Q1. Could you identify the major waves that have been forming in healthcare?
We are certainly experiencing an interesting time due to major waves that have been emerging in healthcare. These waves present both a challenge and an opportunity for technology and solution providers to excel in modern healthcare. I look forward to sharing a perspective on these major waves, including:
- The wave of omni channel engagement
- The wave of digital health solutions
- The wave of value-based care initiatives
- The wave of healthcare data proliferation
Q2. How did the wave of omnichannel engagement in retail and consumer goods impact healthcare?
Throughout the decades, transformative, technology-driven solutions have often originated in the retail and consumer goods industries before transferring into healthcare. In 2010, omnichannel engagement was initially predicted to significantly improve the experience of customers, gaining momentum with retail innovators including Macy’s, Best Buy, and Home Depot. An omnichannel approach places the consumer at the center of many channels of engagement experienced throughout their journey. Channels include all touchpoints, seamlessly interacting with consumers from digital web/mobile apps to brick-and-mortar locations. The proliferation of mobile devices, especially smartphones, helped fuel these initiatives, often incorporating IoT solutions to empower each individual along their journey. Like many trends, omnichannel engagement has transferred to healthcare to become a fundamental approach for unifying the health consumer experience throughout every care touchpoint.
Q3. How will the wave of digital health solutions optimally fit within the consumer journey?
Historically, healthcare relied on physical locations for interacting with patients in acute, post-acute, and ambulatory settings. Digital health has emerged to remove the barriers of these brick-and-mortar facilities, shifting access to healthcare into the hands of providers and consumers. Digital health is a relatively new field despite rapidly establishing many solutions incorporating features such as telehealth, remote patient monitoring, decision support, and even AI/ML-driven chatbots. While these applications are exciting, many are missing the mark. The inevitable truth is that most digital health applications are “point solutions” that serve a single, fragmented purpose without fitting within an overall technology ecosystem. In addition, the applications frequently maintain their own islands of data. The result is a wide array of disconnected health technologies and solutions spread across the care continuum from physical locations to digital health applications.
Q4. How does the wave of value-based care initiatives, includingpopulation health affect opportunities in healthcare?
According to CMS, US healthcare spending in 2020 surpassed $4 trillion, resulting in approximately 20% of our Gross Domestic Product (GDP). With the increasing numbers of the aging population and escalating healthcare costs, CMS has placed a significant focus on establishing an array of value-based population health models to reduce the overall cost curve. These models are grounded in paying providers with greater financial upside based on quality rather than quantity of care for their patients.
Technology enablement is a clear opportunity in value-based care and population health since it is essential for achieving levels of success. Once clinical resources, processes, networks, and incentives are well established, it is paramount that these areas are empowered with the right technology in the right place at the right time. This requires a healthcare technology ecosystem that is unified and accessible across the care continuum.
Examples of Payment Models
- Fee-for-Service – The original model for reimbursing based upon each service performed on a patient
- Pay-for-Performance (P4P) – Compensation based on specific metrics for quality and efficiency
- Bundle Payment / Episode – Single payment for all services allocated by patient procedure or condition
- Shared Savings – Providers analyze costs to receive incentive payments based on actual savings
- Shared Risk – Similar to shared savings with downside risk and larger upside incentive payments for savings
- Capitation – Full risk with an assigned payment per patient tied to expected usage and level of risk
- Provider-Sponsored Health Plan – Full risk is assumed for a population collecting insurance premiums
- Direct Contracting – Creates value-based payment arrangements with providers for Medicare patients
Q5. How has the wave of healthcare data proliferation created both a dilemma and opportunity?
The HITECH Act was released to promote the deployment of Electronic Medical Records (EMRs) for each healthcare provider, ensuring that written files are converted to a digital format within an EMR. As a result, an endless array of EMR platforms have been separately deployed in locations throughout the spectrum of care, driving the fragmentation of patient health records. Mobile health applications have also become prevalent, adding to the further proliferation of data without sufficient integration to share their data. These factors have created a significant dilemma in healthcare since each consumer has a wide array of fragmented health records spread across many platforms. As a result, technology and solution providers have an opportunity to ensure sufficient interfaces are in place to share data for a unified patient record. Doing so can empower all stakeholders at all levels of care to stay on the same page regarding each patient’s history, plans, and goals.
Q6. What is the ultimate strategy to succeed with technology-enabled healthcare solutions?
If you imagine four major waves converging from the north, south, east, and west into a central point within the ocean, the outcome would be considerable chaos for an individual on their journey. At the same time, if it were possible to align and benefit from the four major waves to act in harmony in the same direction, the individual would seamlessly propel forward.
Overall, the destiny of our healthcare system relies on the ability of technology and solution providers to excel along the four major waves. They must learn from the wave of omnichannel engagement approaches where the healthcare consumer is at the center, seamlessly interacting in a unified user and data experience. They must apply the wave of digital health solutions while recognizing those at the trough of disillusionment and ensuring their data is sufficiently shared. They must become knowledgeable in the wave of value-based care initiatives to offer a value proposition that can enable financial upside for various stakeholders. And, finally, technology and solution providers must address the wave of healthcare data proliferation by ensuring information is exchanged with a unified patient health record to empower every stakeholder at every level of care.