The Rise of Connected Health as a Strategic Imperative
TERRY MAYTIN | VP, Market Development & Commercialization]
Rising complexity and challenges are everywhere across the entire healthcare landscape. Health transformation is well underway and accelerating. Consumerism and web/mobile adoption are at record levels. What is the role of digital strategy amidst all this change?
The Affordable Care Act (ACA) kick-started the shift to value-based reimbursement, driving greater standardization, system efficiency, transparency, accountability and quality of care in order to achieve Triple Aim goals. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) along with a dizzying range of CMS and commercial payer payment programs has dialed up the volume to eleven.
Innovation on such a grand scale has created a much larger playing field for Digital Strategy to affect… with far larger impact potential. Payers and providers must embrace digital solutions to improve outcomes, close gaps in care, and prioritize wellness rather than simply bringing in more patients.
Not surprisingly, nearly half of healthcare organizations say they are behind (or lack) a digital health strategy (Validic survey, August 2015). For those seeking to partner vs. build on their own, options are numerous but require extensive due diligence. The healthcare services vendor space is crowded with mHealth entrepreneurs and traditional players offering care collaboration and population health solutions. Most players are targeting the same customer sets (payers, providers and pharma) with similar value props:
- Support value based care mandates
- Connect patients and care teams
- Improve patient outcomes (individual and aggregate)
- Reduce avoidable costs (readmissions, adverse events and ER visits)
- Eliminate inefficiencies (workflow and operational)
New entrants are often finding commercialization more challenging than expected with much longer business development timelines in their quest for internal sponsors. To be fair, payers and providers are often deluged with multiple potential vendors. Care models are still evolving, and RFPs aren’t fully baked. Healthcare organizations’ goals and ROI expectations differ as well depending on their degree of digital sophistication.
By now, most Healthcare leaders are aware of Digital’s theoretical potential to positively impact value-based care outcomes (e.g. quality scores, more engaged patients, fewer readmissions, etc.). Essentially, the most valuable product capabilities to support value based care must have many, if not all, of the following characteristics:
- Intuitive, easy to use, available to all provider roles to fully embrace it
- Cloud-based, hardware agnostic (web and mobile, Android and Apple)
- Connectivity to multiple EMRs / organizational data / systems
- Rich dashboards and data visualization
- Ability to transform data into actionable insights including gaps in care alerts (real time at point of care OR post-discharge) and predictive analytics (population OR patient-specific due to trends)
- Enable seamless patient-centric care coordination across disciplines / sites
- Remote patient monitoring (e.g. adherence, PRO, vitals tracking via wearables) with rule based alerts for early detection and proactive outreach
- Facilitate direct provider-patient communication (secure messaging, televisits)
For Health Plans actively transitioning towards value-based care, digital strategy should consider solutions for all key stakeholders, recognizing benefits to each will differ:
- Tools to proactively engage patients outside the hospital setting
- Access to data if/when necessary to help with quality measurement (e.g. out of network clinical information and claims)
- B2B payer/provider capabilities (reports, dashboards, information, inquiry and issue resolution)
- Excellent service experience to proactively manage their benefits
- Ability to seamlessly access via channel of choice
- Provider engagement and behavior change management tools
- Member service: Ability to serve customers efficiently and effectively regardless of channel
- Analytics: Integrate digital with enterprise data (individual or population)
- Ability to assess effectiveness/performance of new VBC plans
- Sales and marketing: Develop value story (comparative effectiveness and advantages) and give brokers tools to effectively demonstrate VBC plan benefits vs. traditional offerings in consumer friendly language.
PBM partners / Pharma:
- Patient tools to optimize medication therapies, adherence and risk management (MTM, reminders, interaction checkers, education)
- Data analytics to assess utilization and impact of drug utilization on medical spend /clinical outcomes (CER, HEOR, ePRO, trial recruitment)
Medocity, headquartered in Parsippany, New Jersey, is a recognized leader in comprehensive virtual care products and services including chronic condition management, televisits, and remote patient monitoring. Our unique, innovative technology combines multiple telehealth capabilities onto a single, integrated care coordination and management platform, along with robust clinical intelligence including rules-based algorithms, alerts and decision support tools to help drive earlier detection and proactive interventions.
The Medocity platform is specifically designed to enable and improve patient-centered care delivered outside the hospital setting, particularly for patients at home who have chronic conditions responsible for more than 80% of the nation’s annual healthcare spend. By promoting patient-clinician engagement through shared connectivity and virtual technology, we enable rich, real-time interactions between patients, clinicians, care professionals and support teams. Virtual care. Real outcomes.™