A wide variety of issues that patients are facing in the interaction with healthcare actors qualify the industry for digital transformation.

Issues include trust issues caused by deaths due to medical errors. In 2016, 9.5% of all deaths in the U.S. were caused by such medical errors [errors]. Mobile apps could be designed that improve trust by involving patients with their therapy. Decisions regarding treatment could be made transparent and risk factors such as medication could be mitigated through second opinions given remotely or instantly by an expert AI or a community of users. A possible result could be that patients start feeling in control of their therapy. An approximately 12.3% of adults in the U.S. have no access to healthcare coverage at all in 2018. A number that is increasing [nohealthcare]. New business models could make healthcare services more accessible to low-income individuals. Key here might be to increase the supply side which makes healthcare so expensive in any aspect. In 2025 a shortage of 446,300 home health aides and 95,000 nursing assistants is predicted [shortage]. Lower qualified workers could possibly be supported by automating certain aspects of their work through virtual assistants that take on non-physical and repetitive work. This might also address long waiting times that are among the most common reasons for patient dissatisfaction at medical centers [wait]. The biggest motivator of all for unconventional players to enter the healthcare market might just be its size. Per capita, spending on healthcare in the U.S. alone has reached $10,348 in 2016 [spending] and surpasses per capita spending on healthcare in all other developed countries [oecdspending]. Holistic services that are digital from the ground up might be able to streamline processes that make receiving care more affordable as a study by Deloitte suggests [deloitte]. Headlines from the like of Alphabet, Amazon, and Apple about plans for company internal healthcare programs and the development of employee hospitals support this assumption [disruption].
One part of the high monthly cost is healthcare coverage. Traditional health insurances provide tangible value only when the customer needs medical support if the customer needs that support at all for long periods of time. Other than that, not much value is provided in the activities of everyday life that can have an impact on health later on. Virtual assistants could make positive impacts on customers well-being throughout their life.

Despite healthcare being a highly attractive market for so-called disruptive innovation[hbr], it remains to be a particularly complex area to innovate in. Start-ups especially are challenged by strict regulations and a comparably high cost of entry. Smartphone apps for example that seek to change existing interactions between patient and provider are already improving certain aspects of the overall experience but most remain solutions limited to isolated problems such as diabetes management, making appointments or meditation. Leading technology companies powered by revenue from their core businesses might be able to approach the market in new ways. Recent headlines and patent filings signal high interest.

Rethinking outcomes There is a very fundamental difference between the high-level value proposition of traditional healthcare services and that of industries which have already seen the significant success of internet-enabled services. It starts with terminology.
Whereas other major industries discuss the experience of a customer or a user, the healthcare industry chooses the term patient experience [px] to describe the journey of a person interacting with any given healthcare service provider. The term patient originates from the Latin adjective “patiens” which stands for long-suffering [patiens]. Thus discussing the patient experience implies that the person in question is or assumes to be suffering. The basic value proposition of traditional healthcare services including the core value provided by insurers is to support people in their recovery from illness or to support a life with chronical diseases, disabilities or mental issues.
Looking at this value proposition from an outcome driven [oci] point of view, it seems rather unlikely that anyone would desire to suffer (i.e., get ill) in the first place if avoidable.

What would an outcome-driven healthcare service look like that prioritize prevention to keep people healthy for as long as possible? And how much of their privacy and self-determination would people be willing to sacrifice for reaching potential outcomes that are wellbeing and longevity?

To answer these questions, a critical design approach is proposed that addresses possible negative implications on people and society. This thesis furthermore evaluates existing applications and patient-facing services in the digital healthcare and wellness space. It explores the role that new technologies and subsequent ways of interaction might play for future services.