Healthcare has seen significant change in the last decade, with the rapid emergence of technology empowering consumers and shifting expectations for how, when and where healthcare services should be delivered.
Traditionally, consumers are viewed as patients—the recipients of care, with clinicians as the experts: prescribing therapies and creating care pathways based on scientific evidence to provide care that is considered best practice. These healthcare delivery approaches inherently assume the clinician knows best and are based on the assumption that one size fits all. Today, consumers are demanding care that works best for them, placing significant demand for more personalized approaches to care delivery.
Although there has been progress toward patient-centered care and/or patient engagement, these efforts focus more heavily on increasing patient participation in health system processes, rather than engaging them to define the best care for their personal and unique life circumstances.
In order for a health system to transform toward a consumer-enabled system, the key motivations and expectations of users must be foundational to the design of healthcare delivery.
Consumer-enabled healthcare offers choices, values patients as partners, and focuses care on striving to reach their personalized health and wellness goals—defined by the individual, not defined for them. As technology continues to advance, transformation toward consumer-centric health systems leverages technology to support the redesign of healthcare delivery to meet user expectations, needs and values.
A consumer-enabled healthcare system positions the user as the expert in managing their own health and wellness in a manner that is consistent with their personal values and unique life circumstances. Individuals choose the healthcare delivery model or strategy that best suits their needs, such as online or in person, and choose from various digital technologies like sensors or wireless technologies, with the expectations that data flows seamlessly to and from the consumer to their circle of care, including clinicians. Care is fully integrated, coordinated and focused on the personalized health goals for each individual, where care pathways are personalized—one size fits one, not one size fits all.
Many new technologies are designed to meet users’ expectations by supporting and enabling self-management of health and help them make decisions about their health.
One health app analyzes DNA, provides personalized advice on foods and nutrients, as well as lifestyle behaviors and even offers bar code scanning of food labels to generate suggestions on food choices, depending on the person’s activity level. Another device tracks the air quality as a way to help people manage asthma. The device can send data back to doctors to help with diagnostics and prescriptions at the request of the consumer. It tracks air quality data in real-time and supports the consumer’s learning about environmental triggers that impact breathing.
The use of these and other technologies are now transforming the internet of things by engaging AI and machine learning technologies, to what is now emerging as the intelligence of things. This connected intelligence now engages users more meaningfully (e.g., facial recognition, sensing movement behavior, or object detection) signaling an important shift toward a consumer-enabled health system.
These technologies are in the consumer market, and developing rapidly. However, the critical question becomes, will health systems leverage these trends to transform healthcare delivery services to be more consumer centric? The future of health system sustainability, quality and safety relies on the ability to meaningfully engage consumers and to meet their drive toward self-determination in managing their health and wellness.
Virtually every other business sector has transformed their services using digital technologies to better engage and be more responsive to their customers.
In the automotive sector, vehicle technologies inform the driver when an oil change will be required, or how many miles a vehicle can drive before needing fuel. In the airline industry, passengers are notified by text or email when there are anticipated flight delays and when a flight is expected to take off. Retailers inform consumers when their packages will be delivered, and can locate a product in any store in their global network so that the consumer has access to product availability worldwide.
The common feature of these business sector strategies is the proactive engagement of their consumers, keeping them informed of what to expect.
By comparison, proactive health services have not been widely adopted to support and engage consumers. Today’s healthcare system prioritizes the treatment of illness and disease using a reactive approach¬—engaging people once they have become ill and then treating the illness.
While health systems have deployed screening programs to diagnose diseases in early stages to optimize treatment outcomes, they have not prioritized proactive strategies designed to focus on helping people stay well, nor have systems leveraged digital tools to support self-management of health and lifestyle behaviors that guard against illness and disease.
For example, chronic illness is widespread among North American populations, but there is limited evidence of health systems that proactively identify their patient population at greatest risk of illness and then create health services designed to delay onset or prevent the illness altogether.
A consumer-enabled healthcare system is proactive, analyzing data to identify consumers or patients at risk for decline in health and then proactively intervene to prevent threats to health to support and sustain consumer wellness.
Proactive healthcare means:
Health systems are beginning to design proactive approaches for identifying patient populations at risk. However, these efforts remain early in their development and tend to focus on specific diseases rather than prioritizing health and lifestyle behaviors to proactively manage or prevent chronic illness—the most prevalent and most costly of all population health challenges. Future health systems will need to accelerate proactive approaches to keeping people well to accelerate progress toward health system performance and sustainability.
Chronic conditions carry significant cost for healthcare organizations. In the U.S., 12% of adults have five or more chronic conditions and account for 41% of healthcare expenditures. Chronic illness accounts for 75% of total health system costs in the U.S.
Predictive analytics applied to population health data supports learning health systems. By using analytics, health systems can identify health risks and implement care programs to mitigate these risks and track outcomes. With this data, providers can learn what programs work best and for which population segments best outcomes are achieved.
For example, the use of predictive models to identify population segments at greatest risk for Type 2 diabetes have supported preventive healthcare delivery strategies to reduce the progress of the disease. The use of predictive analytics has identified the key indicators that best predict which patients are at the greatest risk for severe flu outcomes that require hospitalization. One health system, Ochsner Health, has been able to tailor their flu prevention strategy to meet the needs of their unique population segments to support reductions in flu outcomes, and hospitalizations in particular, to support these higher risk population segments to stay well throughout flu season.
These key elements are part of the movement toward a consumer-enabled healthcare system and are immanent in meeting the needs and wants of the user. Positioning consumers as partners creates a better consumer/health system relationship with the focus on co-creation, instead of top-down implementation. The world is being driven by new technologies and ways to create data. Healthcare systems need to get on board with this movement, as many are not only demanding it, they are using it on their own to take control of their health. A consumer-enabled healthcare system is the way of the future, with the individual at the helm.
Health systems are at a crossroads—they are facing financial and resource limitations, while consumers are looking for more personalized care. The digitally enabled health system of the future focuses on health and wellness, and is the key to connecting consumers to health systems that will have a transformational impact on care delivery and quality.