The New Health Care Experience For Consumers

Nov 16, 2017• 1

By HEALTH 2.o SPONSORED CONTENT

We are human and we need health care. These are universal truths. Here’s another one – we are consumers. Consumers who happen to be in a constant state of adapting to new health care protocols. The advent of value-based care over fee-for-service has also seen an emergence of empowered consumers who are not only informed but savvy in their health care decision making. Where do I purchase? From who? How much does it cost? How much can I afford? When do I purchase? What if I need a specialist? The list goes on. Luckily there is an ever-growing group of people and organizations who continue to make the consumer experience streamlined, affordable, and personal. Even in the gravest of scenarios.

Cambia Health Solutions, based in Portland, OR, is one such organization. They are affectionately referred to as “the-100-year-old startup” which is as much a testimony to their legacy as it is their bold insistence on moving the needle. What Cambia does perhaps better than most is Palliative Care. In 2014 they launched their greatest initiative to date – a program that serves patients living with serious illnesses in a new way. Cambia’s approach is to prioritize the person, as well as the experience of their families. Their revised care plans often include a collaboration with the family and reflect physical needs as well as the social and the spiritual.

With over 31 million in financial support from their Foundation, Cambia has been able to create and grow what they call “a shared network of competency” which includes interdisciplinary care teams across hospitals, providers, and regions. And it’s working. Cambia’s Palliative Care program has seen such wild success in Portland, OR that they have expanded across the Northwest and to Utah, Idaho, and into California.

Leading Cambia’s audacious model of radical empathy and exceptional transparency since 2003 is Mark Ganz. He is the son of a doctor and has dedicated his career to the transformation of health care by putting people first. His upbringing as an Eagle Scout taught him to ‘leave your campsite better than you found it’ – an ethos he infuses across all of Cambia’s projects.

Ganz will be headlining Health 2.0’s Annual WinterTech event during JP Morgan week on January 10 in San Francisco. His presentation will cover how to create seamless health care experiences to meet the needs of consumers, and provide a contextualization for a day’s worth of programming dedicated to the empowered consumer as well as investing and digital therapeutics.

Categories: Uncategorized

Healthcare is a complex industry that does not function like any other. There is a finite amount of resources with competing interests and public health policies that require regulations that often prioritize everything but the consumer. To further cloud this already convuluted industry, we are now entering a brave new world attracting tech companies that are bringing in their expertise to shape the way consumers navigate their health care. Since 2014, about $16 billion dollars in venture capital has been invested across more than 800 digital health companies [1]. It seems like the best way to address the problems is to simplify the way we shop for care and thereby increase the accessability and engagement of the informed consumer. What better way to have people understand all the intricacies of the system than by transforming it into something that fits the innovative, socially-driven and technologically-advanced box of digital health? As powerful as technology is in injecting momentum within a failing industry, the main problem with this apprach is that it’s being catapulted from the wrong foundation, which does nothing but direct it towards failure.

Health care as we know it today is centered and stuck on the institution, which results in a one-size-fits-all approach that perpetuates the problem for every stakeholder in the industry. Patients come to the clinic or the hospital where the goals are to cure from the illness at hand and to ensure the hospital does not exceed its expenses. Services are rarely customized to meet the needs of any one patient, and the approach is to get rid of the condition and not necessarily to heal the person, much less to address the needs of the population that gave rise to the illness. Why is this a problem? Essentially, a one-size-fits-all approach is inappropriate and ineffective for the field of healthcare. Research has demonstrated that reactive and segmented strategies counteract the very premise of health care: to help those who need it [2]. Due to this, a strong disconnect has emerged between the consumer of care and those providing the care.

We see this in the field of prescription drugs and pharmacy benefit programs where success is often only measured by two things: increasing patient co-payments and decreasing drug utilization [2]. Data on patient behavior and demographics demonstrates that more often than not, those who are unable to afford larger co-payments, tend to have a lower probability of medication adherence. They are less likely to refill their prescriptions, which indeed lowers drug utilization. However, for these patients this underutilization only adds to the amount of clinic and hospital visits they will likely need to take on. In the long run, this only increases the burden by augmenting healthcare costs and perpetuating disease development. So, even though the two measures of success were met, patient co-payments did rise and drug utilization did lower, can this truly be considered a success? The way we measure success in this industry must be reassessed. We must shift away from an institution-focused approach to one that is patient-focused, just as Cambia Health Solutions has done.

