Too Big to Feel: Remaking Human-Centered Health Care Using Technology
A few months ago,an employee of a large health system and I spoke about the current state of our health system. He shared a very sad account of a family member with a brain tumor. As the hospital system and the insurer worked through the rather inefficient approval processes leading up to the surgery, the tumor more than doubled in size, requiring a more invasive and risky removal procedure. In recent months I’ve thought often about this story. It reminds me of our obligation to remake health careputting the needs of the person at the forefront.
How do we foster a more effective and consumer-centered health system? Some await major disruption by a technology company, that is, the health care equivalent of Netflix or Uber. Yet the U.S. health system, in all its enigmatic complexity, seems to defy disruption.Even so, health care is transforming, not all at once, rather slowly, but changing for sure. Let’s consider fourways technologyis improving health care for patients.
1. Cutting Costs and Delays
To create a human-centered health system we must address affordability. In 2018, eight million people in the U.S. were driven into poverty because of medical bills. If that were not enough, some hospital systems are suing even the poor who cannot pay medical bills—going as far as garnishing wages. A significant portion of medical costs are consumed in administrative processes such as billing and claims processing. Administrative costs, as a percentage of total cost, are reported to be as high as 25-31 percent, depending on the study.
Recent technology standards have gained industry support and offer a solution to inefficient and manual administrative processes. Notably, Fast Healthcare Interoperability Resources (FHIR), a data interoperability standard mandated by the federal government, has gained industry momentum. So why does this matter? Health systems and insurance companies constantly share information, for example, to authorize medical treatment, share details on patient care quality, and to understand risks inherent in a patient population. We are actively employing such standards to reduce wait time for patients and reduce manual labor. (Yes, many health systems still share data with insurers via outdated technology like fax machines.)
2. Caring for the Whole Patient
The U.S. is regularly reported as having the worst health outcomes among developed nations. While I believe we have excellent hospitals and academic institutions, health outcome measures are not limited to quality of individual care episodes.They instead relate more to the health of the overall population. U.S. health systems and insurers are now more deliberately embracing this responsibility,culminating in the move to value-based care, or care where payments are based on patient health outcomes and not on individual interventions or treatments. At Blue Cross and Blue Shield of North Carolina, we’re establishing one of the nation’s most advanced value-based care initiatives through a statewide program called Blue Premier.
Technology is playing an essential role in understanding the whole person and meeting their health needs. For example, technology and data are now used to identify patient needs such as a lack of transportation, healthy food options, or access to high quality primary care physicians. Regarding transportation, modern options such as Lyft and Uber have been tailored for health transportation and are covered by several insurance programs. More advanced technologies, such as artificial intelligence, are also being used to understand individual needs and devise personalized interventions.
3. Artificial Intelligence to the Rescue
Artificial intelligence (AI) has many applications in health care leading to more personalized treatments and care. Two notable areas of application are diagnostics and health event prediction. Regarding diagnostics, AI has proven very effective in image analysis, helping increase effectiveness of physicians,and at times outpacing physicians in accuracy. For example, AI has demonstrated to be at least as effective as human physicians in diagnosing brain tumors, predicting heart disease deaths, and diagnosing eye diseases.
Beyond diagnoses, at Blue Cross and Blue Shield of North Carolina we’re actively been developing AI-based technology for predicting the health journey of a patient by identifying likely health events and probable timeframes. The intent, of course, is to understand the care path of each person and ensure they receive needed care in advance to stay healthy.
4. The Connected Patient
I recently spoke at a conference along with a leader from a well-known farming equipment manufacturer. I was seriously impressed by the number of sensors collecting data in real-time to ensure optimal operation of the farm equipment.While humans are far more valuable than farm machinery, we employ far less rigor in monitoring human health. Notable exceptions have emerged, such as use of fitness trackers and smart watches to track sleep quality as well as heart rate and rhythm.
We can expect a growing number of technologies for tracking and assessing the health of individuals. For example, Amazon has developed a skill for its Alexa-based smart devices to detect cardiac arrest by analyzing breathing patterns. And companies from many industries are joining the quest to improve health. Comcast is developing an in-home health monitoring system, creating a new service and use for its telecommunications network. Many other examples exist,from monitoring glucose levels in diabetics to detecting falls or injury.
Though our health system in totality may not be disrupted any time soon, it is being transformed piece-by-piece; through caring health professionals using technology to create a more personalized and humanized experience. In the next five years, technologies will mature allowing us to uncover the true needs of the patient, intervene early to protect health, and monitor thoroughly to preserve wellbeing.
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