This is the third article in a series on individuality and inclusion in healthcare, pulling largely from interviews I conducted and sessions I attended at the HLTH: The Future of Healthcare conference in Las Vegas in May, 2018.
The first article dealt with how organizations can turn individuality into better outcomes by operationalizing inclusion. The second article examined how we can embrace individuality without making people feel or be vulnerable.
Along the way I’ve been sharing some of the indicators I use to help companies assess their own readiness to operationalize individuality and inclusion within and throughout their enterprises. I do that because I know from experience that without strategy, change is merely substitution, not evolution.
In this article I am looking at more innovations that help expand the scope of individuality in the way we deliver healthcare. Once again, we have significant and interesting advancements in technology and creativity in solving the massive challenges of caring for people’s health while keeping costs sustainable. And once again I will look at these advancements through the lens of someone who works with organizations at the leadership level – to help them turn these advancements into change that leads to evolution and better outcomes.
Sharing Insight Across the Continuum of Care – PatientPing
One question I ask healthcare leaders is whether or not their organizations have processes in place for getting to know patients as individuals, and then to make sure that knowledge is shared across the continuum of care. This first story involves an innovation designed to do just that – a method that operationalizes that kind of knowledge-sharing.
I met with Jay Desai, CEO and co-founder of PatientPing, a company that connects healthcare providers across the country through a network of real-time notifications to better coordinate care when patients receive ER, hospital, and post-acute care.
Desai used to work at the Center for Medicare and Medicaid Innovation, where he was trying to help providers work toward coordinating patient care across the continuum. But the major pain point for the providers was: how can I coordinate care for 3,000 patients who may be going anywhere on any given day? According to Desai, providers wanted a way to know when a patient checked into a hospital, a nursing home or home health agency, because that's the moment of opportunity to intervene and coordinate care.
As explained on PatientPing’s website: The average elderly patient sees seven different providers each year. Those with chronic conditions or serious illness can see more than 25 across unaffiliated facilities like primary care clinics, emergency rooms, hospitals, rehab facilities, and home health agencies.
PatientPing offers two products to address this challenge: pings and stories. Pings are real-time notifications when a patient gets admitted or discharged from anywhere. When a patient shows up at a hospital and then goes from there to a nursing home and then from there to a home health agency, that primary care physician will get pings about each of those transitions in real time.
If pings are where your patients are, stories are where your patients have been. When a patient shows up in the ER, PatientPing will flag all prior providers, tell the ER who the primary care provider is, and list any other resources that may be available to the patient. That becomes a story that’s available to the admitting provider.
“We're really trying to think about this system and how it's working for any given patient and stitch things together,” said Desai. “Patients should be able to get care from a lot of providers, and they shouldn't have to start over every time they go to a new provider.”
In other words, PatientPing is an inclusion enabler for the needs of the individual.
Learning and Responding to How Individual Health is Shaped – Intel
Intel is another company tackling the challenge of helping providers account for the realities of their patients once those patients are outside the walls of the medical facility.
Jennifer Esposito is worldwide general manager of health and life sciences at Intel Corporation. Bryce Olson works with her as a strategist and precision medicine pioneer.
“We are an ingredient company,” said Esposito. “You know us as a chip maker. But what we do as a health and life sciences team is work with the industry, with the ecosystem, to understand the unique challenges, the use cases and workloads that are in this industry, and think about how we can apply Intel technology to improve on those things and make it better.”
Olson said many healthcare delivery organizations initially want to improve costly, potentially preventable things: say, identify who's most at risk of needing a rapid response team while in the hospital, or who's at risk of getting sepsis. He described those initial goals as transforming the electronic medical record from serving as primarily a system of record into a system of insight.
That sounds like an obvious goal but it’s not always immediately possible. Esposito emphasized that they have to assess how technically capable an organization is, from an infrastructure perspective and also from the perspective of the manpower. Do they have data scientists, and are those data scientists open to learning new analytic methods? Not all organizations are ready.
