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The rise of search in healthcare

As a company who’s mantra is - find, connect and transact - it’s a bit surprising (and maybe a little disheartening) to realize the industry doesn’t care about two-thirds of our little jingle (at least not yet).

After all, we began this journey to transform the way consumers and providers communicate with one another. Healthcare is a transactional business and all the transactions are broken and inefficient. These inefficiencies create horrible consumer experiences for patients and make the business of medicine unmanageable for healthcare providers. If we can digitally connect consumers to the industry and the industry to itself, we could change the healthcare world.

At least that has been our thinking. When we tested our vision on the industry, the response was... curious. Everywhere we turned, people gravitated to search. Not the cool process of seamlessly executing five different but interconnected transactions on a smartphone with a few taps of the finger, but search. What the hell is going on here?

No one cares about improving these transactions? Benefits transparency...broken. Scheduling...broken. The check-in process… broken. Price transparency… non-existent. Payments… broken. Data… still a no-show.

That’s the way it seemed, anyway. After further testing, we learned something perhaps even more interesting. It’s not that the industry doesn’t want to fix the transactional problems, it just cannot see past search.

It’s ironic. If you were to look at our first app, you’d probably conclude that it looked something like GrubHub or OpenTable for healthcare. Our goal was to help the user find a provider, establish a connection, and then support a set of transactions. In fact, as much as I admire Yelp, I have also been critical that they dropped the ball. They proved the value of location-based, vertical search and triumphed over the classic double-sided market problem. Nevertheless, they seemingly failed to recognize that people don’t search to search. They search to do. Hence, despite their incredible success, they left the door wide open for companies to essentially take the Yelp model and extend it to the transactional layer, including reservations (OpenTable), and take-out delivery (GrubHub).

The irony lies in the fact that while our vision is far reaching, it has also been far-sighted. Never has it been clearer that people only see what they’re ready to see, and that there is an apparent evolutionary order to things.

So, what’s going on with search? Why all the interest? We’ve always known it was important, even critical. After all, you can’t really connect and transact with people and/or places until you first find them. But it goes much deeper than that.

For starters, you cannot look at the problem from the perspective of the consumer - and, for whatever reason, most people cannot do this (keep in mind, I speak regularly to early stage investors and VCs, so my sampling group may be skewed). Their first response is nearly always - I don’t have a problem finding a doctor, therefore a problem cannot exist.

This is a horribly flawed perspective for a couple of reasons. First, no one said that you had a problem finding a doctor. The issue is that doctors and provider organizations frequently have a problem being found. You wouldn’t think this would be so difficult to understand. After all, if I were talking about the challenges a dog food manufacturer has in getting appropriate shelf-space at the grocery store, the average MBA could understand that easily enough.

Even in spite of Yelp’s success, so many people still think Google owns search. It doesn’t. In fact, it’s pretty abysmal when you’re doing searches across a vertical market. It’s even worse if you’re looking at vertical markets that have historically under-invested in online marketing. Restaurants are a perfect example, and a perfectly logical place for Yelp to start. How many restaurants even have websites, let alone ones that are responsive (web and mobile) AND have SEO juice?

Yelp leveled the playing field, in a sense, giving restaurants an opportunity to be discovered within highly focused, location-based searches, creating huge wins for both restaurants and consumers. All of sudden, you may now discover that the best Thai food in the country is only three blocks down from your house in a non-descript strip mall that you’ve driven past a thousand times.

A lot of people don’t realize that healthcare fits the restaurant example to a “t”. Historically, so much of healthcare has been transacted on a B2B model that hospitals, health systems, and doctors have invested very little in direct-to-consumer channels. About five or six years ago, healthcare started investing more and more. Big billboards with ER wait times should ring a bell here. Ah, it seems like just yesterday when those started to pop-up... and in some places it was.

Why the sudden change? There’s probably a number of contributing factors, but overall healthcare is becoming consumerized, and as a result, more and more business is being procured directly by consumers making their own purchasing decisions.

There’s essentially a new front in the provider marketing war. Hospitals and health systems everywhere are overhauling their websites and pouring money into pay-to-play channels like Google Adwords and ZocDoc. They have one simple goal - get their doctors and facilities found by consumers.

It’s funny how many people still question whether or not there is going to be a consumer revolution in healthcare, and when it’s going to happen. I used to get so frustrated arguing this point to the healthcare hardliners who always have some quip like - oh, we went through the same thing back in the ‘90s, and it never amounted to anything… The truth is, it doesn’t matter when it’s going to happen. The battlefield is already being redrawn to account for this new front and all the major forces are mobilizing accordingly.

When consumers eventually begin to show up (and it’s going to happen like a tidal wave), they are going to realize that while they were able to find a doctor in the past, they frequently could not find the most appropriate one for them. And what does that look like? I don’t really know because it depends on the person. All I can tell you is that if I’m paying for the services, I want a little more information to go by than what’s included in the yellow pages, or online equivalents like Healthgrades and Vitals.

The bottom line is that before the industry will be ready for GrubHub, it first needs Yelp, but Yelp with a twist.