A person can get on the internet, look at a product and learn virtually everything there is to know about it from experts and peers. At the press of a button, someone can uncover price, pros and cons of use, alternatives, competitor offerings and many, many other insights. This puts the consumer in the driver’s seat on the decisions they make. Technologies focusing on ease of use and consumer choice have made a significant impact on industries from retail to banking to airline travel. However, consumer-enabled decision-making hasn’t quite made its way into the healthcare sector.
Healthcare can learn a lot from the digital strategies of the retail world. The adoption of EMRs laid the foundation for digital health transformation. With this advancement, patients and providers gained greater opportunities to leverage health data to help make more informed decisions—but in reality, there is quite a long way to go.
The future of healthcare relies on providers entering into a partnership with their patients based in trust, with technology making it possible for consumers to connect to their provider teams, access data and analytic tools to inform their health decisions, and engage in dialogue with clinicians that builds trust and offers consumer choice. For health systems, this signals a shift from provider-centric care focused on disease management, to an ecosystem approach that proactively identifies risk and enables consumers to work with provider teams as partners to reduce risk and support health. By using digital tools to access data and predictive analytics tools to inform decisions, health systems are able to predict health challenges among populations they serve to ensure programs and services are personalized to the unique needs and circumstances of individual consumers and populations.
Based on the current trends and shift in consumer demands on healthcare organizations, we’ve identified four dimensions of digital health ecosystems that we view as critical to the realization of digital health transformation for global health systems.
For decades, health systems have been described as provider centric. For one, patients are required to visit their provider when the provider’s schedule permits, rather than at a convenient time and place for the patient. Provider-centric care is organized around disease management pathways, where the patient follows a defined pathway—rather than a health journey they helped define.
Consumers have become accustomed to personalized, responsive business sectors that strive to be consumer centric, yet, most healthcare systems have failed to offer consumers the same personalized experience. Chronic disease is responsible for 75% of total healthcare costs in the USA, existing care delivery models are not well constructed to manage chronic illness effectively. High rates of hospitalization for chronic disease, the growing costs of healthcare, and consumer trends and preferences all signal the need for transformation in healthcare delivery models that are person centric, not provider centric.
Consider the family who lives in a rural community without specialist care, but needs help managing their chronic conditions like diabetes and heart disease. Or the woman unable to attend obstetric care appointments due to her full-time job and the demands of caring for her children. The hallmark of consumer-enabled care is offering choices and options to address a person’s unique needs and life circumstances—ensuring care is available when and where it is needed.
In a consumer-enabled system, provider teams partner with consumers who define their personal health goals and preferences, providers then tailor care delivery to personal health goals and provide the tools and support needed to make informed health decisions on how they wish to manage their health. These tools could include managing health conditions and tracking progress digitally, or virtual care visits with a provider team, to support patients in actively managing their personal healthcare journey. Care is focused on achieving the consumer’s personal health outcomes and goals.
So, what does this future of healthcare look like? Think about how online retailers make it easy for you to shop. What do they do that makes it so simple and seamless? They make everything available to their consumers, online, with all the tools necessary to make informed choices to purchase anywhere, anytime. Imagine having that type of service when making healthcare decisions and choices—having all the options in an easily digestible format. With the click of a button, you’ve made a decision, you have the tools to make informed decisions, track your health progress and can connect to provider teams when needed. Digital technologies have transformed nearly every other industry and allowed businesses to meet customers where they are—now the opportunity is ripe for the same transformation to happen in healthcare.
Predictive analytics is the language of the future of healthcare; one that is proactive, predictive and focused on keeping populations healthy and well. In the current system, provider organizations engage when people get sick and then spend a lot of time, money and effort to help them get better, particularly for people managing chronic illnesses.
As analytic capabilities and technologies advance and are adopted by health systems, organizations can use predictive analytic tools to quickly identify which patients are at greatest risk, to inform decisions on prioritizing care to proactively reduce or mitigate risk before they get sick, and ensure delivery of the best care possible to maintain or strengthen a person’s health and quality of life. Machine learning algorithms are beginning to demonstrate significant value, identifying risk and enabling provider teams to personalize care delivery, while also tracking and monitoring outcomes so that health systems can learn what care approaches offer patient populations the best outcomes.
