Healthcare: In service of the people

In the age of consumerism, chronic disease, and technological innovation, the future of patient-centered healthcare will be very different from today’s experience. That is a good thing.

Healthcare is a service. Transformative methodologies deployed for decades in other service industries will be adopted, albeit evolved, into healthcare. And by far, the foremost service trend across all sectors is heightened personalization and greater choice — expressions of brand empathy with the customer.

The future of healthcare lies in authentic empathy for the individual patient — healthcare’s ultimate customer — and cultivating long-term relationships with brands based on trust and value.

At the recent HLTH conference in Las Vegas, there appeared to be some confusion around identifying healthcare’s ultimate customer. Speakers intermixed “consumer” and “patient” throughout their talks. It raises a question, “How about person?” A talented patient engagement leader exclaimed, “Our patients are just like the real people in the community.” News flash: They are the real people in the community.

This muddling reflects the perceptual difficulty healthcare faces as it tries to adapt to a modern continuous engagement model. The old idea that “patients” are event-driven phenomena requiring treatment at a hospital on the hill is fine for acute illness and injury. But it does not work for conditions that individuals live with continuously. Today’s most pressing health issues overwhelmingly skew toward chronic disease prevention and management — which requires a much more cooperative and participatory care and service paradigm. You probably will not need to see an endocrinologist at a big medical center tomorrow if you join your neighborhood diabetes prevention program (DPP) today: People require both kinds of healthcare delivery and they need to be treated as people just like any other industry selling services.

The future face of healthcare also requires contemplating brand and its role in service delivery. The incentive structures, technologies, and care requirements of our system traditionally encourage shining temples of exemplary care — where glitzy décor, classical statuary, and a hotel-like experience convince you where you should have your surgery.

Beyond the “fanciest building” approach to drawing customers, health systems have not contemplated the lifetime value of the people they engage — preferring, more typically, a distinctly transactional outlook. Our engagement and evaluation tools reflect this, and few large systems have an engagement plan that matches the shine of their new hospital building.

On the other end of the spectrum, a company like BMW can tell you the long-term value of all its customers. This Customer Lifetime Value (CLV) is a measure that drives the automaker’s decision-making around marketing, sales, product development, service, and more. The underlying logic is to get you started with a 3 Series, upgrade you to a 5 Series, and ultimately shepherd you into an MClass, SUV, or 7 Series. BMW’s goal is to be your preferred car provider through all the stages of your driving life.

Conceptually, CLV traces back to the late ’80s, when marketing had a revolution in data-driven analytical approaches to better business insight. The work helped justify spending early to forge a customer relationship and fostering profit growth over time. CLV heuristics are obviously rooted in general business sentiment — the idea that it’s good to keep a customer is not new. Yet advancement in data-based spending and profitability models supporting long-range customer engagement strategy has transformed our entire retail experience and most service segments. And it should transform future healthcare delivery as well.

This model has further matured as companies like Amazon and Google articulate the value of investing to perpetuate customer loyalty — acceptable losses today incurred as a pathway to steady profits tomorrow. At the core of this analytic mindset is a very simple concept: empathy.

Exponential tech advances will change the world faster than we think

We live in a world of exponentially increasing technology advancements. Never in the history of mankind have so many such advancements emerged in parallel and in combination, carrying so much impact.

The phenomena are marked in time: The timing from what once seemed impossible to possible and functional can become extremely short – sometimes measured in just days or weeks. Ever heard the maxim that internet years are like dog years, where one in actual elapsed time equates to seven? Exponential advancement is the reason.

Some exponential advancements are now so predictable, such as the rate of growth of computing power, that companies have baked-in the expected advancements in their products. Similarly, it is fairly predictable that full genome sequencing today can be done for a few hundreds of dollars, as opposed to the thousands required in 2015, or the millions in 2006, or the billions for the first full sequence in 2003. The speed of wireless communications will soon multiply by at least 10X, and deep learning will continue to exponentially advance in capability in our near future. And all of this is happening in concert. As a result, it has become harder and harder to develop new companies based on any of these advancements alone.

The greatest opportunities for new venture breakthroughs come when we apply multiple exponentially growing advancements of these technologies together. Call this the “collision of exponential technologies.” This collision amplifies both power and possibility. It’s not the old business adage of 1+1=3. It’s 1+1=1000.

At HLTH, 3 patient experience officers indicate emergence of new era of patient engagement

Jack Stockert, managing director at Health2047 and who was the panel moderator, asked them to share some examples to illustrate their feelings about enhancing the patient experience. Dubovsky offered a quote from a former head of spiritual care, underscoring health’s transitory nature: “Cedars Sinai is a place where the temporarily well take care of the temporarily unwell.”

Boissy talked about one of her multiple sclerosis patients, who had been hospitalized for an infection. She found him crying in his room and soon learned his son had been killed but was still on life support at another Cleveland hospital. She had the son transferred so her patient could say goodbye.

