Innovations in Healthcare - Where does Disruptive Change Start?

mHealth

Health care ‘system’ seems to be an oxymoron. There is limited observable evidence that there is anything systematic about health care delivery.  Jim Champy highlighted this point in his article the Radical Rethinking Health Care Delivery. It is not systematic because it is not integrated. Because health care delivery is not integrated, it is inefficient and costly. Therefore it needs drastic and disruptive change. The proof is in the facts from an annual employer survey conducted by the Kaiser Family Foundation:

• Employee premiums have jumped to 9% in 2011 
• Over the course of 13 years of this survey; health insurance premiums has increase by a whopping 168% in drastic comparison to workers wages and inflation which only increased 50% and 38% respectively over this same period. 

Technology and innovation has improved the efficiency and effectiveness of services in almost every industry but health care.

This is starting to change.  Innovation to improve health and care beyond treatment is being pioneered by small and dynamic start ups and entrepreneurs. There are exciting health incubators like, Rock Health that are cultivating innovative ideas and helping deliver them to the masses.  An example is Genomera; Genomera seeks to heal the world through personal health collaboration, connecting people solving similar problems in health.  

To create an integrated system like Mr. Champy suggests, the system or solution must be designed to integrate the people, process and technology. The tremendous innovations that are sprouting are being developed to address specific needs or challenges and seem to fall into three (distinct) streams. These streams are having an important impact, but if integrated could create disruptive change.  The three streams that these innovations seem to be categorized in are the following:

1. Tools and Aids
2. Education and Awareness
3. Community

Tools and Aids

Mobile technology is putting tools that were reserved for medical professionals in the hands of individuals.

To successfully improve the performance of any organization or machine, data is necessary. Data that was once captured by experts and advanced technology can be captured by individuals in their everyday lives. Now, individuals can track data regarding their own health. This provides the opportunity to increase the quantity, quality and frequency of data that medical professionals can analyze. And it nurtures ownership by giving individuals the tools to measure their biofeedback regularly, record this information and easily analyze trends. Just as the 'Like' feature on Facebook allows you to track feedback on a post, these tools will enable us to monitor the performance of our own biofeedback.
Here are a few exciting new innovations to easily monitor biofeedback:

• The iBGStar blood glucose monitoring system allows users to track blood glucose levels on their iPhone, iPad or iPod Touch
• The Withing Blood Pressure Monitor allows users to check their blood pressure and heart rate at home, anytime and stores their results on their iPhone, iPad or iPod Touch
• FitBit and BodyMedia are two tools used to track daily activity, calories expended and quality and quantity of sleep. 

These are some examples of how smart phones and new devices are empowering individuals to capture and record vital biofeedback in up to real time.  The possibilities of this trove of information are endless.

Education and Awareness

A big factor in improving health care is in improving education and awareness. How do we do this? First, we need to recognize the importance of on-going dialogue. We can then change the way we give, get and share information. Creating a platform for dialogue—in the office, online, at the pharmacy, etc.—we can improve preventative health and optimize therapies.

An example of the negative effects of inadequate communication (dialogue) was highlighted in a study titled 'Physician–Patient Communication About Prescription Medication Nonadherence: A 50-state Study of America’s Seniors'.  The study states that:

"recent data suggest that patients often do not report medication-related symptoms to physicians, and that physicians do not always respond when they do. We show that this problem is widespread among U.S. elderly. The confluence of the factors we describe—multiple chronic conditions, use of numerous medications, a variety of prescribing physicians, lack of regular review of medications, and poor communication about medication side effects and perceived efficacy."  

Changes need to occur in both patients and health care professionals.  One systematic change that may incentivize this dialogue and change behavior is outcome based care.

Outcome based care is an innovative health care delivery model where health care providers (hospitals, clinics, doctors, etc.) are compensated when a patient's health and vital health measures improve.  If only improved outcomes are rewarded than providers have incentives to be more engaged in an individual's health and lifestyle.

This model has the potential to open the necessary on-going dialogue. The care offered then goes beyond mere treatment. Improving education through dialogue can improve the effectiveness of care and overall health.

One such example is Genesys HealthWorks outcome based care model.  Genesys HealthWorks describes itself as:

• A new model of care that is focused on health, not just disease
• Promoting continuous healing relationships with primary care physicians
• Health Navigators who support patients and providers, linking with community resources to promote health
• Integrating and aligning a coordinated network of providers working in teams

The goal of the outcome based model is that the provider is rewarded for a healthier patient. The patient’s reward is improved health and reduced long term cost of care. In order for patients to realize this reward, dialogue is key.


Community

Communities of support - for individuals, caregivers and their care network - are essential to health and wellness. These communities can help relieve burden on a primary physician, nurture accountability, relieve stress associated with illness and facilitate rich dialogue. Furthermore, these communities offer information and emotional support to help individuals manage illnesses.  This is done by connecting individuals to those who can empathize and provide answers to questions associated with similar ailments.  Two excellent examples of this are:

• PatientsLikeMe is an online community committed to putting patients first by providing a better, more effective way for individuals to share real-world health experiences.
• TuDiabetes is an online community where the members help each other out, educate themselves and share the steps they take every day to stay healthy.

As we work together to develop the necessary innovation in health care, we know there is a lot of opportunity to make drastic and disruptive changes—changes that will significantly improve quality and efficacy. It is our responsibility as individuals, patients, medical professionals and innovators to spark that change.  Your insight can help answer the following: 

• What are other areas of innovation happening in health care? 
• What are your thoughts? Disruptive change: Where do we start?

Guest blog by Matt Sitek - Chief Cultivator @ www.pillpouch.net