Healthcare evolution is in progress worldwide at differing rates with specific focus areas, and being driven by key stakeholders–patients, providers, payers and governments–with varying degrees of participation. However, a few common themes are emerging from this evolution –
- Care Anywhere – Healthcare is moving from a hospital-centric care to hub-spoke model with integrated transitions of care across nursing homes, aged care centres, rehab centres and eventually moving to patients’ homes. This has drastically improved the convenience factor for patients.
- Coordinated Care – As healthcare gets democratized, there are multi-disciplinary teams that get involved in supporting and improving care delivery. Coordinating care and ensuring everyone has the right information, protocols and process becomes key to efficient care delivery.
- Monitor & Prevent – Healthcare systems are increasing their focus on disease-prevention and proactive monitoring. This is an important transition from sick care to true “health care”. Today, we diagnose at late stages and chase after the problem. New technologies enable us to monitor based on certain risk factors, collecting data to ensure we can identify patterns for early diagnosis, which will go a long way in preventing a health problem before it arises or at least in giving care providers more time to work out more effective treatments to tackle the problem early.
Connected Health is often misunderstood to be only about devices. A holistic perspective on connected health includes these 4 areas:
- Connected Devices – Consumer and hospital diagnostic devices, wearables, and tele-health tools that enable the final connectivity with patients. These collect diagnostic information and transmit health records over mobile phones, IoT and onto the cloud.
- Connected Services – Services that can be provided in association with one another and span the entire journey of a patient. This idea enables services across primary, tertiary, post-discharge, transitional and home care to be seamless for a patient.
- Connected Systems – Connecting data and systems so information access is seamless for patients and providers is critical for the above ideas to take shape. With a connected system, extended care teams and patients’ next-of-kin can see aggregate information, care plans, progress and protocols.
- Connected Healthcare Ecosystem – Connecting with national or regional government-led databases, aggregations of systems, services and policies helps build a connected ecosystem.
Two key building blocks for making connected health a reality would be: (1) Technology strategy, solutions and its readiness; and, (2) Understanding business models and opportunities.
Right Technology & Strategy
Existing tools and applications, although important, need to be evaluated for their technical capabilities to support a connected health strategy. New solutions and tools need to support some of the core principles outlined below to enable this strategy.
- Technology architecture that is modern – Natively built as a web-based system with a service oriented architecture (SOA)
- Open standards based system with HL7 and FHIR interfaces that enables interoperability and data exchange with minimal custom integration work
- Adoption of a micro services and integration approach using ESB to collect data from diverse sources, prioritize and create queues for data processing, identifying alerts and building consolidated dashboards
- Built-in integration with wearables, devices to capture activity levels, vital stats with an IoT or mobile gateway
- Mobility strategy with applications for key users (e.g. Mobile EMR access, Nurse assistant)
- Responsive user interface built using HTML 5 that conforms to the latest UI standards
- Integration with national databases and revenue cycle interfaces—NEHR in Singapore, ACFI in Australia or HAAD in UAE and others in different countries
- Ability to leverage advances in Artificial Intelligence and Machine Learning to create superior interfaces for key stakeholders as well as automatically detect errors, fraud and optimization opportunities in care delivery
Business Models and Opportunity
Connected Health is a business opportunity that can be looked at as a differentiator with an integrated approach to healthcare. It opens up new business models that can be looked at independently as new business lines with their own P&L or to augment and enhance existing core businesses. It also provides an opportunity to build an ecosystem with suitable partners.
The opportunity cost and impact of not preparing adequately for this transformation and not having the right technology strategy and solutions will severely hamper the healthcare business going forward. It risks:
- Losing referrals without a working referral management system that automates the ability for general practitioners (GPs) to send and track their referrals
- Significant revenue losses due to the absence of well-established and fully functional interfaces with payer and government reimbursement systems such as ACFI in Australia, HAAD in UAE etc.
- Negatively impacting patient experience, net promoter score (NPS) and hence patient loyalty when the patient journey between primary care, acute care to transitional care to home care is broken
- Loss of revenue growth opportunities with new add-on services such as lab services at home, chronic care management, digital access to EMR, patient portal with booking/scheduling capabilities, mobility access for patients etc.
- Reducing business velocity. With ongoing consolidations and formation of larger healthcare networks, smaller business have to build on their healthcare services with trusted partners, referrals and data exchanges. In the absence of such a network, their room for growth is limited.
However, with a good technology strategy, the right solutions and taking on the approach of building business models with service extensions or with a partner centric approach, the healthcare business can emerge stronger and better equipped to take advantage of the Connected Health-driven healthcare evolution.
— By Anil Kumar, Vice President, Products, Napier Healthcare Solutions