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.
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.