“This is about recognizing the work we do is incredibly human, and it haunts people,” said Boissy. “Whether it’s cool technology or simply recognizing that we have human beings delivering human being care, we will go much further, faster.”

In keeping with the conference’s attention towards precision medicine, Dubovsky discussed precision engagement.

“We’ve convinced ourselves that every single patient discharge from our facility needs the exact same survey at the exact same time with the exact same questions…It just makes no sense.”

He wants to reverse-engineer this approach, starting with the patients and determining which questions are most appropriate for a woman who just delivered a baby or someone with stage 4 cancer.

The panel agreed they have a long way to go, but expressed optimism that cultures are changing and they will ultimately get there.

“So, for the first time we have a clearly articulated strategy about what we’re hoping to accomplish,” said Boissy. “I feel a tremendous amount of hope around all of us…united around what we’re hoping to accomplish in this strategy and then building it out.”

Cybersecurity Is Not Necessarily A Technology Issue

The latest affront to cybersecurity in the healthcare space is an investigation conducted by ProPublica discovering that medical images and health data belonging to over 5 million Americans have been sitting on 187 servers across the nation that are unprotected by passwords or basic security precautions and accessible to anyone with internet access and "basic computer expertise."

It made for shocking headlines, and steps have been taken to rectify the situation. However, most people will no doubt soon forget it, just like the 551 active cybersecurity breach investigations currently listed on the Department of Health and Human Services website. The ProPublica investigation noted that incidents have affected over 40 million individuals in the U.S. over the just past 24 months.

Cybersecurity failures involving what should be sacrosanct health information have become so frequent and common that we are collectively desensitized.

There's even a now-standard response usually involving many apologies and promises to do better, followed by a brief witch hunt and the purchase of some supposedly improved technology or security system. Then it's back to business as usual. Like popular consumer security systems for the home, we collect the greatest new gadgets, install them and play with them for a few days. Then we quickly decide they're too much of a hassle to activate all the time or maintain, and we forget about them — until porch pirates attack and we decide it's time to buy the latest upgrade.

The same thing happens in healthcare cybersecurity. We buy lots of software and technology and then hope for amazing miracles to ensue so we don't have to worry about it anymore.

But that's not how cybersecurity works. Technology will not fix this problem.

AMA CEO: Innovation isn't about theory — it's 'a new idea'

Innovation is not merely a synonym for brainstorming, but should instead describe the process of developing actual life-changing solutions, according to James Madara, MD, CEO and executive vice president of the American Medical Association.

During a recent program updating AMA employees and partners on the work of Health2047, the organization's Silicon Valley-based innovation arm, Dr. Madara explained the AMA's innovation philosophy.

"Think of innovation as a new idea that's helpful brought to market," he said, per a recap of the program from the AMA. "It's not theory. It's something that can be applied and can change lives."

Among Health2047's ongoing projects is an initiative to improve interoperability and the exchange of data. "The problem with healthcare data is it's sort of like your grandmother's attic. It's got all this stuff up there; nobody really knows what's up there, and it's not organized. … That data should be assisting us in how we do healthcare," Health2047 CEO Larry Cohen, PhD, said at the program.

As such, Dr. Madara quipped that success for Health2047 and the AMA's innovation efforts would be like "cleaning Grandma's attic."

Read more here.

Zing Health to launch tech-driven approach to tackle SDOH

Zing Health was formed last August by Silicon Valley-based Health2047, a company co-founded by the American Medical Association to address issues in chronic care, value-based care, data and productivity.

"Zing Health is uniquely positioned to transform value-based care thanks to its innovative approach, its laser focus on service delivery and its tech-enabled platform that works alongside members and physicians," says Lawrence Cohen, CEO of Health2047. "Isolated point solutions in healthcare are not enough—we need effective, transformational change from forward-thinking companies like Zing Health which focus on the entire healthcare ecosystem and address inadequacies, deliver value and produce better outcomes."

Zing says it plans to co-locate healthcare providers with community partners to collect “real-time, on-the-ground data” about members. By partnering with community organizations and clinics, Zing Health's clinical care teams can connect members to lower-cost or overlooked local services, the company says.

The approach will help Zing’s members achieve the best health possible by ensuring they can access convenient, effective and comprehensive care, Whitaker says.

Community health experts will work with Zing in the community to create individual care plans for members, help answer member questions and follow up on care. Zing’s clinical teams will address contributing SDOH issues, such as: housing quality, food availability, access to transportation and racial and gender inequality. The clinical teams will also make house call to identify asthma triggers, Zing says.

Zing members will each have a health team that includes a medical provider, a nurse, a behavioral health specialist and a community health worker. Twenty-found hour nurse advice lines will be available, as well as telehealth video services.

