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How Today's Healthcare Industry Resembles the Tech Industry of the 1980s, and Why That Gives Me Hope

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While watching my son's lacrosse game last weekend, I was introduced to another "lacrosse dad" (the new "soccer mom") by a mutual friend who relayed that I oversee the healthcare practice at Hill Holliday. That little opening was enough for this relative stranger to open up about some very personal frustrations he'd experienced in trying to get the right diagnosis and care for a condition his daughter developed this winter. As we kept one eye on the game, I listened empathetically, offering little in the way of real advice. But it struck me that this was a very different conversation than I might have had if my client were, say, a car company. Everyone has a healthcare experience to relate, and the nerves are exposed.

In the ad world, we reflect daily on how emotion drives behavior. Health care is an emotional issue. We're driven to discussions like these because we all feel health care far beyond our care settings: we feel it in our paychecks, in the unemployment rolls, in the harsh and polarizing tones of policy and politics, and through the far-reaching impact health care makes on every corner of this country.

But above all else, we feel the personal inevitability of health care. If you and your family have had the good fortune to not yet experience a significant health issue, brace yourself. In an otherwise opaque system, the one transparent truth is our universal need for health care. It's that truth that makes the system's failures all the more alarming.

Finding Hope for Health Care in the Evolution of the Tech Industry

Where do we look for hope? How can we find a path to improvement and - dare I say - success for health care?

I believe there's a tremendous lesson to be learned from another industry that radically transformed from a closed, confusing system into one that is now open, user friendly, accessible, and aligned with the needs of consumers. It's an industry that went from treating the consumer's experience as an afterthought to its North Star. This industry is information technology, more commonly known as IT.

Take a look at your smartphone. Not only is the information technology residing in this device infinitely more powerful than that of a box 20 times its size 20 years ago, it's now also intuitive, accessible, customizable, and nothing short of miraculous when you consider the data, services, and connectivity it provides the user. Remember that we are one generation removed from the era when Ken Olsen, founder of Digital Equipment Corp, allegedly remarked, "why would anyone ever want a computer in their home?" He couldn't imagine one even more powerful in your teenager's hand.

The Tech Industry's Power Struggle: IT Experts vs. End User

To find the parallels between tech back then and health care today, we first have to understand IT's evolution from mainframes in cold rooms to iPads in living rooms. In the 1990s, after years as an account guy on beer commercials, I moved to San Francisco and joined a tech-focused B2B agency called Anderson & Lembke. I learned quickly that while beer brands focus intently on the needs and emotions of their consumers, technology companies didn't factor "end users" into their plans. Products were designed to make sense to the small cadre of IT experts who either developed or deployed them; end users were considered poor, tech-illiterate slobs trying - usually unsuccessfully - to coax magic out of computer programs built by untouchable tech wizards. They were expected to learn to work the way the software needed them to work. In extreme cases like SAP and Oracle, entire enterprises were coerced into reorganizing their business processes and operations to fit the contours of some of the most inscrutable software programs known to man.

During my tenure at A&L, however, I began to witness a power shift occurring in the larger IT world that would change consumer technology forever: developers went from believing the end user was at the mercy of IT to understanding that, in fact, IT's success was at the mercy of their end users. Three significant developments drove this shift:

1. Apple's commercialization of the Graphic User Interface: This was the first real "Rosetta Stone" in translating the computer's language into an intuitive interface, and it ushered in the personal computer.
2. Microsoft Windows and the Office Suite: As polarizing as opinions are regarding Microsoft's products and business practices, there's no denying that it was Microsoft that more successfully delivered on Apple's promise of "the computer for the rest of us" by creating the software that ran almost every personal computer in the 1990s.
3. The World Wide Web: Mark Andreessen led the Netscape team that developed the "browser," which translated the heretofore powerful, yet closed and private, system of the Internet into one that end users could actually navigate.

The common thread across these milestones, of course, is the end user as the focal point.

"Patients" are the New "End Users"

I believe that the healthcare industry today is where the information technology industry was in the late 1980s. Consumers are playing more active roles in their health care than ever before, yet the system remains dominated by experts speaking in coded languages to other experts. These experts show precious little interest in opening this closed system to the humans on the other end.

In health care, end users are known as "patients," a term every bit as condescending as "end user." A "patient" is only a patient when in the active care of a medical professional or system: not when they're deciding what to eat; not when they're exercising; not when they're tracking high blood pressure at home; not when they're teaching their kids about the importance of good hygiene or the evils of tobacco. And like IT companies back then, our hospitals, health plans, and pharmaceutical companies expect "patients" to uncritically accept and adapt to the way the system needs them to work, -- even if that system is far more complex than SAP's most mind-boggling software. Healthcare consumers today have no graphic user interface, and certainly no "Google," to help them navigate the system's complexities and translate codes. When people can't figure it out, they're on their own.

In health care, as with the old world of IT, there are myriad systems all doing a piece of the job that don't effectively communicate with each other; in fact, they argue with and contradict each other. And just like significant IT implementations, the "price" of health care that people see is always the tip of the iceberg. Healthcare pricing is ridiculously opaque and variable, and nearly impossible for consumers to correlate to the value they receive.

The Case for Optimism in Information Tech vs. Healthcare Parallels

Yet amid all of these incredibly stiff headwinds, I'm optimistic that health care will gradually get better. Information technology is a complex, chaotic, yet essential industry that has transformed over three decades into one of the most vital engines of our economy, our productivity, our culture, and our identities. It did so by humanizing its products and services, making the end user's experience the focus of design and utility.

It may take a generation or more for an order-of-magnitude change, equivalent to the shift from mainframes to iPads, to occur in health care. But it will happen, for two fundamental reasons that make the conditions riper than even those that drove the transformation of information technology. First, health care has to find a way to work for everyone--it's a matter of life and death. IT has never had to contend with that kind of pressure, and we as "patients," have more incentive to demand and drive change in this system than in any other. The second factor is the untold amount of money to be made by the entrepreneurs, companies, investors, and visionaries who figure out how to tame the system and make it work better for the people it serves--its end users.

We're all waiting for a Steve Jobs, Bill Gates, or Mark Andreessen to emerge in health care. We are seeking ideas that will blow the doors off of this broken system. It's time for "a healthcare system for the rest of us."