As we enter the new world of digital health, one proposed solution to the problem of misaligned targets in care is customization. Highlighted in the reference post, we see in the example of Cambia that customized care increases the effectiveness and efficiency of care by returning the power to the consumer. Founded in Portland, a city known for its progressiveness and spirit for outside-the-box solutions, Cambia has been a leader in shifting the health paradigm, particularly in the area of palliative care. I believe their approach serves as an outline for tech companies seeking to position themselves as relevant and effective in the growing and well-intentioned field of digital health.

First, for a company to stay relevant, it must be continously searching for better ways to serve its customers and meet the demands of a vastly changing and technologically-driven market. Cambia has been successful because this is not only one of their goals but their foundation. People’s needs are always changing, and solution-driven frameworks must change with them, even if it means completely redifining how we measure success.

Second, companies must prioritize the patient above the technology. Digital health has often been criticized because tech companies tend to lose focus on the ‘who’ and ‘why’. While trying to fit the individual to the technology many initiatives have fallen short. For instance, despite the fact that the use of health applications increased from 16 to 33% from 2014 to 2016, studies show that less than 50% of these apps have the functionality to be used among those who need it most, i.e. seniors and lower income households [3]. So, the questions that must be asked by companies are: who am I serving and why. Technology must be seen as a tool for the solution. It must be adapted and tailored to the needs of the population, and not the other way around.

Third, companies must collaborate across networks and regions to ensure seamless integration for the user. Cambia has been particularly proactive in the development of care teams made up of interdisciplinary networks that extend beyond hospitals and regions. They refer to it as a ‘shared network of competency’, and it has enabled them to not only understand their patients, but has also extended their ability to provide care that is truly personal and effective.

Customizing care in this way benefits both the patient and the industry. When people feel they are taken into account and that their personal perspective is being considered, it automatically increases their comfort level, allowing them to be more open to the provider’s recommendations. If patients would take the necessary steps to improve their health, this would reduce the unnecesary additional visits and potentially alleviate the costs associated with overutilization. After all, a provider’s job is only as effective as the patient’s adherence to their advice.

All in all, the healthcare industry must capatilize on the potential that technology can have in addressing healthcare’s most pressing issues. Digital health can be effective in catapulting the industry forward, but only if companies are driven by consumer engagement and not only technological prowess. We have a lot to learn from companies like Cambia, who continue to expand the usage of such tools. Because healthcare is a complex industry that does not function like any other, our previous methods must be adapted to truly attain success.

Reference:
1. Coppedge, R. (2017) Digital health is dead, says this health-tech investor. CNBC – Tech. Retrieved from: https://www.cnbc.com/2017/09/06/digital-health-is-dead-says-this-health-tech-investor-rob-coppedge.html
2. White, W. D., & Chao, S. (2014). U.S. Patent No. 8,799,023. Washington, DC: U.S. Patent and Trademark Office. Retrieved from: https://www.google.com/patents/US8799023
3. Jacob, C. (2017). Digital health solutions from hype to impact. Huffington Post. Retrieved from: http://www.huffingtonpost.co.uk/christine-jacob/digital-health-solutions-_b_14370214.html

1 reply »

maldonado1 says:

Nov 20, 2017 at 6:41 am

Healthcare is a complex industry that does not function like any other. There is a finite amount of resources with competing interests and public health policies that require regulations that often prioritize everything but the consumer. To further cloud this already convuluted industry, we are now entering a brave new world attracting tech companies that are bringing in their expertise to shape the way consumers navigate their health care. Since 2014, about $16 billion dollars in venture capital has been invested across more than 800 digital health companies [1]. It seems like the best way to address the problems is to simplify the way we shop for care and thereby increase the accessability and engagement of the informed consumer. What better way to have people understand all the intricacies of the system than by transforming it into something that fits the innovative, socially-driven and technologically-advanced box of digital health? As powerful as technology is in injecting momentum within a failing industry, the main problem with this apprach is that it’s being catapulted from the wrong foundation, which does nothing but direct it towards failure.

