New outcomes: activating health consumers

We live in an era where digital consumerism is a way of life and
the prefix ‘über’ has lost its original meaning along with its umlaut. Today, ‘uberfication’ is used to describe almost any digitally enabled process that has been optimized to deliver the ultimate consumer experience in terms of speed, ease of use, geographic agnosticism and level of service. From taxi service, to online shopping, to listening to music, life has become much more convenient and expansive for those with a credit card and a smartphone.

Why should managing our health be any different?

In fact consumer expectations in this regard are quite high. Individuals want to be able to interact with the health system and care team digitally and to have access to general health information as well as their own personal health data. They want to be able to address their own healthcare as they go about their day-to-day activities; not only during scheduled appointments or worse-yet, during a health crisis. This need may be felt most acutely by the ‘sandwich generation’; those who are caring for their children and also assisting parents with chronic illness at the same time.

This point was underscored in a 2014 survey by PwC’s Health Research Institute (HRI) that found consumers are willing to abandon traditional care venues for more affordable and convenient alternatives. Nearly half of respondents said they would choose new options for more than a dozen common medical procedures, such as using an at-home kit to diagnose strep throat or having chemotherapy administered at home.

After all, face time with health practitioners during scheduled appointments comprise only a few hours each year for the average person – even those living with chronic conditions. When health maintenance is digitally possible 24/7, the opportunities to take ownership for one’s health and wellbeing are amplified as is the potential for positive health outcomes.

Making the retail connection
Today the retail sector and, in particular, pharmacies is playing a key role in bridging the gap between daily life and scheduled healthcare.
The neighborhood drugstore is now a place where people get flu shots, measure blood pressure and get advice about a host of other health management topics. For example, Costco describes its pharmacy as ‘a health awareness information centre’ and local Rexalls offer more than 20 clinics on topics ranging from asthma to blood glucose to osteoporosis and diabetes. In the US, Walgreen’s share of the $10 billion immunization market is 4% (and growing). The evolution of the role of pharmacy in daily health and wellness is indicative of consumer migration to more affordable and convenient care options.

Moreover the role of pharmacists is evolving as regulations enable them to do more and more for their patients, albeit not universally across all provinces. For example, pharmacists can make therapeutic substitutions in most provinces, but not in Ontario, Manitoba or North West Territories; similarly pharmacists can prescribe for minor ailments and conditions, but not in British Columbia or Ontario.

Mobility stores, like TELUS, sell health and wellness devices. There are countless health and wellness apps available for download. It is no wonder that consumers expect that everything should be mobile now. Retail is making good health more widely accessible and is engaging consumers in truly managing their own health. At the same time, increasing the traditional scope of service is good for business. It increases customer loyalty and opens new commercial avenues. Perhaps the pharmacy is poised to become the walk-in clinic of the future.

Supporting healthy workforces
Another important place to activate health consumers and reinforce health management in daily lives is at work. Workplace wellness programs not only create a culture of healthy behavior, they also translate into tangible ROI. According to a recent Medisys survey of Canada’s top 100 employers, wellness programs boost employee engagement by 96%, improve productivity by 76% and reduce drug benefit and disability costs by 54%.

Research by Towers Watson shows that companies with the most effective health and productivity programs experienced superior human capital and financial outcomes, with 11% higher revenue per employee, 1.8 fewer days absent per employee per year, and 28% higher shareholder returns. Furthermore, American research conducted by Harvard University found that workplace wellness programs also delivered significant cost savings for employers. For every $1.00 spent on wellness programs, medical costs fall by about $3.27 and absenteeism costs fall by about $2.73. This is a real, tangible ROI.

In a world where the most serious health risks are stress, followed by lack of physical activity and obesity (both leading indicators of type 2 diabetes and cardiovascular disease), many employers are approaching their workplace wellness from a strategic standpoint versus a tactical one. Think: improving the organization’s overall health culture versus launching a singular smoking cessation program.

Collecting data for insight
The proliferation of health apps and wearable devices has spawned a nation of health consumers who are motivated by measurement and taking their personal game to the next level. But how does this translate to actual health management? What’s needed here is an accelerated quantum leap ‘beyond the FitBit’ toward integrated health data from multiple sources in order to draw insights, customize care plans and really focus our personal health maintenance in daily life.

Data in isolation has minimal impact. When we can compare lab results, medication and fitness measures along with other biometrics, this can yield true insights for individuals and for health populations. Taking this a step further, the consumer health horizon will also include predictive analytics. With more sophisticated learning systems for home health monitoring, for example, we can not only monitor patients on generalized health indicators – like weight, blood pressure and so on; we can predict precursors of adverse events for an individual. Why serving health consumers will work. (Hint: it’s not the technology)

To my health IT colleagues who, like me, have seen important and well-designed implementations fail, go over budget, or not get off the ground, I say: it is time for tenacity. We are at a convergence point where consumer behaviour is becoming recognised as the lynchpin to the ‘uberfication’ of healthcare. That is, creating health services that are more accessible, embedded in day-to-day activities, and not wholly dependent on provider interaction.

The evolution of pharmacies, the strategic role of employers and insurers as enablers of healthy behavior, and recognition that health data needs to be integrated to serve the health consumer are all bellwethers of consumer-based healthcare. I believe that KPMG got it right in a recent publication that states, “…it is clear that success isn’t achieved by replacing analogue processes with digital ones. It’s about rethinking the purpose of services, reengineering how they are delivered and capitalizing on opportunities afforded by data to adapt and learn. Where technological interventions have failed, technology has simply been layered on top of existing structures and work patterns.”

As we rethink and reengineer how health services are delivered, expect to see new health entrants in the market. Consumer health will require consumer-oriented solutions. In light of that, it is not surprising that two dozen of 2013’s Fortune 50 companies are healthcare new entrants and included retailers as well as technology and telecom carriers. These organizations will be essential in building the backbone and services that will enable consumers to access care anywhere, anytime.

Einstein once said the definition of insanity is expecting different outcomes by doing the same things over and over again. Have we not effectively proven this theory with regards to healthcare transformation? Surely we need to enable new players to change the conversation and introduce new models of care. Truthfully we cannot afford not to.

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