted above, COVID has forced a change of practices here, although as the Vaccine Economy takes shape, a common complaint has been the ongoing inability to get a doctor’s appointment. The desire to look your general practitioner in the eye remains strong. How the balance between online and offline works out in the years to come will be a fascinating question.

Trust

COVID has thrown up other questions of trust, most notably with the rise of the anti-vaxxer movement. Trust or lack of trust in the vaccine programmes has become a hugely contentious issue around the world and one that has led to a societal split between the vaccinated and the unvaccinated, sparking in turn political and ethical questions that every country around the world needs to address.

All of which brings us back to that Salesforce report. There’s a lot of data to be found here - Salesforce surveyed over 12,000 consumers in 13 countries - but let’s start with a few provisos. The overall breakdown of respondents was 33% US, 42% Europe - which still includes Brexit Britain for the purposes of this - , Asia 17% and Latin America 8%.

In terms of Europe, the UK, France, Germany and several others accounted for 8% each of the total. What isn’t immediately clear from the demographic breakdown is how different models of national healthcare systems across Europe have been factored in. The report focuses a lot on private healthcare provision models of the US kind rather than state-provided, so-called socialised models to be found in other parts of the world.

That’s potentially an important point. Asking a British citizen if they trust the NHS may well result in a different response to whether they trust, for example, a service such as Test and Trace provided by a government agency. I’ve asked for further clarification on this and will update this article if/when that comes through.

With that said, there are some valuable insights to be had from this report. The study notes:

The pandemic accelerated adoption of virtual care and spurred historic innovations — all against a background of waning consumer trust. More than ever before, consumers are taking matters into their own hands, managing their own health, and relying on a wider variety of channels to do so.

But there remains the question of trust. Just over a third of respondents (36%) say they completely trust their health providers, while 49% say they ‘somewhat trust’ them. That raises some concerns, notes the Salesforce study:

Yet in an industry that witnessed both nightly cheers for health workers as well as vaccine skepticism and misinformation, the decline in trust is complicated and varies across sectors.

Pharmaceutical companies are regarded with particular suspicion by consumers, it seems:

Only 13% of consumers with prescriptions completely trust pharmaceutical companies. While heightened skepticism around vaccines hasn’t helped consumer confidence, there’s more to unpack across this sector.

Misinformation

COVID has encouraged over two-thirds of us (69%) to seek new ways to get at existing products and services, finds the report:

Today’s health consumers are comfortable using digital versions of traditionally in-person services, from remote monitoring to virtual checkups and more. Increasingly, digitally empowered consumers are taking matters into their own hands. Nearly three-quarters of consumers — 11 percentage points more than in 2019 — have been responsible for managing their health across different parties (for example, primary care doctors, specialists, insurers).

There are clearly demographic splits on show here. For example, 69% of Baby Boomer respondents still look to get public health information from physicians with only 3% turning to social media for the same.

But a quarter of GenZ respondents are happy to look to Facebook and Twitter and the like for information. That provides anti-vaxx conspiracy theorists with a sizeable audience for spreading false information and paranoid ‘proof’ of Bill Gates’ plan to implant micro-chips in everyone’s bloodstream. As the report notes:

While greater access to health information is powerful, it can also lead to misinformation and mistrust.

Building up trust is vital to the success of healthcare transformation. The Salesforce study makes the point that the more consumers trust the healthcare and life sciences companies they interact with, the more open they are to using their services, citing the medical technology sector as a case in point:

Patients with high levels of trust are more than twice as likely to welcome assistance — whether in the form of patient and caretaker support programs or help getting to appointments — than patients who are distrustful. Lack of trust dampens consumers’ desire to engage, weakening connections between patients and health companies as consumers pull away. These connections are an important way for health companies to encourage and facilitate healthy behaviors, and ultimately, improve patient outcomes.

So what is it that the ‘trusting’ consumer is looking for from health tech? The Salesforce respondents expose a significant gap between what is wanted and what is currently delivered. For example,  91% of us want access to a complete view of health expenses, but only 40% are offered this. (Again, this is based around a very US healthcare model; NHS patients in the UK are unlikely to ask for a breakdown of their treatment costs!).

Meanwhile 88% of respondents said they want targeted comms from their healthcare providers, but less than a third (30%) get this, while 85% want personalized health insurer policies, but less than a quarter (23%) receive such a service. This results in a basic conclusion:

The lack of comprehensive service offerings also jeopardizes consumer trust. More broadly, our research found that the more services a health company provides, the more trust it engenders. 

My take

Overall there’s a lot of work to be done to realize the full potential of so-called connected health for most of us, but there is a great opportunity here. Nearly two-thirds of respondents under age 65 (64%) already believe that providers with better online capabilities are more likely to deliver better service. As the Salesforce study notes:

If providers take the time to prioritize convenience on digital properties — through electronic form fills, online appointment scheduling, and user-friendly websites — it stands to reason that they would prioritize convenience across the entire patient journey. And if younger generations are any indicator, the importance of digitalized administrative tasks and online care will only increase.

That’s the sort of conclusion that is going to make the Vaccine Economy health tech sector one of the most open to disruption in the coming years.

Now, go and get your booster shot!