The healthcare industry has some ambitious goals. Your organization should have the same ones.
The healthcare industry is more like every other major industry than you think. While it is unique in critical ways—lives literally depend upon its effectiveness—it shares the same goals all business leaders do of cutting costs and improving outcomes for users and customers. While attending the Health 2.0 Conference it became clear to me that the healthcare industry is wrestling with the near universal challenges of rising consumer expectations, disruption and competition from new entrants, and a changing model for value.
Your business may or may not be affected by the fate of the ACA, or by the complexities of an aging population, but regardless of where you work it is likely you are facing similar challenges to healthcare insurers at a high level. Healthcare is an incredibly important industry making up over a sixth of the US economy, and its challenges overlap greatly with that of the rest of the economy.
Health 2.0 focused on taking an entrepreneurial and digital approach to solving the issues, and there were five themes in particular which drew my attention.
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It is no secret that healthcare insurance is at an inflection point. As I touched on above, consumers with higher expectations are taking a more active role in their healthcare choices, shopping for the best and most economical options. And there are more options than ever, with major tech companies like Microsoft, Apple and Amazon (to name a few) moving in with wearables and software, pharmacies like CVS and Walgreens expanding services, and startups like these on the fringes.
To be more competitive, an overarching solution is to transition from “pay for service” to paying for outcomes. Done correctly, this should eliminate wasted services while providing a better experience for the patient. This change will be part of the next generation of care, cutting across the clinic to the home, utilizing all the health touchpoints out there today in a seamless manner. There is urgency here—with costs and complexity rising, and with the population aging, the time to do this is now.
I didn't have a single conversation where the challenge of integration didn't come up. Integration is a broad term, and there are many pieces to the healthcare puzzle that all need their own integration solutions, from analytics to the user experience to managing privacy. Integration also needs to improve between the provider of healthcare and the payer, as well as between providers.
Patients should not have to navigate different bills from different providers for the same service, for example—and they wouldn't, if the systems were integrated. It will be interesting to watch if some of the solutions being discussed, from FHIR to blockchain, can create the standards and APIs that will eliminate these integration issues.
Just as in other industries, there is an incredible amount of health data out there that can be used to improve outcomes, most of which is currently not being analyzed. What if a doctor could look at a patient's medical history and combine that with genome data and behavioral data to provide a more insightful diagnosis? Or if data from a huge population of patients could be used to help doctors identify non-routine problems? Or even if manual data entry like clinical coding could make use of machine learning to reduce errors and increase accuracy?
To accomplish any of this—and to be able to use it to notify patients quickly and effectively—requires the ability to process data in real-time from a variety of sources. This could be apps, home monitors, sensors in clothes, even social media interactions and voice data and much more. Once all this data is collected and processed, you can drive powerful new insights with analytics.
The patient experience with healthcare today tends to be messy and complex. Patients don't really care about how health insurance works, they just want to be healthy with the least cost and hassle. So how can providers both simplify and improve the experience? By putting patients in the center, getting research on what they really want and earning their trust.
In my opinion, healthcare can learn from other industries, like retail, to achieve this. Retailers today are focused on improving the customer journey and customer retention rates, and similar tactics can be employed by providers. There is also a movement towards enabling self-service and using things like net promoter scores to measure the experience. At the end of the day, providers need accurate data about what patients really need to improve their healthcare journey. To get that, they must build trust by making the journey easy and effective.
Under HIPAA, patients today have the right to request their complete medical records—but in reality, few organizations have the ability to provide this. As the amount of data increases, including from new sources not currently regulated by HIPAA, the challenge of keeping all this data securely is only getting more pronounced.
Aneesh Chopra, former CTO of the United States, spoke about the power that we could achieve if we combined the internet with regulated HIPAA data - think an open standards FHIR (like the Argonaut Project) and the HIPAA Right of Access working together. Aneesh spoke passionately about the need to speed up the process and increase secure access to this data, to eliminate issues such as harmful conflicts arising from different doctors not being aware of what other doctors have prescribed.
Modernization of complex industries is no easy task, and requires quite a blend of improvements—you probably noticed that just about everything above overlapped. Yet there is an urgent need to make progress on this in healthcare and other markets. We've gone far beyond becoming mobile-friendly… mobility is part of customer experience, sure, but there was no dedicated session on mobile alone at the conference.
One key technology that can modernize the digital experience is to build cognitive capabilities into your business applications. Rather than bolting this on, this should be part of your strategy from the beginning, whether you're revamping your backend services, applying machine learning or updating your entire platform. A flexible and cognitive-first approach is a powerful way to leapfrog the competition as you modernize your apps, making life easier for consumers and employees alike. I was excited by the energy I saw at the Health 2.0 conference and, and will be watching with interest as they invest in the next generation of care.
Mark Troester is the Vice President of Strategy at Progress. He guides the strategic go-to-market efforts for the Progress cognitive-first strategy. Mark has extensive experience in bringing application development and big data products to market. Previously, he led product marketing efforts at Sonatype, SAS and Progress DataDirect. Before these positions, Mark worked as a developer and developer manager for start-ups and enterprises alike. You can find him on LinkedIn or @mtroester on Twitter.
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