What is the Future of the Direct-to-Consumer Model in Healthcare?

There is a lot of money sloshing around digital health and investors are scratching their heads and becoming wary and suspect of outcomes. One concern is the viability of a direct-to-consumer business model instead of business-to-business or business-to-business-to-consumer models.

Selling products and services direct to patients comes with many hazards:

1. Consumers have a low rate of health literacy.

2. Consumers have a low rate of insurance literacy and will be confused about who pays for what.

3. Behavioral health issues complicate acute and chronic care issues and behavioral health is smokestacked and not integrated into the EMR or care coordination.

4. Do-It-Yourself medicine comes with its own set of issues and threats.

5. Sick Care is different than disease prevention and chronic disease management.

6. Patients have a contradictory mindset — wanting control but unwilling to take responsibility for their decisions.

7. Direct-to-consumer advertising from Big Drug and Big Device has created pushback because patients don't trust them and there might be a halo effect if digital health does the same.

8. Investors are not putting a lot of stock into the necessity for clinical validation. One noted that, “Getting providers stamp of approval with clinical validation is like getting a hunting license. It’s useful, but it’s not an end all be all. You still need to win over consumers.” The result will be that most won't spend the money to do human subject trials.

9. Even if clinically validated, technology adoption and penetration depends more on emotional and human habits than whether they work or not.

10. We still have not figured out how to traverse the last mile when it comes to changing patient-consumer behavior.

Using a direct-to-consumer Sick Care or behavioral health business model is fraught with risk. Some will find the secret sauce and thrive, while, my guess is that most will fall into the abyss of Sick Care business hell. It will take a lot to successfully keep it up and working well enough to satisfy the end user.