September 20, 2022 - 759 views|
By creating cross-disciplinary teams focused on prototyping and testing personal health technology experiences, health organizations can become effective wellness advisors.
My colleague’s husband uses a glucose monitoring sensor and his iPhone to manage his Type 1 diabetes. The sensor delivers detailed data about his blood sugar levels throughout the day and alerts him if he needs to act. During check-ups, his physician reviews the data to evaluate and adjust his therapy.
The use of personal health technology (PHT) like this is exploding, from voice-based personal assistants and social and companion bots, to in-home diagnostic devices. PHT also takes many different shapes and forms, from ingestible sensors to wired clothing.
Health plans could use PHT data to deliver diagnoses earlier, prevent exacerbations, avoid expensive re-admissions, slow disease progression and become more effective wellness advisors. Members have told us they’re willing to share PHT data in return for exactly that kind of help.
Yet most healthcare organizations aren’t using PHT data. In addition to concerns about data reliability, regulations and liabilities, they face siloed data, low technology adoption among members and the need to determine which use cases are worth pursuing.
These concerns are not insurmountable. By setting up innovation hubs—focused teams that quickly prototype, test and refine PHT systems—healthcare organizations can solve these problems and design experiences that anticipate and meet member and patient needs.
An innovation hub—whether set up as a separate business entity or as a development channel untethered to corporate planning cycles—can give payers a safe way to test PHT use cases and technology. These teams should include technology, design and healthcare experts from different organizations, such as an academic center, a technology vendor and a payer organization. The goal: find and fix issues to ensure PHT experiences remain safe and reliable as they scale.
Here’s how innovation hubs can address three primary concerns our clients raise about investing in PHT:
Designing PHT experiences that provide meaningful insights for members and consumers may mean integrating PHT data with databases, devices or third-party apps. Wearable devices use the Message Queuing Telemetry Transport (MQTT) data transfer protocol, which doesn’t include encryption or authentication. The potential data breaches could trigger liability issues and regulatory fines.
This situation gets more complex for international medical insurance providers, which must comply with rules from many different regulatory bodies around the world. These varying standards could create compliance issues, such as a device collecting data that’s allowed in one country but not in another.
Innovation hub solution: Analyze vulnerabilities and determine how to avoid them. The hub team would identify the data the business case requires. For example, if a plan wants to help members make sense of their sleep tracking results, its care managers and health coaches likely will need additional information to put those results in context. Diet, exercise, medications and stress all affect sleep, and data about those factors is likely in a member’s medical record and other apps and devices.
The hub team would determine security vulnerabilities and compliance issues involved in tapping these data sources, using its resources to develop, test and mitigate a wide range of scenarios.
In our experience, payers are not using PHT data for utilization and care management, and providers rarely access it at the point of care or capture it in electronic medical records. The industry is largely missing a source of continuously generated health data in the time between annual check-ups and follow-up appointments. The missing data can lead to care gaps and lost intervention opportunities.
PHT also could reveal health trends in specific member cohorts and the local community. Payers could create evidence-based population health improvement strategies. For example, data from apps that manage chronic obstructive pulmonary disease (COPD) could reveal unexpected increases in exacerbations. A payer might correlate these with a new industry in town or natural disasters such as an extended local wildfire season.
Such insights could guide an organization’s strategy for care management and coaching. The payer could also use the data to forecast medical utilization rates and costs before deciding whether to enter the local Medicare and/or Medicaid markets.
The risk organizations face is failing to capture all the data required to create an intelligent rule, clinical guideline or business action. With enough data, AI tools can accurately identify social determinants of health and other patterns, but much healthcare data remains in closed and often proprietary databases.
Innovation hub solution: Integrate new PHT data and systems of record on a manageable scale. The innovation hub team can work with small cohorts of member or community data to test theories and determine how to orchestrate and normalize different data sources. Some of these databases are managed by third parties on the payer’s behalf. Others could be as diverse as a Salesforce-based wellness cloud.
The key is to piece together comprehensive, accurate pictures of community and member health. The hub’s “start small and learn fast” approach can quickly reveal which data sources are required to support sound conclusions and policies.
Innovation hubs are not limited to payers with deep pockets. Smaller and medium-sized payers may partner with technology vendors, sharing financial risk and rewards. Or they may choose to use a technology partner’s innovation hub resources. These should include a library of PHT use cases to help jumpstart prototypes and pilots.
With PHT data plus their own member data, healthcare organizations are uniquely positioned to build member loyalty and market leadership with proactive advice and interventions. That’s a competitive advantage that competitors won’t easily beat.