The healthcare and life science industry in the United States has, over the last few decades, dramatically changed. And not all change has been for the better. In addition to rising costs and challenging access, inequalities, and racial, financial, and rural health disparities, the current healthcare system has caused needless suffering for patients and doctors alike.
There are well-documented racial and ethnic disparities throughout health care at the patient, provider, and health care system levels. And among experts, there is a growing realization among healthcare researchers, clinicians, and advocates that a focus on health care disparities is an important aspect of improving healthcare outcomes and that activities toward improvement must bring together many elements of our healthcare delivery system.
Rural health disparities are, according to the Centers for Disease Control and Prevention (CDC), affecting people who live in rural areas—from Appalachia and the Deep South to the Midwest and western states to Alaska and Hawaii—who, as a result, are more likely than urban residents to die prematurely from all of the five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.
There have been many attempts to overhaul the healthcare system, but, so far, nothing has cured healthcare of its ills.
In her new book (Humanizing Healthcare: Hardwire Humanity into the Future of Health), Summer Knight, MD, MBA, a Managing Director in the Life Science and Healthcare Consulting Practice at Deloitte, shares a bold new vision for healthcare that puts people first. In her book, Knight argues that the advances such as AI and ever more sophisticated analytics hold the potential to create an ecosystem of care for a healthcare future that is more efficient and more patient-centered. In writing her book, Knight based her narrative on the transparent and often unvarnished stories of her patients as well as her own experiences.
The editors of Onco’Zine and The Onco’Zine Brief asked Knight some candid questions about her refreshing approach designed to transform healthcare and the strategies needed to get there.
Question: How has healthcare strayed from its original purpose?
Summer Knight: Healthcare used to be based on a relationship between a patient and their doctor—an intimate alliance with a proven power to heal. Today, people are instead vulnerable in a complex system that lacks coordination, integration, or information sharing. The various players in the healthcare industry aren’t aligned around what should be a singular goal: caring for the patient
The outcomes of this problem are familiar to most of us. Patient’s deductibles are often US $ 3,000.00, but the average American has less than US $ 1,000.00 in the bank. Providers write prescriptions, but when patients try to fill them they realize that the cost is prohibitive. There are too many layers between the pharmaceutical companies that bring drugs to market and the patient who needs those drugs. The rebates and discount landscape is dizzying. There are countless more examples. This has to change.
Read an Excerpt from Humanizing Healthcare: Hardwire Humanity into the Future of Health
by Summer Knight, pp. 19-27 (McGraw Hill, April 2021).
Q: What is humanizing healthcare and how could this be a solution?
SK: Humanizing Healthcare is restoring the human connection in healthcare. This transformation requires changes from interpersonal interactions, cultural commitment, and the big picture of how healthcare intersects with our economy. That’s what I call humanizing healthcare and I’m glad to discuss the many ways we can achieve it.
Q: How do you propose reinventing the healthcare relationship between patient and provider?
SK: I believe in the power of what I call Therapeutic Alliances – a bond between the healthcare consumer, their clinical team, and their Natural Support Network, the free army of friends, family, and volunteers who are highly motivated by a mutual sense of caring, trust and a shared goal of good health.
We’ll always need skilled physicians for specialized care, but we can make healthcare sustainable—and more humane—by reshaping the care team, especially for the chronic conditions and disabilities that absorb most of our healthcare budgets. Changing the care delivery model involves integrating the clinical team with the home team, sharing engaging and actionable information with consumers and designees of their natural support network, and exploring multiple options in a consumer’s journey toward healthfulness.
This new approach to care injects compassion and empathy into the science of medicine, which creates better outcomes, decreases costs, and humanizes the experience for everyone—consumers and their natural support network and, just as important, clinicians. By building therapeutic alliances we can achieve a comprehensive community of care comprised of everyone who cares about a consumer’s health.
Q: What’s wrong with the word patient and why do you prefer to say Activated Consumer?
SK: While many industries prioritize people with names like passengers, guests, and members, the healthcare industry still categorizes people as “patients.” This puts them in a submissive role and dehumanizes them. While the word patient implies what clinicians will do “to them,” we prefer the terms “client’ or “activated consumer”, which better describes what clinicians do “with them” as proactive partners. This new definition suggests that the healthcare consumer aims to optimize health whether one is healthy or impacted by a chronic condition
Q: How can consumers take more responsibility for their own healthcare and why is this usually more effective?
SK: Today’s healthcare consumer is ready to take more responsibility for their healthcare: 9 out of 10 consumers say they prefer to be in control of their medical decisions; 65% of consumers are taking steps to learn about their health condition instead of relying on their provider; and more than half of consumers are very likely to speak up when they disagree with their doctor.
Instead of getting lost in the healthcare system, imagine how different the consumer’s experience would be if they became the “Captain of their Ship” by hiring a team that they trust, and can communicate with, as a partner in their health journey.
With the consumer in the driver’s seat, they hold themselves accountable for their lifestyle choices, and they advance past today’s episodic interactions with healthcare to continuous connectivity where consumers can reach their care team whenever and however they need. This empowered approach can transform a consumer’s healthcare to focus on wellness instead of disease.
Q: How can digital health technology scale and improve your more human and compassionate vision for healthcare?
