Is mHealth changing the concept of concierge care?

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The concept of “concierge care” is being applied in various ways these days, and as such, it means different things to different people.

iTriage President James Greiner, for one, sees the technology as a personal assistant, guiding the consumer to know when and where to access healthcare. He told mHealth News that iTriage is “positioned as a medical well-being solution,” not entirely unlike an Uber for healthcare – without the questionable drivers and haughty executives.

Others, meanwhile, refer to technologies that enable doctors to offer more personalized services to their patients (at a cost, of course).

A French word that, as a noun, means “doorkeeper” or “janitor,” concierge medicine is defined in its adjective form for healthcare: “pertaining to or being medical care for which the patient pays the doctor an annual fee for special or extra services.”

Indeed, before the proliferation of consumer mobile health technologies, that  meant a doctor would literally be on call for the patient, expediting healthcare services, and the practice was most often associated with high-end physicians treating the rich and famous.

Nowadays, the idea of providing “special or extra services” has many in the industry on edge. They view the concierge model as a form of healthcare for the masses, and a natural progression for consumer-facing care.

PlushCare, a San Francisco-based “virtual healthcare concierge” service that debuted last October,  defines the process as a means of connecting patients with medical services at any time and ensuring that the relationship is maintained. HealthTap, another choice, presents the technology as an enabler connecting consumers to their own doctors.

mhealth-infographics-480px“Concierge care is a relationship-based system, like Facebook,” HealthTap CEO Ron Gutman said. “You can’t just connect with anyone.”

PlushCare co-founder and CEO Ryan McQuaid said his service works to forge a relationship between the consumer who wants immediate medical care and a trusted doctor. “At many times we are becoming the patient’s advocate,” he said, “or the concierge for the patient’s healthcare system.”

The heart of the debate may lie in the shift to consumer-facing healthcare. If doctors treat “consumers” rather than “patients,” the expectation is that the consumer can move on if he or she doesn’t like the service, and can shop around for better or more cost-effective options. A “patient,” on the other hand, is generally viewed as someone who has a specific relationship with a doctor, and will keep coming back.

But there’s an emerging perception that consumers want to shop around for healthcare. Whether that’s true is up for debate. They might want a quick, easy and effective diagnosis for a minor issue – the online consultation or kiosk visit would be the ideal venue, then – but they may also prefer a doctor who knows them and has treated them before. That’s where concierge care comes into play.

Now flip that around, and ask doctors whether they want to be any doctor or your doctor? Most would say they want strong relationships with their patients, and see mHealth as a way of improving that relationship. Others might see this as a new line of business, and embrace the idea of offering quick (and billable) consults over the Internet to complete strangers.

Advocates for concierge care say it is the future.

“People want to connect with their own doctors,” Gutman said. “And medicine through mobile devices is making that happen.”

iTriage, which forged its identity as a resource for emergencies, is undergoing a makeover under Greiner’s guidance. The company, which was acquired by Aetna in 2011 and saw the departures of co-founders Wayne Guerra and Peter Hudson last year, is shifting its focus to what Greiner calls “meaningful engagement” between the consumer and the doctor.

It’s perhaps telling that the iTriage app, which set the benchmark for consumer-facing mHealth emergency care, is now trying to bring the doctor into the conversation. And while the plan is still to give the consumer what he or she wants, sustainability will only come through physician interaction.

In the end, it’s not “special care” that consumers want, but effective care.


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