Health care as we know it today is centered and stuck on the institution, which results in a one-size-fits-all approach that perpetuates the problem for every stakeholder in the industry. Patients come to the clinic or the hospital where the goals are to cure from the illness at hand and to ensure the hospital does not exceed its expenses. Services are rarely customized to meet the needs of any one patient, and the approach is to get rid of the condition and not necessarily to heal the person, much less to address the needs of the population that gave rise to the illness. Why is this a problem? Essentially, a one-size-fits-all approach is inappropriate and ineffective for the field of healthcare. Research has demonstrated that reactive and segmented strategies counteract the very premise of health care: to help those who need it [2]. Due to this, a strong disconnect has emerged between the consumer of care and those providing the care.

We see this in the field of prescription drugs and pharmacy benefit programs where success is often only measured by two things: increasing patient co-payments and decreasing drug utilization [2]. Data on patient behavior and demographics demonstrates that more often than not, those who are unable to afford larger co-payments, tend to have a lower probability of medication adherence. They are less likely to refill their prescriptions, which indeed lowers drug utilization. However, for these patients this underutilization only adds to the amount of clinic and hospital visits they will likely need to take on. In the long run, this only increases the burden by augmenting healthcare costs and perpetuating disease development. So, even though the two measures of success were met, patient co-payments did rise and drug utilization did lower, can this truly be considered a success? The way we measure success in this industry must be reassessed. We must shift away from an institution-focused approach to one that is patient-focused, just as Cambia Health Solutions has done.

As we enter the new world of digital health, one proposed solution to the problem of misaligned targets in care is customization. Highlighted in the reference post, we see in the example of Cambia that customized care increases the effectiveness and efficiency of care by returning the power to the consumer. Founded in Portland, a city known for its progressiveness and spirit for outside-the-box solutions, Cambia has been a leader in shifting the health paradigm, particularly in the area of palliative care. I believe their approach serves as an outline for tech companies seeking to position themselves as relevant and effective in the growing and well-intentioned field of digital health.

First, for a company to stay relevant, it must be continously searching for better ways to serve its customers and meet the demands of a vastly changing and technologically-driven market. Cambia has been successful because this is not only one of their goals but their foundation. People’s needs are always changing, and solution-driven frameworks must change with them, even if it means completely redifining how we measure success.

Second, companies must prioritize the patient above the technology. Digital health has often been criticized because tech companies tend to lose focus on the ‘who’ and ‘why’. While trying to fit the individual to the technology many initiatives have fallen short. For instance, despite the fact that the use of health applications increased from 16 to 33% from 2014 to 2016, studies show that less than 50% of these apps have the functionality to be used among those who need it most, i.e. seniors and lower income households [3]. So, the questions that must be asked by companies are: who am I serving and why. Technology must be seen as a tool for the solution. It must be adapted and tailored to the needs of the population, and not the other way around.

Third, companies must collaborate across networks and regions to ensure seamless integration for the user. Cambia has been particularly proactive in the development of care teams made up of interdisciplinary networks that extend beyond hospitals and regions. They refer to it as a ‘shared network of competency’, and it has enabled them to not only understand their patients, but has also extended their ability to provide care that is truly personal and effective.

Customizing care in this way benefits both the patient and the industry. When people feel they are taken into account and that their personal perspective is being considered, it automatically increases their comfort level, allowing them to be more open to the provider’s recommendations. If patients would take the necessary steps to improve their health, this would reduce the unnecesary additional visits and potentially alleviate the costs associated with overutilization. After all, a provider’s job is only as effective as the patient’s adherence to their advice.

All in all, the healthcare industry must capatilize on the potential that technology can have in addressing healthcare’s most pressing issues. Digital health can be effective in catapulting the industry forward, but only if companies are driven by consumer engagement and not only technological prowess. We have a lot to learn from companies like Cambia, who continue to expand the usage of such tools. Because healthcare is a complex industry that does not function like any other, our previous methods must be adapted to truly attain success.

Reference:
1. Coppedge, R. (2017) Digital health is dead, says this health-tech investor. CNBC – Tech. Retrieved from: https://www.cnbc.com/2017/09/06/digital-health-is-dead-says-this-health-tech-investor-rob-coppedge.html
2. White, W. D., & Chao, S. (2014). U.S. Patent No. 8,799,023. Washington, DC: U.S. Patent and Trademark Office. Retrieved from: https://www.google.com/patents/US8799023
3. Jacob, C. (2017). Digital health solutions from hype to impact. Huffington Post. Retrieved from: http://www.huffingtonpost.co.uk/christine-jacob/digital-health-solutions-_b_14370214.html