What the healthcare system can learn from the Citi that never sleeps

Healthcare is one of the world’s largest industries. Health spending is estimated at around $7.2 trillion, or 10.6% of global gross domestic product (GDP). Spending is also accelerating, rising an average of 5.2% a year to a potential $9.3 trillion by the end of 2018. For such a vast and live-impacting industry it’s surprisingly under-digitized. To put it another way, it’s at the point where banking was around 20 years ago. Let me explain.

In the mid-nineties I worked at Citigroup, leading their Tech Lab in California and working on the transformation of consumer banking. At the time most banks hadn’t opened their eyes to see that they were actually in a consumer industry. Banks built branches (sometimes three or four in one street) and expected people to come to them during strict opening hours, stand in line and wait patiently to be serviced when the bank was ready to do so.

I am proud to say that Citigroup was the first to launch Internet Banking back in 1995, being true to their slogan ‘The Citi Never Sleeps’. We saw the potential to get closer to consumers and we ran with it. Even then we were using data analytics to understand our 50 million customers better, breaking them down into thousands of segments of people with similar needs, we applied analytics to assess people’s credit-worthiness and to get early warnings of potential fraud. We were designing new models to make the banking experience secure, connected, customer-centric and personalized. We automated processes and we took a data-driven approach. At the same time global payment and ATM networks emerged allowing every shop and restaurant to plug in a secure payment device. You can pay your meal anywhere in the world with a card and now by just swiping your phone.

It was a revelation but it didn’t happen overnight. Plenty of people thought we were wasting our time – that “no one would trust their financial data on the internet.” Citigroup, the banking industry and the world never looked back.

Citigroup, the banking industry and the world never looked back.

These days the Financial Services Industry is undergoing yet another revolution as machine learning-based systems are starting to give better financial advice and risk assessment than the experts and highly sophisticated algorithms perform trillions of dollars in trades. Many millennials have signed up to apps like PayPal and Acorns that give you a save-to-invest experience, bypassing the Banks altogether. Blockchain technology allows new players to create trusted contract repositories outside the walls of the banks. From where banking was 20 years ago, to where it is now, it’s almost unrecognizable.

Of course, the world of healthcare is infinitely more complex than that of finance. But that doesn’t mean that a similar revolution can’t take place. I believe we’re on the eve of that revolution, and 15 years from now, we may be faced with a health system that is truly patient-centric, highly networked and data-driven.

If we can learn some of the things the banking system already knows how to do

If we can learn some of the things the banking system already knows how to do – how to focus on a human-centric approach, customer segmentation and secure infrastructure, advanced algorithms and regulatory frameworks – we’ll have a solid place to start. We can move towards patient-centric systems that offer a seamless experience as we age, including tools for self-management, augmentation and 24 hour access to care. We can use population analytics to group patients with similar profiles and allow care providers to package, price and brand services around their needs. We can get infrastructure in place that will allow personal health data and personal pathways to follow wherever the patient goes, and regulation to a point where it provides both the incentives and the guidance.

What makes this utopian future seem more realistic is the fact that this is already happening. Not everywhere, not at the same pace and not easily, but it is happening at grass-roots level. We are working on multiple pilot programs with hospitals and other stakeholders that are innovating, integrating and moving the system forward towards truly human-centric care.

One of my favorite recent examples is Liverpool. It was named the UK’s unhealthiest city and the Clinical Commissioning Group was given the difficult task of turning it around. Their goal is to make the city the healthiest in the UK by 2020, quite an ambition coming from behind. To achieve that target they’ve had to take a disruptive approach.

In the past few years, they’ve embraced ‘health-system design-thinking’: integrating all that comes with managing health into one network - hospital, GP, care givers, fellow patients, community services. Supporting people across the full health continuum and moving away from silo-ed islands of practice.

They have set up multi-disciplinary teams, and established a “remote care hub” with nurses, GPs, physiotherapists and tech support. Over 2,700 people with chronic conditions are now managed from home, new patient pathways have been created and video-based education programs are in place to help shape healthy behaviors. The outcomes of this approach are yet to be publicly announced but I can tell you they are remarkable, just like other studies for chronic disease management we have completed in the US and the Netherlands.

The next job will be scaling up these efforts and others like them and enabling care collaboration at a macro level.

The next job will be scaling up these efforts and others like them and enabling care collaboration at a macro level. We will collect the data and we will be learning from every patient engagement. To foster these new care models, Philips is building a secure, cloud-based, IT infrastructure – HealthSuite digital platform - that ingests all data related to our health, allowing for interoperability, analysis and actionable insights to enable more personalized health and care management, on both a personal and population level.

It’s difficult to suspend belief and envision a future where all the benefits of transformational healthcare are present. But it will happen - we will transition from sick care to health care – we just need to picture the naysayers in the banking sector 20 years ago and imagine if they’d stopped us from bringing online banking to the world.

The healthcare industry will evolve. It will evolve faster if it can learn from other industries that have faced similar upheaval.

* The health-related information found above is meant for informational purposes only. It is not intended to serve as medical advice, substitute for a doctor’s appointment or to be used for diagnosing or treating a disease. Please work with your health care provider to evaluate the best treatment options for you.