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October 22, 2015

Defragmenting the Healthcare System With Connected Care

Posted by Sanjay Dalwani (View Profile | View All Posts) at 11:53 AM

Defragmenting the Healthcare System With Connected Care

The US healthcare landscape today is quite fragmented. As a result, care delivery too is fragmented. What does this mean? If one patient has varying needs arising from one medical condition, each need will more likely be addressed in siloes by specialists. Many times, it's not because physicians want to work this way. It's because they do not have access to that one source that has all the information needed for a comprehensive picture of the patient. Even physicians who have access to this data through Electronic Health Records (EHRs) may not have access to the infrastructure necessary to transfer it to another physician who needs it. Little wonder then that close to 95% of America's healthcare providers state that one of the biggest obstacles to becoming interoperable is their limited ability to share data with each other - a factor that can create big lacunae in a patient's treatment.

This system of healthcare delivery that has prevailed until now is not a sustainable model, with a growing population, especially of Americans above the age of 65, who has increased by 15% in the last decade - and who require healthcare treatments and effective medicines for more ailments as they grow older. Adding to the demand for a more effective approach to reduce fragmentation is the renewed patient-centric focus. One emerging healthcare model that I believe encompasses features to support these needs and can become the future of the healthcare industry is Connected Care, which facilitates a more seamless connection among patients, healthcare providers and payers with a single focus - addressing the overall healthcare needs of the patient.

The need for Connected Care in healthcare is further catalyzed by ObamaCare (the Affordable Care Act). How? According to a report by the US Census Bureau and CDC, post ObamaCare, the number of insured have increased - the first half of 2015 saw about 11 million getting insured. This means that the US healthcare system has to defragment and accommodate the care needs and data generated by the growing number of insured. This is possible with an approach where all those eligible for healthcare can be cared for through Connected Care.

Two Connected Care enablers, telehealth and mhealth, have seen widespread adoption across the US. Payers see a lot of promise in both areas, and are encouraging healthcare system players to adopt them. With telehealth, physicians can provide healthcare to patients without unnecessary hospital visits - a key factor that influences their incentives in value-based system the industry currently follows. It also enables patients to receive treatments for non-life threatening urgent healthcare needs (which make up about 70% of the visits to emergency rooms) anytime, anywhere. A PwC report states that about 10% physicians see the potential for these e-visits to replace in-office consultations.

What's more, patients and physicians are comfortable with telehealth. Based on a 2013 Consumer Survey Segmentation by the Deloitte US Center for Health Solutions, about 52% participants were at least somewhat comfortable with video chat based physician consultations. Nearly 62% were at least somewhat alright with healthcare professionals addressing concerns through texts or emails. A study by PwC reveals that about 75% physicians are willing to prescribe apps that help patients manage chronic ailments like diabetes, and nearly 79% physicians and 50% patients believe mobile devices can enable better care coordination. This is a key step forward towards making healthcare more connected and giving patients a better chance at a better outcome. Telehealth also connects physicians with patients in remote locations requiring immediate healthcare interventions through specialized services like Telestroke for stoke patients.

Massachusetts General Hospital and Brigham and Women's Hospital have together, created Telestroke, which enables their specialists to examine patients remotely, connect and liaise with other healthcare professionals and prescribes the timely administration of medicines and compounds like tPA, a protein that helps reduce clots in ischemic heart conditions and eventually reduces the chances of stroke-related complications. "I can examine someone very interactively with the help of a physician or a nurse on the other end and I can make a determination of the stroke severity and the type of stroke by looking at the patient and at the brain image... It's almost like being in the room," states Dr. Lee Schwamm, Massachusetts General Hospital. Specialized telehealth services like Telestroke are critical, especially since - as we saw earlier - the US has a fast increasing population of those over 65 who have a need for such services.

Wearables are another type of enablers here to stay. The sensor-based data generated by wearables, when enabled with the right analytics tools, can yield valuable information. A few healthcare organizations are leveraging these devices, thanks to the benefits they deliver. For instance, Dignity Health is using Augmedix's Google Glass program to update EHRs with patient information. Their application value is not just being understood, and appreciated, by physicians, but by consumers too. According to a report by PwC, about 56% of the survey participants stated that wearables have the potential to increase user lifespan by about 10 years. This indicates that the consumers, who are ultimately the adopters and possible future advocates of this technology, see benefits in using it. In the long run, these advantages could translate into visibly and measurably better quality of health and wellbeing.

The full potential of wearables can be unleashed when paired with a telehealth system that allows physicians and payers to leverage the information generated by devices into treatment plans, prescriptions and health insurance plans that can ultimately benefit the patient. According to Daniel Garrett, PwC's health and IT leader, "Digitally-enabled care is no longer nice-to-have, it's fundamental for delivering high quality care." All these drivers are powerful change-agents that will continue to challenge the healthcare industry to integrate Connected Care enablers at a very deep level and defragment for a more seamless care delivery ecosystem.


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