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By Eric Gombrich
I’m a fan of the television show Modern Family. My wife and I enjoy the weekly giggles triggered from the various characters’ quirky but real personalities, and the ensuing subtle but smart dialogue. No laugh track, personalities we see ourselves in, and real-life scenarios combine to provide the two of us a brief reminder to laugh at ourselves.
One of my favorite sayings belongs to the character Phil Dunphy (played by Ty Burell); “Slow is smooth, and smooth is fast.” I’m not suggesting he was the first to recite this, but his use of the term tends to be perfect.
I’ve used this term in business to express the idea that often times, to avoid the “Fire, Ready, Aim” knee-jerk reaction that can be so tempting – and damaging – taking a breath, slowing down, analyzing, planning, and then acting can often times result in better outcomes, achieved faster. Often times speed to act and the impact such rapid action can have will actually impede medium and long-term success. But this isn’t a novel idea; patience is a virtue (one I struggle with constantly).
This concept recently came to mind as I read about Humana’s partnership with Doctor on Demand to provide 24×7 access to MDs via telemedicine with no copay or out of pocket cost.[1] While I believe we will look back at this in a few years and think “Yeah, so?” as this will be common, it triggered a memory of an article I read in the Atlantic by writer Derek Thompson back in 2012 entitled “The 100 Year March of Technology in 1 Graph”[2] (good to know the memory isn’t totally gone!).
This short article highlights the following graph:
I believe this graph can inform our thinking about changes in healthcare and ‘transformation,’ and as such our expectations around the adoption of telemedicine or telehealth.
While I’m obviously not a sociologist or an economist, as I consider this graph I immediately look at the various initially-consumer focused inventions and apply a ‘risk’ consideration to each of them. In my mind, the less risk there was (is) in their adoption to the individual, the more rapid the adoption curve, which intuitively makes sense. But I also note that the graph begins tracking these items long after they were initially invented or created. Specifically, depending on your perspective of history and innovation:
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- The phone was invented as far back as 1849 and is generally attributed to the patent Alexander Graham Bell received in 1876, a full 24 years prior to the graph
- The automobile was invented by Karl Benz circa 1885, a full 20 years before the graph conveys
- The radio (Marconi) circa 1885 as well, roughly 40 years before the graph denotes
- The microwave oven was born immediately after WWII, in 1946 (RadarRange) roughly 25 year before appearing on the graph
- The internet started as ARPANET in 1983, roughly 10 years before appearing on our graph
But perhaps my favorite to consider is electricity. Electricity has been around since the planet’s formation in the form of lightning. It took millennia for us to learn how to harness it, and take advantage of it. Yet we place some (arguably) arbitrary point in time to declare it was ‘invented’ (Benjamin Franklin, circa 1740) and then consider its adoption in the early part of the 20th century.
Given this my question is this: do we expect too much in terms of the rate of adoption of telemedicine or telehealth?
When you consider the perceived risks of not doing what I, like my parents, grandparents, and great-grandparents before them have done my entire life in terms of going to the doctor, this has a higher perceived risk-profile than buying this new-fangled thing called a television, a dishwasher, or a cell phone, the failure of which costs me a paycheck or two, not my life. Furthermore, if I were a physician the risk of a potential lawsuit would similarly pose a significant risk.
Arguably ‘telemedicine’ has been happening since the telephone was invented[3]. In the 1920s radio was used to transmit electrocardiogram information. If we use what we consider the more likely current definition of video encounters, even this started circa 1960s. And if we fast-forward to today, I believe we’re referring to direct to consumer telemedicine which required the foundational elements of the internet, tablets, and smartphone technology to become a possibility.
But I think the impatience of our innovation and investment culture is driving the narrative of ‘slow adoption’ in the field. Personally, I have no doubt telemedicine will be a primary means of delivering (physicians and allied health professionals) and receiving (patients and family) care. But perhaps like electricity, our challenge is not adopting an invention, but learning to harness and manage how we use it. And when lives are on the line, the change requires changing behaviors of generations. In that context, perhaps Slow is Smooth, and Smooth is Fast.
How do you think we’re doing in the adoption of telemedicine?
[1] https://insurancenewsnet.com/oarticle/if-you-want-cheaper-health-care-you-may-have-to-visit-your-doctor-on-your-phone#.XRisx-hKjZs
[2] https://www.theatlantic.com/technology/archive/2012/04/the-100-year-march-of-technology-in-1-graph/255573/?
[3] The Lancet (1879) https://www.ncbi.nlm.nih.gov/books/NBK207141/
