I2W (Illness to Wellness) Technology - Continuum

Background

Never before has the healthcare industry witnessed such a rapid and profound increase and diversity in technologies. Fueled by federal and state governments’ quest to manage costs (Affordable), incorporate the underserved - who are often the most sick, and the subsequent drive toward best practices such as evidenced-based medicine (Accountable) to the explosion of consumer technologies and platforms such as Fitbits©, Health kit by Apple and Healthcare Platform by Samsung, the continuum of healthcare products is vibrant if not overwhelming. Healthcare delivery systems of all sizes, the healthcare insurance industry and governments at every level are investing heavily in information technologies to meet government directives and to enhance the patients experience in an increasingly competitive marketplace.

Coordinating the fragmentation of provider, facility, payer, regulator and personal technology is the challenge for everyone in healthcare. Furthermore, the emphasis is changing from reimbursement to caring for illness, to reimbursement for maintaining wellness and preventative care.

In addition to technology overall, the adoption of wellness technologies are exploding. Moreover, while consumer adoption of these technologies is real and transformative, there are forces that will bolster adoption into the healthcare culture:

1.      Patient Satisfaction

Patients expect and demand technology become part of their care and their care delivery system. From self-service online appointments to advanced robotics for clinical procedures, customers perceive technology as a differentiator. For healthcare systems, technology is mandatory to stay relevant.

2.      Newer Paradigm

Hospitals, the traditional acute care centers, are under pressure to change the model from “fee for service” to “population management”. (Market segmentation?) Encounter-based technology must shift to population-centric (read: patient centric) technologies.

While this change happens slowly, smart organization are utilizing technology to lower length of stay (LOS), readmissions, etc.

 

 

This article contemplates never models that we need to pay attention to, Consumerization (of healthcare) which is going to demand that the industry focuses on wellness.

Challenge:

Hospitals want to maximize value from the acute care settings before the reimbursement model changes; Insurance companies want to retain the customer base and technology companies want to sell consumer devices. At a macro level, these are powerful forces, but without a patient centric platform we are heading toward an environment where none of these very powerful and meaningful technologies can be taken advantage because of a lack of “a platform” or “a continuum” for the patients/customer.

 

Solution:

In this emerging environment, the aware organization can visualize and apply technology as an integral partner in a patient’s life – from wellness to illness and back to wellness! The strategy is to develop a platform that allows anyone to traverse this continuum using technology - let’s call it the “Illness-to-wellness technology” continuum.

Illness to Wellness Technology Continuum

To illustrate this concept, figure 1 highlights “technology” encounters (listed vertically) along the illness to wellness continuum. Customers interact within this continuum in 4 specific groupings listed across the top: Admitted Patient, Patient, Member of Patient Population, Member of General Population.

Figure 1

Beginning at the left and moving along the continuum to the right, we identify four major categories

·        Admitted Patient

·        Patient

·        Member of  a Patient Population (may be more than one)

·        Member of General Population

Admitted Patients will use in-room technologies to request services, ask questions, receive responses, provide ‘live' feedback – in short, engage in their own care. Patient-engagement technology is complemented by connecting the care giver to the patient primarily through the application of electronic medical records (EMR) technologies, facilitating and enhancing communication between care giver, patient and multiple hospital systems such as lab, radiology and pathology. The care-giver continuum broadens when technologies such as  eICU/eConsults are incorporated for enhanced outcomes management and moves the continuum to the home.

This also accommodates for all interactions associated with being a patient (ambulatory or inpatient), like consent documentation, scheduling, payment and registration. 

Because there are incentives to keep patients out of the most expensive acute care setting – as we move right along the continuum - the patient population must be cared for proactively through technology such as e-visits, vaccination reminders and other disease management technologies.  Effectively engaging, attracting and caring for the general population into the wellness pool becomes critical for hospital systems. Engaging in social media, integrating consumer devices in personal and enterprise EMR’s play an active role in keeping them healthy.

As public and private payment models evolve toward a covered-life (defined covered life) paradigm, engaging the general population to keep them healthy becomes increasingly critical.

 There is tremendous interest in the Medicare payment data (http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html) that is released by the Centers for Medicare & Medicaid Services. Software applications are being developed to compare costs and outcomes that will expose “bargains” (or value). This will be yet another disrupter that is part of this continuum.

Conclusion:

The goal is to keep the population healthy and help the ill move towards wellness in this continuum. Technology plays a powerful role, a modality, to shepherd one from illness to wellness. Understanding the  Illness to Wellness Continuum is critical to ensuring technologies are meaningfully integrated and better yet - exploited to provide the value we are all expecting to see in healthcare – which is already leading to consumerization of healthcare.