Beyond using data for individual insight while in the hospital, Intel is also working with organizations to gain and integrate insight about patients’ lives outside hospital walls. Esposito and Olson shared innovations that are underway now in Chile – working with AccuHealth to do remote patient monitoring. As outlined in more detail here, AccuHealth, a Chilean-based startup, uses wearable sensors linked to a smart Intel-based monitoring device. Patients perform five-minute checkups throughout the day from their home or office, and that data is sent in real time to a data center where processors apply data mining and predictive modeling to identify and anticipate health concerns that need to be addressed. AccuHealth has what it calls a virtual hospital, which is a nurse who can take care of 50 patients at a time in this remote monitoring environment.
And there’s even more in store for the future. Olson said eventually people might be able to make requests from home, like an ultrasound to examine their stomach. “That's a big image,” said Olson, “so today it’s not realistic. But in the future you'll have this immersive conversation where you can almost feel like you're in the doctor's office but you're at home, in real time sharing big data files – whether it's imaging files or even some personal genomics thing that you've done and can send it over. It will really transform things.”
Ultimately the benefits include better health and lower costs, because problems can be detected earlier and ER visits can be avoided. What Intel is solving for is the role that data plays in bringing together the healthcare ecosystem to cut costs, to better manage health, to allow the individual to become their own self advocate for their own care.
Reducing Costs While Enhancing the Experience – Vitals SmartShopper
Another question I explore with healthcare leaders is whether or not their organization has processes in place for discovering how to manage costs in a way that doesn’t diminish the experience for patients and their families. How an organization tackles that challenge (or not) reveals a lot about its readiness for inclusion.
One of the companies I met with at the HLTH conference is tackling the cost issue in a way that not only doesn’t diminish the experience for patients, it actually enhances the experience with lower costs for procedures and incentive payments on top of that.
Rob Graybill is a vice president at Vitals. He oversees market strategy for SmartShopper, an incentive-driven program that rewards people with cash when they shop for and select lower-cost, high-quality facilities for treatments and procedures. SmartShopper gives people tools to feel empowered to ask questions and shop around.
“We want people to see themselves as consumers in the context of healthcare,” said Graybill.
But it’s not easy to break long-established patterns.
“At the end of the day, that patient is in the doctor's office by themselves or with someone who is a caregiver with them,” said Graybill. “Everything has been set up so they don't really have a voice. They're afraid to ask. They don't know what to ask.”
To help people get over that hurdle, SmartShopper is proactive. If you’re scheduled to have an MRI at the hospital, a SmartShopper Personal Assistant might call you and say: “Your MRI has been approved. It’s $3,000 at the hospital, but there’s a high-quality imaging center down the street where you can get the MRI for $750 and you’ll qualify for a $150 reward.”
Graybill is asking questions like: What does it take to get people to feel comfortable enough to break through referral patterns? As he put it: “We don't even really know what they're up against, in terms of the inertia of the system.”
So they’ve opted to do a lot of the work for people: SmartShopper Personal Assistants will cancel the original appointment, set up the new appointment, and make sure the claim doesn’t bounce (because now the authorization number is different). They offer to help arrange transportation to get to the appointment, and follow up with the patient afterward.
When you consider the various players in any given healthcare relationship – the consumer, the doctor, the employer that provides the insurance, and the insurance company itself – the consumer is the one finding the better deal in this scenario, to make the procedure less expensive for everyone.
“Shop with us, we tell you what your options are, and you decide where you want to go,” said Graybill. “That's why we feel the consumer should be rewarded. It's not the doctor. It's not the insurance company. It's the consumer who is making their own decision. We've had the consumer in the center of that from the very beginning.”
As you can tell from these stories – which are just a small sampling of what was shared at the conference – there is no shortage of innovation in healthcare. The words I heard the most throughout the event were "connectivity, trust, interoperability, value, quality." Those are lofty concepts. But those things can't happen without the healthcare industry going from silos to inclusion very, very quickly. That also means recognizing that we must bridge quickly from old school healthcare thinking to the 21st century.
Here is a collection of the questions explored in this article, to serve as indicators of whether or not your own organization is ready to lead individuality and inclusion as a growth strategy:
Are you ready to lead inclusion and individuality as a growth strategy? Click here to find out.
In the next article, I will explore the evolving role of employers as major players in improving health outcomes through individuality and inclusion.