Doctor Loblaws!

During the recent HIMSS conference in Chicago, I had dinner with several ITAC members, including the young COO of a Canadian start-up company developing mobile applications for health care. During the course of the conversation someone asked him who his “dream” employer would be. I was expecting a response like Telus, Google or Microsoft; those companies out on the leading edge of health information technology. I was quite surprised when he answered, “Walmart… or maybe Walgreens”.

Pressed to explain his response, he took us through the possibilities of integrating data that included our clothes sizes and what we ate, information streamed from our fitbits, our medication record at the Walmart pharmacy, and numerous other sources of lifestyle and health data.

Imagine streaming advice and alerts back to consumers on their smartphones while they are in the store. Does that product you are about to buy contain peanuts or gluten or too much salt? Do you really need that package of cupcakes in your cart? Wouldn’t a tub of (more expensive) organic yogurt be better? Did your belt size really increase by two notches?

Intrigued by the young COO’s response, the next day I visited the Walgreen’s booth on the tradeshow floor. This was no 10X10 booth. It was closer to a city block. I picked up a brochure for their “Balance Rewards” program: 500 points per prescription filled, 500 points per immunization, 250 points for setting your first healthy goal, 20 points per mile walking, 20 points per log for tracking your weight, blood pressure and blood glucose!

During his keynote address to the HIMSS conference, Walgreens president Alex Gourlay demonstrated a Walgreens app that enabled customers to go online using their smartphones for video conferences with a physician who in many cases could diagnose the condition and issue a prescription (no doubt to the nearest Walgreens pharmacy).

When I got home I visited my local Loblaws (Great Canadian Superstore in some regions) located in north Toronto. I noted that they are co-located with a walk-in medical clinic, have an in-store pharmacy and have a dietician on staff. Its where I go to check my blood pressure periodically. I got my flu shot there.

Is this the future of health care?

It would be silly to think that hospitals and primary care clinics will be replaced by retail grocers and big box stores. But with the growing trend towards consumer health applications, who better to cater to consumer health needs than the retailers who have already established relationships with their customers. Health and wellness is just another added-value service.

These new entrants may have an important role to play in healthcare delivery, particularly on the wellness end of the spectrum. I know that my daughter, with two small children, would be happy to combine a trip to the doctor for routine vaccinations with grocery shopping. For chronic disease management, the convenience of being able to access basic health services and manage medications where they shop will be attractive to many seniors.

The most interesting aspect of this phenomenon is that consumer health retailing might change the business model for health care. We’re entering a predominately private sector world. While public health insurance will be a factor for medical and hospital services, private insurance and out-of-pocket spending dominates the drug, dental, assistive device and wellness markets. There is an opportunity to create new incentives for wellness behaviours and preventative health care that are valued by health care consumers.

The private sector will invest the money needed because retailers can reach out to consumers with new goods and services, while enabling access to health and wellness services at the same time. As governments struggle to find the resources necessary to fund enhancements to our health Infostructure, consumers are willingly paying for consumer health apps, mobile devices and telecom services. We have the opportunity to leverage the investments in technology made by individuals and private sector companies.

Central to the business model is the data. The data has extraordinary value. While culturally we take a dim view to commercializing data, several decades of loyalty points programs have demonstrated that consumers are prepared to allow access to their data so long as there is value in it for them. That value can be an enhanced state of health and wellbeing or a discount on their next purchase.

Privacy is a consideration, but shouldn’t be a barrier. All private sector companies in Canada that deal in personal information are subject to privacy laws. So long as retailers respect the privacy of customers and share the benefits, they should be OK.

I have to admit that this one snuck up on me. Are we starting to see the Uberization of healthcare? Uber revolutionized taxi services just like iTunes revolutionized the recording industry. Is healthcare far behind?

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