The State of Health Care: Challenges and Opportunities

The healthcare industry is being disrupted from multiple fronts and transformed right before our eyes. Consumerization trends, emerging technologies, and new players entering the space lead this new digital transformation, creating a perfect storm that will leave the industry completely changed within the next few years.

The Consumer

Perhaps in no other time in recent history has the consumer had so much power to demand a radical change of so many industries, healthcare included. The healthcare industry is now seeing the shift to consumerization that the retail and hospitality industries already experienced. With millennials, generation Xers, and baby boomers entering new life stages, the demand for new experiences tailored to their needs is rising.

As the largest labor force in the U.S., millennials look at the patient-provider relationship differently than previous generations, forcing providers and hospitals to re-think the way they engage this starkly different generation. In addition, a shift from fee-for-service to value-based health care also seeks to place the consumer at the center of the experience. While the status quo leaves the consumer with a sub-par experience, frustrated and confused as they try to navigate the complexities of the industry, value-based care puts them at the center of and supported by a coordinated care team that partners with them as they traverse the system. A value-based approach to care also addresses the lack of incentive for providers to coordinate care with other health professionals by empowering them with the technology that gives them access to data across the entire healthcare system.

In the end, the patient no longer must settle for the “just the way it is” mantra; instead, they may evaluate their patient-provider relationship based on the new standard: the value received by a better health outlook. Providers and payers all work together to make what the consumer pays based on quality and patient health improvements. Under value-based care, integrating data points such as social determinants of health (SDoH) become imperative as providers and payers seek to gain a holistic view of the patient.

Emerging Technology

As the consumer moves to the center of the experience, technology continues to be the enabler to make supporting use cases a reality.

Wearables

With the diversification of the wearables market, more products are jumping into the health and medical space. This shift of wearables from fitness to clinical is made possible by health-related features such as the ability to measure blood pressure and track sleep patterns. An example of this development is the Apple Watch, which offers groundbreaking features like a built-in electrocardiogram (ECG) and fall detection features. The latter is already becoming an invaluable asset for consumers. Hospitals and other health care providers are increasingly evaluating wearables to monitor patients and give the provider a look into the patient’s day-to-day life without having to be right in front of the patient.

A twist in the wearable market is hearables, a hybrid technology that combines the advantages of wearable technology with the form factor and functionality of headphones. Many companies are still trying to actualize the use cases and long-term role this technology will play in the marketplace. Notwithstanding, a combination of wearable and hearable technology could improve the accuracy of the collected data that providers would use to make meaningful decisions as they diagnose and treat patients.

Telehealth

There is no more widely adopted emerging technology than telehealth. Leading electronic health records (EHR) vendors, such as Epic and Cerner, have implemented offerings that provide telehealth services, with providers and hospital systems conducting successful pilot programs aimed at making telemedicine a part of their regular offerings. In addition, all major commercial payers now cover some form of telemedicine visit.

Perhaps there is no other greater beneficiary of this technology than rural areas. According to the Centers for Disease Control and Prevention (CDC), about 15% of the entire U.S. population lives in sparsely populated areas with low housing density, often hours from urban centers. Generally, people living in rural areas come from lower socioeconomic levels and are less insured. Telehealth connects rural providers and patients to services at a remote location. Despite the shortage of medical specialties in rural areas, telehealth bridges the gap between a rural primary care provider and a specialist at a remote location. A patient who once was required to travel to an urban provider or hospital to receive the care of a specialist can now partner with their local doctor without travel to receive the specialized care they need.

The Health Information Management Systems Society (HIMSS), which supports the transformation of the health ecosystem through information and technology, offered a number of educational tracks during its annual conference this year. They discussed how to design and launch effective and sustainable telehealth programs, indicating an interest in formalizing this practice across the industry.

Artificial Intelligence

As industry professionals continue to investigate the potential of artificial intelligence (AI), advancements in this technology make it an excellent fit in the healthcare space. One of these use cases is around imaging and diagnosis. Examples include the doc.ai platform, which aims to help predict health risks by reading patient pictures, the GE Edison platform, whose AI-powered apps and devices help with scan consistency and accuracy, and many more. This will help imaging professionals arrive at better diagnoses, which lead to improved outcomes—for example, early detection in certain types of cancers, Alzheimer’s, and other diseases.

This technology also shows great promise in the pharmaceutical sector. The process of discovery, development, and commercialization of new drugs can all be improved by leveraging AI:

• Discovery helps in the identification of therapies to treat more diseases.

• Development in the screening of clinical trial patients leads to more accurate results.

• Commercialization in the personalization of medicine leads to better precision and predictive medicine.

Finally, industry leaders are also applying AI technology in the cybersecurity space. The healthcare industry is not the only industry that has to deal with constant cyber threats, yet with over 500 data breaches in 2018, up three times from 2017, it still struggles the most to address its cybersecurity issues. AI cybersecurity tools can detect and thwart threats by continuously monitoring network behavior and identify network anomalies.

Blockchain

In less than a decade, blockchain has become one of the most promising technologies of our time. At its core, it answers questions around digital trust, data privacy, and security as it records and tracks information being shared across trusted entities. With 40% of health care provider records containing errors or misleading information, the technology could help centralize all information in a way that could be maintained while avoiding data duplication and inaccuracies. In the pharmaceutical space, industry leaders are exploring the use of this technology for the tracking and flagging of counterfeit drugs that plague the market.

The challenge of blockchain is that, for it to be effective, trusted entities have to agree to join the blockchain. There are several efforts underway aimed at enabling healthcare blockchain and promoting information sharing. While the benefits of the technology are yet to materialize in a tangible way, blockchain has the greatest potential to revolutionize the industry.

New Players Entering the Space

Outside players entering the space may be the largest catalyst for change. Companies such as Amazon, Apple, and Uber have all indicated their interest to break into the industry. Amazon purchased online pharmacy, PillPack, and announced that it would form an independent healthcare company for its employees in partnership with Berkshire Hathaway and JPMorgan. Apple has updated its Health app to display medical records from 39 hospitals and added an ECG feature to the Apple Watch. Uber has launched Uber Health, a new tool that allows providers to book rides for patients and caregivers.

The common denominator of these new players is their ability to keep the consumer at the center of the experience. By entering the industry through different channels and with different goals, outside players entering the space create the conditions to maintain the momentum of the ongoing disruption.

It Is Still About People

Health care has been and always will be about people. There is no single technology or trend that can solve the challenges the industry is facing because it is ultimately a human problem. The change management aspect is a daunting task, considering that many providers are not fully digital and those that are might still be getting used to navigating their EHR. As with digital transformation in any industry, the biggest challenge is maintaining the focus that, while it is all about the consumer, the process of getting from here to there involves people buying into the vision and embracing the change that is needed. Beyond the ADKAR model, it also needs to be at the core of why providers joined the profession in the first place: to help get to better health. In the end, it is a conversation that a provider has with the patient as they partner together to achieve improved health.

Looking Forward

Healthcare is changing rapidly at a rate not seen before, and it will leave the industry unrecognizable from its former self. It’s an exciting time to be working in healthcare technology, and there’s great hope for the future. As technology addresses more and more use cases in healthcare, technologists can be at the center of the change. If you’re investigating how to address some of the challenges and opportunities in the healthcare space, feel free to reach out to us at findoutmore@credera.com.

• Transformational Change
• Healthcare