As predictive analytics and machine learning tools advance within organizations, clinicians are gaining access to point of care tools that translate data into knowledge and insights in real time, to not only inform decisions, but also automate and streamline work processes to reduce the burden of providing care that is informed by accurate and complete data for every patient situation.
Analytical tools will continue to make it possible for healthcare systems to transition from a reactive disease management approach, toward a proactive and predictive care system that is personalized to the unique health needs and life circumstances of every consumer and population segment to improve health outcomes and reduce costs.
Interoperability is the fundamental foundation of digital transformation within health systems. An organization cannot create a consumer-enabled healthcare system that is proactive and focused on keeping people well unless they have the digital infrastructure required to enable interoperability. Interoperability allows data to move from where it is captured to where it is needed—whether to the consumer or the clinician, or both—at any location, in real time. This data can then be transformed, using advanced analytics, into meaningful knowledge and insights, accessible to both consumers and their provider teams, to inform the best decisions focused on keeping people well.
If we want patients and healthcare consumers to have the ability to choose when and where they seek care, and how they can best manage their personal health, we need to make it easier for them. Health data is captured in many organizations, using many digital tools and platforms that are far too often unique to each organization and not exchanged or communicated across the journey of care. Radical interoperability mobilizes data for every individual consumer, from all data sources, to ensure data, information and knowledge is complete, accurate and accessible when and where it is needed. Interoperability enables patients and consumers to access their data, input data into their record to report outcomes and track progress. Interoperability makes is possible for mobile navigation tools to be orchestrated and available to consumers while also connecting to providers and organizations consumers engage with across the journey of care to enable and support personalized care and services that meet their unique needs and preferences. Interoperability also means community members have access to their personal health records, and can access health services, educational tools and health navigation tools to support their health decisions, navigate access to care and services from their own homes, including virtual care and remote health service delivery.
With an interoperable system, each and every person has choices along their journey of care, informed by their personal health data and track progress towards outcomes. Interoperability is critical to unlocking the power of digital tools to enable a consumer-centric health system.
Governance has become more important than ever for the future of healthcare. The rapid growth of data assets and reliance on digital health platforms present new challenges for data governance teams as growing risks and threats to security and privacy can compromise data integrity and ownership.
Data governance is the policy infrastructure that ensures data assets are carefully managed and protected against privacy and security threats. Policy frameworks in a consumer-centric health system must also offer transparency in quality and safety outcomes informed by accurate and valid data so that health systems learn what care offers the best outcomes and under what conditions best outcomes are achieved.
Healthcare organizations must have strong and responsive governance policy frameworks to ensure digitally enabled health systems are safe and secure, while at the same time ensuring patients and clinician teams have access to data and analytic tools they need to make informed decisions. Organizational strategy must consider policies on who owns health data, how data can be protected and verified as accurate, and how data can be seamlessly accessed when and where it is needed to inform decisions.
In addition to data governance, for an organization to move toward a high-performing, digitally enabled ecosystem, its the vision and strategy from system leaders that guides digital transformation within and across the system. Leaders must understand and value the consumer as the center point of care and drive this vision and strategy across the organization. The future of healthcare requires leaders to educate and empower their workforce to build digital health capacity through education and training that enables new care models such as virtual care, remote care delivery, and care pathways that engage consumers to manage their health and wellness using digital tools and technologies scaled across the system.
Predictive, proactive care focused on keeping people well based on their unique values, needs and circumstances is the digital future of healthcare. By utilizing the right tools, technologies and strategy, healthcare systems can reduce costs, increase operational efficiencies and improve patient outcomes, all while building a system that benefits consumers and providers alike.
Analytics has long offered strategic pathways for advancing key areas of healthcare through its maturity models and is now driving beyond these to create the tools needed for building strategic change in digital health—strengthening the partnership between consumers and health system teams focused on health, wellness and quality of life.