Changing Consumer & Healthcare Dynamics are Finally Moving the Point of Care Wherever it's Needed.
Over the past decade, I’ve led and worked with teams focused on addressing healthcare needs outside of the hospital – helping to make the home a viable “point of care”. The goal has been to develop technology and software platforms that link the right solutions to the right patients and populations to increase adherence and better maintain (or improve) patient conditions through behavioral and data generated insights. If done right, there is a resulting increase in operational efficiency for entities that provide care and are financially responsible for patient populations (Integrated Health Providers, ACOs Payers, 3rd Party Solution Providers, Home Healthcare and Employers) as they straddle existing and new payment models. With payments now tied to performance instead of “fee for service”, it is more critical than ever for financial stakeholders to address 30 Day Readmits, Bundled Payments, MACRA, MIPS, etc. – while increasing quality of care and influencing Star and HEDIS ratings.
There is great need for change and it needs to occur rapidly. There are many innovative tools in the technology toolbox that can help in the transition from Mobile Health to Digital Health, unfortunately many of the same hurdles in scalability still exist. There are many clever one-off solutions (“shiny objects”) that aren’t connected to anything. The lack of interoperability, cost and time to integrate, and mis-alignment of technology to users’ needs has kept the industry in a state of treading water, but the timing is now right for real change.
As digital health evolves and new solutions gain strong evidence for enhancing outcomes, there is increasing need in the industry for the architecture and development of a service platform that will enable providers to quantify, stratify, integrate and align appropriate digital health solutions to scale to individuals across all populations that engage in the healthcare system – from Health and Wellness to Complex Care.
Integrate, Align and Engage.
This platform must be able to streamline integration, alignment and procurement of the thousands of digital health solutions and related services used by enterprise customers. For end-users – individuals and populations using the solutions – the platform must be intelligent, flexible, nimble and easy to engage with to drive adoption and keep solutions relevant going forward. Engagement is key to both business and consumer users.
I discussed this platform concept recently in an article, Creating a Unicorn in Mobile Health: Moving from Efficacy to Scalability, which described the challenges and escalating opportunities for the next wave of digital health – and the need is even greater now.
EMR/EHRs and Analytic backend software systems must meet the growing demand for cost effective, transparent and actionable data. This demand is driven by an industry moving to “at risk” (Fee for Value) programs and new payment models. More and more data gathered from disparate sources will continue to soar over the next decade. However, healthcare systems are not yet prepared to handle the large volume of divergent data that will come from outside the hospital, nor are they organized to integrate and contextualize it effectively.
A New Digital Health Platform
Digital health and remote health monitoring solutions cover a wide spectrum of products and services. At the far end of the spectrum are traditional remote health solutions that have concentrated on the more costly patients in the healthcare system – the high risk / complex care population. These solutions have demonstrated efficacy over the years, but their higher cost and complex implementation have limited deployment to a broad population. To really impact the healthcare system, these solutions need to “shift left” into medium/moderate risk patients in order to address a greater population that aligns with new payment models, increased ROI, Quality of Care and Engagement.
On the other end of the spectrum is Wellness and Fitness. These solution providers need to move into healthcare to prop up sagging sales with narrow margins, like those in consumer wearables. Healthcare industry leaders realize the data sets from these consumer technology solutions do not significantly impact the level of care required for most patients. Even though the majority of these solutions are lighter in touch and lower in cost – their ability to really “move the needle” in the care of a larger patient population is minimal – again, the economics simply don’t work for their financial / business models. These solutions must “shift right” into the higher cost burden of the pre-chronic, working chronic and retiree chronic patients.
Scaling “left” or “right”, aligning the best fit solution with the patient needs to achieve the best outcome at the best cost – this is the real benefit of an integrated Digital Health as a Service Platform (DHAAS).
Moving from Efficacy to Scalability
Challenges still exist today that are significant barriers to scalability including:
Lack of interoperability between EHR and digital health solutions. Digital health solutions should integrate into the clinical workflow and back-end, however, healthcare providers simply cannot integrate the thousands of digital health solutions into their backend and make the timelines for delivery and economics work. Because of this, Health Systems will typically address the low hanging fruit and leave the rest on the vine and untouched.
There are 1000’s of digital health solutions to choose from Creating the Digital Health Marketplace with little to no characterization, alignment or stratification of which patient characteristics, environments, and situations will benefit the most from the solutions. Mis-alignment results in bad user experiences, low adherence, and poor ROI. On the other hand, limited integrated solutions can cause the healthcare provider to “cherry pick” patients to work with a given solution – typically those they already know, leaving the alignment and ROI at risk.
The bulk of chronic care is in the Senior population, and although 60% of Seniors have a smart phone, very few use them for much more than calls, texts and emails, and even fewer are utilizing it to help control their health.
The days of disconnected systems and platforms are numbered. In order for the industry to scale in the next 18-24 months, digital health solutions must be quantified, integrated, aligned and patients engaged on a common platform that allows those that are financially responsible for the patient to choose from a host of solutions, already accessible from their backend enterprise platform.
Health systems want to and must be clinicians first – not technicians. Offering a Digital Health as a Service platform and Health IT Middleware Framework will allow this transformational step to be implemented and scaled across their enterprise.
End users of these solutions need to be engaged properly – otherwise, the enterprise can save some time and money on implementations, but outcomes will still miss the mark and payment models will be at risk. The majority of consumers want to shop for and receive healthcare and medical services in a new way that doesn’t exist yet. Health systems want to select and deliver healthcare and services more efficiently. This new way is the DHaaS platform.
The Life365 Digital Health as a Service Platform is a big vision, but we’ve received validation from leading innovators in the industry – we are already rolling out the our solution with customers in practical phases. This platform is the engine that will produce an integrated Digital Health Catalog – and help drive the “Amazon of Healthcare”.
Until next time.