Top ways payers, providers use tech to improve care

October 4, 2017

How payers, providers are improving work flows, patient care, and cutting costs.

The goal for many healthcare technologies is the same as for other gadgets: to meet consumers where they are and become a part of their everyday life. The marketplace for technology-enabled care is wide-it includes everything from wearable sensors that monitor patient vitals to end-to-end population health platforms that stratify data.

Technology-enabled care that makes primary care more accessible and less expensive includes sensors and applications that attach to and are incorporated with mobile devices that then send data to providers. Several technologies-including remote patient monitoring from Vivify Health for chronic heart failure patients, a renal care management platform from Cricket Health, and a mobile application from Deloitte prescribed for diabetes patients-aim to use mobile devices and sensors to curtail chronic disease and increase program adherence, says Dan Housman, chief technology officer of ConvergeHEALTH, a health and life sciences software consultancy created by Deloitte.

On the payer side, technology-enabled care includes add-on technology to existing software that streamlines claims and clinical data, Housman says. Horizontal tech players such as Salesforce are working to connect back-end provider systems with payer systems to coordinate care at lower costs. On the EHR side, Cerner and Epic are consolidating with smaller, specialty systems in order to work more efficiently with payers.

According to research by McKinsey & Company based on 2014 healthcare expenditures, technology-enabled care could shave up to $220 billion per year off primary care expenses with widespread use, and an increase in automated and self-service technology in healthcare could save up to $48 billion annually in productivity. New revenue streams brought about by tech-enabled care, including remote patient monitoring and telemedicine, could add $13 billion to $24 billion in revenues.

Deloitte’s 2016 Survey of U.S. Healthcare Consumers found that people of all ages are becoming more open to tech-enabled care. They survey found that seniors show a growing interest in remote monitoring technology, and millennials with chronic diseases are more interested in telemedicine. Fifty percent of survey respondents said they are interested in using telemedicine for post-surgical care and chronic disease monitoring. The survey also found that more than 80% of adults want to receive care at home, if possible, a fact that makes self-regulated and continuously monitored technologies an increasingly important part of care models.

“There has been a big shift in mobile utilization combined with sensors and artificial intelligence. We are starting to see more engagement to the patient on the channel of their choice,” Housman says, adding that in the future, healthcare technology will aim to take advantage of chat and voice-enabled engagement already present on platforms such as Facebook and Google.

Next: Making tech make sense

 

 

Making tech make sense

Healthcare organization must begin forming tech-forward strategies, says Kimber Lockhart, chief technology officer at One Medical, which helps patients virtually interact with physicians. “As patient care moves from episodic to continuous care, it will be extremely difficult to have high-quality patient care that isn’t tech enabled,” she says.  

Lockhart cautions that organizations must understand the needs and lifestyles of their patients first, before investing in technology because of its bells and whistles. “Tech-enabled patient care isn’t only about the technology. It’s also about integrating the design process,” she says. “Healthcare organizations often make the mistake of selecting the technology first to support a current, inefficient process; or trying to shoehorn the process into the capabilities of a popular software product. This is why it’s important to develop strong design and technology integration and/or development capabilities in-house.”

Forward-thinking and flexible providers are a big part of making tech-enabled care programs work, as they will need to iterate their work flows to make the most of technology. The most successful organizations will have a culture that values continuous improvement over day-to-day familiarity, Lockhart says.

“I see tech-enabled healthcare as care that is enhanced in quality, made available regardless of location, and stretched from episodic to continuous care through thoughtful integration of technology tools,” Lockhart says.

Next: Barriers to adoption

 

 

Barriers to adoption

Though technology can move at the speed of light, healthcare organizations often face barriers in implementing innovation. On the payer side, many health plans struggle with adapting new technologies to old systems. “Payers have a handicap because there are so many poorly integrated legacy systems. Many of the tech-enabled solutions are to build back-end systems to integrate clinical and claims data,” Housman says. “A lot of the strategy is to just get the data right, and exposing the data to other data in a way that is consistent.”

Lockhart adds that technology costs and slow adoption can deter health organization from investing in technology. “Healthcare is traditionally amongst the slowest of major industry players to adopt and effectively utilize technology. To support technology-enabled care, it’s important that plans begin to recognize technology-enabled care channels (video, home monitoring, etc.) as cost-efficient alternatives to office visits,” Lockhart says.

Eric Rock, CEO of Vivify Health, a digital health company, says a lot of organizations struggle with having the “operational elements” in place to engage with patients using technology. “Operational elements can include a small team of clinicians to monitor and intervene when necessary. Sometimes these teams also play a larger role of care coordination across partnered provider and payer organizations. In all cases, it is necessary to assure seamless work flows for proper stratification and overall care management,” Rock says.

He says tech-enabled care models should include call center strategy, seamless work flow and IT integration, and a multi-tenant architecture enabling health plans to offer a single platform white-labeled across all partnered providers.

“Most importantly, there needs to be the ability to continually improve best practice care plans to accomplish high engagement levels and a reduction in high-cost clinical care,” Rock says.

Next: Measuring results

 

 

Measuring results

Patient adherence usually increases, and hospitalizations decrease, when technology is used to monitor and engage with people, says Rock. Subtle changes in patients can be identified by care teams, and physicians can intervene before a trip to the hospital is necessary.

“A primary reason why patient adherence is increasing with these programs is because they can quickly connect with clinicians, on request of the patient or on automated alert escalation by care teams,” Rock says. “A good remote patient monitoring program can keep patients out of the hospital and in the comfort of their own homes.” When signs of deterioration become evident through a patient’s continual biometric, health, and education assessments, for instance, care teams can intervene with often modest therapies, he says.

“The bottom line is how much is being spent and what is the return,” says Housman. Organizations need to calculate the per patient cost for technology, and the relative return, which could be cost savings or a reduction in complexities in claims, he says. “It is important to run programs quickly enough to get feedback because it’s not a one-size fits-all approach. Some technologies will be used differently for certain segments of patients. A closed-loop analysis can help you determine if impact is cost alone or benefit to patient alone.”

Donna Marbury is a writer in Columbus, Ohio.