Dr. Charlie Miraglia is not only the Chief Medical Officer at hc1 - he is also a die-hard movie buff. Connect with Charlie @ccmiraglia.

If we ignore the obvious geopolitical issues on the surface of this 1999 film starring Clooney, Wahlberg, and Cube (Ice Cube, that is), and focus on the underlying basic moral dilemma the characters face, those of us in the business of disrupting the status quo of healthcare find ourselves in a somewhat similar situation. While the soldiers in this film are searching for gold (and, really, who isn’t?), they are faced with the conundrum of whether to help a group of local refugees who desperately need them or focus on the gold.

In the case of healthcare, the refugees can be represented by those of us who are searching to be more connected to and engaged with our providers and the health systems we choose for our care. Meanwhile, the gold-seeking soldiers represent the health systems that are caught up in the search for the sweet spot where cost, quality and service overlap to produce value for the consumer. At the end of the day, healthcare providers need to find the gold but they also need to help us patients who desperately need them.


Since so many great things come in threes – the three amigos, the three stooges, three blind mice, etc. – I’ve decided to outline three of the major challenges currently facing healthcare. More importantly, I'll propose transformative solutions that “disruptive technology” and big data offer to shift the focus of healthcare away from the “gold” and more toward the delivery of a personalized, 5-star experience to the “refugees”.

The first challenge is attracting new patients into their networks and – most importantly – retaining their loyalty to the system for all of their healthcare needs. Just as the retail sector has done, healthcare needs to use consumer (patient) data in ways that help them define, better understand, and focus on the things that motivate people to make health-related decisions. Engaging patients in ways that change their behavior, including campaigns to reach out to them proactively by cell phone, email or whatever mechanism they chose, will be critical to the outreach and retention efforts of all providers of healthcare.

The second challenge relates to patient access, which is now much more than merely access to brick and mortar hospitals. Today patient access refers to a variety of experience enhancements aimed at facilitating the patient journey throughout the healthcare system. Simple points of pain and frustration that currently exist can be alleviated with the use of technology. Appointment reminders by text or email, electronic preregistration and insurance preapprovals, and coordination between sites of care are just a few examples of how the entire experience is being transformed into something much more personalized. The current delivery system is simply unable to provide consumer-centric care on its legacy systems.


The third major challenge is the identification and management of at-risk populations – those individuals who are on the path to a chronic illness like diabetes, or whose condition is worsening and requires intervention. Many would categorize this as population health for obvious reasons, but more important than its label is the impact this process has on keeping people healthier, while simultaneously driving down the high cost of health care. As the industry transitions from a fee for service model to a value-based system, improving outcomes and containing costs, engaging patients, and managing their relationships with providers will be critical to the success of these initiatives.

While it may seem as though healthcare systems are all about the “gold”, it’s their investment in the transformative solutions I’ve mentioned that will re-focus them on the “refugees” they are charged to serve. It certainly won’t be easy – change never is – but technology and innovation are what make it possible.

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