- As health IT professionals look at ahead to 2019, they should expect an ecosystem that is consumer-centric and that reflects the patient-centricity that so defines chronic disease and care management, according to Chris Zant, the digital leader for Life Sciences at Deloitte.
The app store has long been home to thousands of tools targeted at improving patient engagement, explained Zant, who’s 24 years of experience with life sciences tech has informed his predictions for the year ahead.
Between those apps and the numerous other patient engagement tools available to both patients and providers, the market was filled.
But as healthcare becomes more sophisticated, those apps and technologies will become refined and will therefore be better at engaging and empowering patients. In short, those tools will become more useful for patients as healthcare consumers.
“Instead of 20,000 or 200,000 apps in the various app stores that nobody is using, we're going to get a more consistent approach to advocating for patients, to engaging patients, to enabling better decision-making through the technologies that are available to us in so many other parts of our lives,” Zant said in an interview with PatientEngagementHIT.com.
The technologies and capabilities that emerge will be the ones that fit the overall industry trend of consumer-centricity, he added. Increased patient financial responsibility and outcomes-based payment models have led to a culture of patient- and consumer-centric care models that integrate the patient as an integral member of the healthcare equation.
“We spend a lot of time getting very engaged and consumerized and digitized in our life in many other spaces,” Zant stated. “Now, over the past couple years and looking forward, we continue to expect the patient part of us to become consumerized.”
The transition to consumer-centered healthcare has been happening for several years, especially as patients have absorbed more of the costs for care and have become exposed to technologies that have overhauled retail experiences in other parts of their lives.
The difference now is that healthcare is poised to meet those expectations.
Healthcare has much more of the data and information necessary to meet consumer-centered care expectations. And although the mechanisms for accessing and then using that data have not become necessarily “easy,” Zant said they have become more functional.
And as a result, the healthcare industry will see single stream healthcare technologies that serve the patient. Just as patients are beginning to seek care from integrated providers and payers – Kaiser Permanente, for example, or Highmark in Pennsylvania – they will look for a single stream technology suite.
Currently, patients have access to their online patient portals, digital clinician notes, online scheduling systems, claims data portals, and numerous other engagement touchpoints. And while these technologies have been useful in connecting the patient with their care, the industry can expect a push for a unified experience.
“You can see that rationalize into a model where that entity providing your healthcare, paying for your healthcare, and providing all that support around it gives you one interface,” Zant explained. “An ecosystem where you can see your lab results, book your next appointment, get information on your disease state. Possibly get information on drugs and treatments, all coming together in an app, a portal, or a single set of tools that you might use.”
Patients will want to engage with their providers, navigate their healthcare themselves, and still engage with their payers all over the same technology interfaces.
That technology might become more agile and better equipped for patient activation in healthy decision-making, Zant continued. Instead of using a blood glucose monitor and looking at that data, the patient will be able to plug that data into their patient portal and receive insights from the device.
An app for diabetics that takes photos of food will not only input that data into the EHR, but will also nudge the patient toward healthier options or give recommendations for insulin, for example. These changes will align with healthcare’s foray into personalized medicine, a priority providers have pushed to create better outcomes for patients.
“We can have a better disease journey if we're able to leverage the incredible amounts of data that are out there,” Zant explained. “If you can combine data sets and use them real time to help define your disease journey, you can actually have different interventions.”
Of course, creating a single stream and personalized technology experience comes with its challenges. Health data interoperability will continue to be the single largest hurdle toward technology innovation, despite the advances the industry has made in data sharing.
“How do we absorb the data from the EMR, combine it with the data from the sensor, maybe accumulate it with other data about your lifestyle? Did you exercise this morning, how many steps have you taken today?” Zant queried.
“You can imagine the data sets,” he noted. “But how do we really move to a holistic view of the patient in their disease state, such that we can act on it using analytics and more robust tools to do so with those behavioral elements?”
Additionally, providers will need to leverage all of this data and technology while maintaining human connections, Zant said.
“You can have a much better journey through diabetes if you can address some of the behaviors that cause that disease state to go badly,” Zant pointed out. “Not being healthy, not being physically fit, eating the wrong foods. You're not necessarily going to cure your diabetes, but you can certainly mitigate the risks of your condition if you address those problems.”
At the crux of these engagement tools is personal behavior change. A streamlined patient engagement tool will only work if the patient chooses to use it, and that will require patient motivation.
“We're hard to influence, right?” Zant continued. “People have behavior patterns that are established over years. Many of the more chronic and difficult diseases arise at least well into your life if not later in your life when those behaviors are entrenched and established.”
Here, too, technology can help, Zant contended. The healthcare industry doesn’t allow providers enough time to make the meaningful patient connections that will make patient engagement technology more worthwhile. But through the plethora of patient data at providers’ fingertips, health IT can make those limited interactions more meaningful.
Going into 2019, providers should look to this patient data to target their patient interactions, deliver more individualized patient education, and make the most of the perhaps 10-minute interaction with the patient.
And in the future beyond 2019, Zant noted that these technologies could also even automate the patient activation factor. While an app is only as good as the patient chooses to use it, Zant said there may be a future where a patient can opt into having a wearable track their data automatically.
“You might consent at the beginning to say, ‘Sure, keep an eye on my heart, let me know if I have an irregular heartbeat at some point and then maybe I can engage with my doctor,’” Zant said. “If we can do more of that, if we can do the automated monitoring or use intelligent devices, we could overcome patient activation questions.”
This will create an ecosystem where the burden on the patient to change behavior is less, but the ability for the patient to learn and share information is more.
Although the pace of change is great, Zant noted that these are just small steps on a larger innovation journey.
“The pace is fast. The changes are happening,” Zant concluded. But we're continuing along a 10- or 20-year journey to health care that will look entirely different. We'll see very meaningful, but for the moment somewhat incremental, changes along that journey.”