SK: Digital health technology is ironically the best way to scale humanized healthcare. It can help the healthcare industry serve an entire population based on individual preferences, 24/7 via mobile, in-home, and on the go. With digital technology, a sense of continuous connectivity is created using AI, nudges and avatars. Healthcare professionals can communicate and coordinate with a consumer and their natural support network. They can share data that allows the home team to take appropriate action based on immediate needs and can ask questions specific to that consumer in order to recommend the next best actions to take. The constant connection and collaboration enabled by digital technology help health systems meet their consumers where they are.
Q: Why do you think healthcare needs a stronger union of emotional and artificial intelligence?
SK: Machine learning coupled with artificial intelligence allows us to get smarter about how and when to intervene with the right level of care, to be more proactive about health and prevention, and to impact disease earlier. With artificial intelligence assisting on all these steps, the healthcare delivery team can focus their energy on treating the person with both compassion and empathy.
Q: How would “healthfulness hubs” disrupt the way care is delivered today?
SK: I envision a future where we rely less on traditional clinics and hospitals, we’ll rely more on less expensive healthfulness hubs, part digital and part bricks and mortar, where high emotional intelligence quotient (EQ) humans and machines work together to support consumers. Healthfulness hubs are built around the human being and provide a more holistic, purpose-driven approach to care than traditional care delivery today. Some distinctions from today’s systems include ease of access to care, always accessible health data, care coordination through a digital care platform, meets consumers where they are, new technology platforms, and puts information in the hands of the consumer. All stakeholders will operate on the same platform and the hubs will create a personalized and engaging life experience through various programs. The hubs will seamlessly connect the digital, virtual, and in-person experiences all together to create a humanized patient journey.
Q: How can your vision for healthcare reduce costs and make healthcare more sustainable?
SK: Shifting the primary care physician upstream is critical for the U.S. economy because decisions made by these doctors affect nearly 90 percent of the country’s total healthcare costs due to referrals, testing, and hospitalization. This is significant as we recognize that unnecessary care wastes approximately 30 percent of U.S. health expenditures each year, which exceeds US $1 trillion annually. Shifting primary care physicians to the role of chronic condition intensivists gives them time to be thoughtful about client disposition, such as which tests are most efficacious and cost-effective, which care team members to include, and how to best manage clients to stay in their homes with a combination of virtual tools and in-home visits to significantly reduce hospitalization. This additional available time will make a critical difference in reducing waste and the total cost of care. This approach greatly leverages the most costly and rare resource on the healthfulness team—the physician—across a much greater population of clients.
The humanizing healthcare approach also reduces costs by aligning with the army of caregiving family, friends, and volunteers who currently supply nearly $400 billion of free support annually. Additionally, the new care approach provides care and attention along the consumer’s health journey, which can help prevent serious, costly diseases. In short, humanizing healthcare leads to better health outcomes, higher consumer and clinician satisfaction, and lower costs.
Q: How has coronavirus reinforced the urgent need to humanize healthcare?
SK: A new type of consumer has arisen out of the COVID-19 pandemic – the terrified consumer. There are some consumers who have traditionally avoided healthcare at all costs and now since the pandemic, a new consumer segment that I call the “terrified consumer” has expanded out of fear of contracting the virus or reticence to burden the healthcare system further. Humanizing healthcare will help bring those consumers back into the system and start taking ownership of their health in a safe, collaborative, caring environment. Consumers need to be able to trust their providers and the healthcare system especially in a pandemic, which requires this cultural shift in humanizing healthcare.
Q: How did your experience as the caregiver to your son facing an acute terminal illness catalyze your mission to humanize healthcare?
SK: The treatment of my son Nikolas received was adequate, but the actual experience was awful. When the caregiving shifted from emotionally engaged clinicians to a command-and-control physician, Nikolas went from an out-going, confident athlete to a withdrawn patient. He felt as though he was being treated not as a person but as a disease. It wasn’t until our family and friends stepped up to be present with us that things began to feel a bit more manageable. The importance of EQ (emotional intelligence) paired with the IQ (intelligence quotient) became very apparent to me as a mother and caregiver. I witnessed firsthand the harm that can arise from a lack of information sharing and human compassion.
Q: How did you arrive at your current mission to humanize healthcare from your wide-ranging career journey from paramedic to a physician to the chief medical officer of the state of Florida to a health startup founder and healthcare provider and health plan and digital health executive to a Managing Director at Deloitte?
SK: My mission to humanize healthcare arises from the intersection of the trifecta of my experience in healthcare: a medical professional and consultant, a patient, and a caregiver to aging family members and to a child with an acute terminal illness. As I’ve experienced healthcare through these different lenses, I noticed the inconsistencies in respect for individuals and the people in their lives. If somebody like me who is as well-versed and intimately involved in healthcare felt overwhelmed by the lack of compassion I saw, I knew there needed to be a significant shift in how we deliver healthcare.
Q: How can others join the Humanizing Healthcare revolution you’ve helped develop?
SK: Anyone can learn more by visiting Humanizing Healthcare, connecting with me on social media, or volunteering through 1HumanKind.org to help us to create the first conference on Humanizing Healthcare. Think about how much we would all benefit if we each reimagined and reshaped our own role in the healthcare system. We all have the power to help make healthcare the holistic and compassionate long-term journey toward optimal health that it was meant to be.
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