Zing Health's team of caregivers takes the time to get to know members' health needs and goals, the HMO says, which plans to remove authorization barriers and give doctors more support in delivering care and guiding outcomes.

Zing Health is the third company to spin out of Health2047. The company's first spin out, Akiri, is building a cloud-based, peer-to-peer network to enable trusted data exchange across the complex U.S. healthcare economy. Health2047's second spinout, First Mile Care, is a preventive chronic care company building an affordable, scalable and sustainable platform to reverse prediabetes.

More, More, More: Removing data inefficiencies will remove healthcare roadblocks

In today’s incredibly connected world, more health data is available than ever before—but how much of it is being transformed into actionable information?

Not enough.

From routine patient care to record keeping to requisite regulatory compliance details, the healthcare industry generates enormous amounts of directionless data. All that data on its own may not hold any tangible value, but the future of healthcare will be reshaped if we can leverage it to improve care.

Massive collections of big data have already permeated many components of the health ecosystem and are fueling new forms of service delivery. The rising ability to collect patient data and transmit from remote locales accelerates the reach of virtual healthcare and telemedicine. Innovative predictive models fed by troves of imaging data can better anticipate disease. Data from wearables such as a Fitbit or Apple watch can aid in developing more personalized, lasting healthcare approaches.

That’s the good news.

The bad news is that the vast majority of these developments transpire in isolated, unscalable, limited-purpose silos. There are very real barriers to translating health-data-based innovation broadly into improved healthcare practice. An American Hospital Association study identified key roadblocks such as a lack of compatible technology among providers, difficulty in data exchange across different vendor platforms, challenges with matching/identifying patients between systems, and the prohibitive costs of customized interface development and data exchange with outside systems.

Meanwhile, frustration over clumsy, one-size-fits-all approaches to fundamental data technologies such as EHRs continues to undermine the physician-patient relationship and hinder greater data literacy in the industry. It turns out that striking a balance between sharing and protecting health data is extremely complicated, as is doing so without alienating or overburdening those who need to use it.

Beyond meeting explicit regulatory or contractual requirements, healthcare organizations still struggle to define data collection intent and purpose within their own confines, much less properly analyze and exchange data insights industry-wide.

There’s a void in data usability standardization—and that void is an enormous obstruction. Filling it requires a means to make health data more purposeful and portable regardless of provider system or interface. It requires that health data, itself, be made interoperable.

Realizing the benefits of health data interoperability at scale will necessitate broad, multidisciplinary collaboration and coordination. That’s no small feat in our necessarily cautious and complex sector.

But it is possible, as data innovation in other highly complex and/or regulated ventures such as geographic information science or algorithmic finance have shown.

MA Plan Zing Health: At-Home Care Providers Are the Vanguards of Patient Care

There were more than 2,700 Medicare Advantage (MA) plans available for individual enrollment in 2019, an 18% bump compared to last year. The number of active MA plans is projected to increase even further in 2020, thanks to federal health care policymakers’ concerted efforts to broaden the program and address social determinants of health.

Launched in August by the American Medical Association spinoff Health2047, Zing Health is just one of the up-and-coming MA players to enter the picture.

Currently eyeing underserved markets in the Midwest, the tech-enabled Zing Health has a two-fold mission: to elevate the patient-provider relationship and alleviate social barriers that impact its members’ well-being.

Zing Health is the third company to come out of Health2047, the Silicon Valley business formation and commercialization enterprise launched by AMA in 2016.

AMA Startup To Launch Medicare Advantage Plan ‘Zing Health’

A new Medicare Advantage health plan—Zing Health—will open in Cook County, Illinois in 2020. During 2021, Zing Health intends to expand to counties in other states. Zing Health is a for-profit company created by Health2047, a California-based business incubator funded by the American Medical Association (AMA). Zing Health was co-founded by Health2047, TWG Partners Founder Eric Whitaker, M.D., and Harthaven Capital Founding Partner Ken Alleyne, M.D. Zing Health will be directly managed by Dr. Whitaker and Dr. Alleyne. Zing Health’s Medicare Advantage plan network features community ambassadors, provider organizations, and hospitals. Zing . . .

Health2047 spins out tech-enabled Medicare Advantage plan for underserved

Health2047 is launching Zing Health, a tech-enabled Medicare Advantage plan for those who are underserved by existing insurance plans.

Zing Health's goal is to address the social determinants of health by delivering a wide array of services with little-to-no cost for members, an over-the-counter formulary and by offering patients access to care at novel sites such as federally qualified health centers.

Its Medicare Advantage plan can be personalized by each patient, Health 2047 said. Each Zing member will have access to a local field care team which can connect the individual to necessary services.

The field team will also embed itself at partner hospitals to coordinate timely procedures and appropriate discharge practices.

Zing will use data from health assessments and socioeconomic situations to lower health risks for members and provide physicians with resources to improve population health management.

It will focus its initial efforts in the Midwest.