PRESENTER
Greg Caressi
Senior Vice President,
Transformational Health
Frost & Sullivan
SESSION ABSTRACT
Riding the hype wave, hundreds of companies are labeling their products as population health management solutions. Reaching population health goals, however, requires a focus on the individual, in terms of health data, analytics and individual intervention techniques, technology, motivation and interactions. Much has been written about personalized medicine in the pharmaceutical sector, but personalization also applies to many factors impacting health outside of the healthcare system, and a better grasp of ways to interact with each of us as consumers making choices of providers or payers, as customers making choices regarding diet, fitness, etc., and as members of a social group.
How can we expand our thinking about how we can interact with individuals to meet population health goals of better outcomes, lower costs, and better experience with the healthcare system and with our health? This panel included views from across the healthcare ecosystem designed to provoke thought on new opportunities to interact with individuals to offer more personalized approaches to health and healthcare.
KEY TAKE-AWAYS
- Insight into the solutions applied today and what is in development
- Examples of where the gaps are and what still needs to be addressed
- A framework of how we can change the approach of tour organizations to make personalized care and precision health the norm (or do we need to)?
- Critical factors and opportunities that will move the needle in applying personalization to meet health and healthcare goals
Q: How to get (medical) devices into the hands of patients?
A: Clint McClellan, co-founder of the Qualcomm Health initiative, advocates lowering the price of devices such as blood-pressure monitoring instruments for customers. Cory Wiegert, a former internist now focused on forming partnerships between health providers and individuals, emphasized concerns about data rights and consent. Kripa Gaonkar, a Senior Research Manager at Ascensia (formerly Bayer) spoke about challenges relating to the integration of data customization regarding, for example, diabetes. Jeff Zigler of St. Jude‘s brought a cardiologist‘s perspective to the discussion, and spoke about compliance concerns with regard to HIPPA.
What are some of the things that are working? What are some of the things that are not working?
Kripa Gaonkar addressed the need for cultural changes within organizations, for
keeping users pro-active and engaged. Connecting about appointments via mobile devices is one way to do this.
Cory Wiegert stressed that data is meaningless unless it is put to some concrete use.
Michael Swiernik, M.D., of Kaiser Permanente talked about physician pushback around incorporating even more data into already overcrowded schedules. He stated that data must be paired with clinical guidelines that take the guesswork out of medical procedures. He also talked about rolling out protocols to care managers and directors rather than just nurses, as a way of increasing patient engagement. Swiernik reminded the panel that, for some patients who may not wish technology to replace human interaction, a visit to a healthcare facility is a form of meaningful social engagement in and of itself. Also, older patients tend not to favor mobile applications.
Q: What are the potential benefits versus the liabilities of mining patient data?
A: Clint McClellan said that one barrier is the question of consent and intent. At
present, certain data sets may not lawfully be combined due to concerns with PHI. On the other hand, there are liability concerns arising from the non-use of patient-provided data.
Swiernik spoke about how to reconcile the way data gets collected in ―front-end‖ day-today care, versus how that data gets used later for research purposes. He spoke about the need to collect a broader pool of patient data in order to make it useful and he emphasized the use of predictive analytics.
Cory Wiegert‘s perspective on the collection of data in clinical trials focused on enabling whatever is appropriate to the trial. He also spoke about digital patient recruitment concerns. What are the incentives for study subjects to participate? Per Wiegert, patients must clearly understand what they‘ve signed up for. Regarding how to change the payment structure and what roles patients, providers and payers should play, he brought up two key issues: 1. Who gets paid? and 2. What‘s in it for whom?
Clint McClellan emphasized that it is no longer about cutting costs, it is about managing the inflation curve.
Q: Moderator Greg Caressi asked the panelists for closing remarks regarding gaps and opportunities.
Jeff Zigler said that solutions vendors have a key role in closing gaps in clinical
consensus.
Clint McClellan stressed the importance of engaging patients about what they have been doing to improve and maintain their own health and why.
Kripa Gaonkar agreed on the importance of giving patients incentives to be more engaged with their health care management.
Cory Wiegert stressed that challenges and opportunities lie in getting to know patients as individuals, and what the cost savings are to those patients as individuals.
Michael Swiernik talked about the social determinants of health, about barriers patients face in taking advantage of the health care system, and about why some people fall through the cracks.
ACTION ITEM
- We need to get (medical) devices into people's hands and not just step counters
- We need devices that read blood pressure, sugar readings, weight, etc. but do so constantly like step counters do
- Devices that monitor throughout the entire day are needed Platform partners are needed
- Costs need to come down to deploy all of these devices
TAKE-AWAY
- Technology is about cost of course, but there's also context, correlation, and consent
- Individuals need to own data and be able to share it
- Data needs to be customized because each patient is different
- Allow providers better application of all of this data
- The industry as a whole needs to change its practice to adapt to all of this new data
BEST PRACTICE
- Culture change: Keep the user engaged
- Don't just keep the data, but use the technology for appointment reminders, etc. as well
- Saving trips for the patients means higher satisfaction from them, although older patients still prefer the social interaction
- Activity is both medicine and mood, so a general reading doesn't always give all of the relevant information needed
- Need to address a generational shift, most older patients have access to but won't download apps because they don't want to adapt to new technology
- There could also be legal problems if patient‘s miss data, so it's better for it to reach doctors first but always be available to the patient
ISSUES
- Kaiser's challenge right now is knowing why data was collected, because there's just too much data to sift through at the moment
- Need to find incentives for patients so that adoption rate increases
GAPS OR OPPORTUNITIES
- Closing the gap of the clinical consensus
- Collect the data, then find out how the patient feels
- How do you incentivize providers as well?
- Know each individual and let them know what you know about them
- Solve the issue of so many patients without care (due to income or location)
FINAL THOUGHT
While wearables have made a huge splash in the market, it's now time to focus on using them to the best of their ability. Don't just focus on step counts or data that's only collected once or twice a day, think about developing a wearable that reads multiple factors throughout the entire day so you can get a true idea about data averages and spikes that you might need to focus on. Incentivize the use and adoption rate of these wearables to consumers so that hopefully the industry can get a broader picture of current population health as well as individual care.
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