Merging Old with New: Not So Easy

There are a lot of problems in healthcare including some ‘basics,’ that don't make the Big Headlines: ensuring patients can afford their medicines, ensuring patients have follow-up appointments after being discharged from the hospital, ensuring patients have access to a primary care physician or nurse practitioner, and figuring out ways to get patients to their doctor’s appointments.

Believe it or not, these reasons accounts for a lot of the reasons why patients have a hard time recovering from a hospitalization, and why it’s hard to keep whole populations healthy.

Basic Problems, Real Consequences

And of these problems, a real big one is the rate of ‘no-show patients. ’  No-show patients are patients who miss their scheduled healthcare appointment. And the cost of missed healthcare appointments in the United States every year is  $150 billion. Each open, unused time slot costs a physician 60 minutes and $200 on average. And no-show rates are as high as 30% nationwide, according to AARP.

And if you're a patient, missing doctor’s appointments means missed medical care and not getting the advice, treatment and prescriptions needed to stay well and/or recover from a recent illness.

Hardest Hit are Seniors and Socioeconomically Disadvantaged

And, this is especially true for two groups of patients: socioeconomically disadvantaged people who don’t have cars or can’t take time off from work, and Seniors, who have mobility and eyesight issues.

Transportation might sound like a secondary issue for older Americans, compared with massive needs like managing chronic conditions, but it's almost as essential and gets far less public investment and policy attention.

Real Challenge of Aging—Getting Around

Getting around represents the single biggest challenge of being old. Elder-focused resource hotlines report that transportation is the No. 1 reason people call—and often, they’re desperately looking for a ride to the doctor the next day. Lack of transportation access is a primary reason older people move into assisted-living facilities, a life change many would prefer not to make.

Possible New-World Solutions

And it didn’t take long for the For-Profit market to decide which customer base to grow—Seniors. Seniors in need of transportation constitute a potentially lucrative market. (Some Medicare Advantage programs now cover rides to medical appointments and pharmacies.)

So Lyft and Uber, GoGoGrandparent, SilverRide and others are contracting with third parties, like health care systems and health insurance companies, to get their patients set-up with rides via these ride-hailing services.  

Yet, according to a new NYTimes article, older adults are not utilizing ride hailing services because of—in part—the digital interface and the requirement to submit payment information into an app. Older adults are continuously warned about scams, identify theft and have justified fears about data breaches and misuse of the information.

While more than half of people over 65 own smartphones, only about 25% of people over the age 50 have used a ride hailing service. (Pew Research)

Analog Meets Digital Divide

So here we have a type of ‘digital divide—’ not classic but a variant of it: Sure, half of all Seniors have smart phones and computers yet smart phones are not native-feeling; These devices and interfaces feel ‘foreign’ and, thus, are to be utilized cautiously. Seniors don’t trust the New (thing, concept, idea, device…). And since they often don’t understand the New, they default to the Old (ways).

So, while there are many opportunities to improve medical access, including virtual care, chat-bot-based therapies, and ride hailing to get to appointments, Seniors need to get over this ‘cultural barrier’ of ‘otherness.’ How are we to smooth this 'friction,' this sense of 'otherness?'

Who will be the ‘cultural ambassadors’ introducing the New to the Old? How will trust be generated? How will the emerging bio/med-technology sector create User Interface capabilities that appeal not to the young, but to the Old?

Elegant Market Solution—Seniors to the Rescue

From a market dynamic’s view, there is an elegant solution here: Use the Old to train the Old on the New. The Old are the target market so use them to inform the user interface and customer experience. (And of course, there are a lot of elders who would be thrilled to have another phase of their career doing just this sort of work.)

And for once—perhaps unique in the technology space—the target customer is not the New, but the Old, and, those of you building apps and interfaces need their help and insights.

Go figure, the Old helping the New in tech! Finally.

About the author: Julie Kliger is recognized by LinkedIn as a "Top Voice" in Health Care in 2015 & 2106, & 2107. She is a Healthcare ‘Strategic Realist’ who is passionate about improving health care and improving lives. She specializes in future-oriented healthcare redesign, optimizing existing operations, implementing new care models and strategic change management. She is an adviser, clinician, health system board member, speaker and author. 

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