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Healthcare Industry Trends: Intelligent Proactive Wellness

By Keith Pranghofer, Director Healthcare Market Development, Microsoft on May 10, 2018

Filed under Health

Focus on: Microsoft in Health Digital Transformation

Trupen Modi, Chris Regan and Firas Hamza believe in the power of technology to improve healthcare at lower costs. They are part of the Digital Advisory Services within Microsoft’s Office of the CTO focused on the Health and Life Sciences Industry, and below, they share insights and address common question about intelligent proactive wellness and the role of healthcare business intelligence and the patient experience.

Meet the panel

Trupen, Firas and Chris advise C-level and business leaders at some of the country’s largest payor and provider organizations on Healthcare Digital Transformation.

 

Trupen Modi

Senior Digital Advisor at Microsoft Healthcare

Advises C-level and business leaders on Healthcare Digital Transformation topics including proactive preventative health management, personalized patient experiences, precision medicine, and improved clinical staff productivity.

LinkedIn: https://www.linkedin.com/in/trupen/

 

Firas Hamza

Senior Digital Advisor in Microsoft’s Office of the CTO

A senior advisor to C-level executives on global digital transformation initiatives, Firas’ expertise includes guiding healthcare organizations through adoption of the latest technological advancements, including AI and machine learning, to improve patient experiences and health outcomes.

LinkedIn: https://www.linkedin.com/in/firas-hamza/

 

Chris Regan

Senior Digital Advisor in Microsoft’s Office of the CTO

With over thirty years of experience in innovating, planning, and enabling organizations and people through business and technology consulting, Chris  brings deep technical and business expertise across a variety of Healthcare and Life Science organizations with a focus on consumer strategies in healthcare, genomics and augmented realty for healthcare.

LinkedIn: https://www.linkedin.com/in/csregan/

What challenges are prompting payors to adopt next-generation proactive wellness programs?

Firas Hamza: Proactive wellness is particularly valuable for payors due to their strong interest in wellness and in reducing healthcare costs. The payor really wants to reduce the cost and keep you healthy before you become a patient, so we don’t even call them patients. We call them “consumers.” 

Trupen Modi: Proactive planning at the individual level can help prevent many chronic illnesses like diabetes, hypertension, obesity, etc., and contribute to healthier lifestyles. Additionally, more people leading healthy lives will reduce the overall cost burden on individuals, government, healthcare organizations, and society at large.

What’s great is that we finally have the data and healthcare business intelligence capabilities to support proactive wellness. We’re collecting all of this data with connected devices, apps, and the internet of medical things. You also have the data that payors are collecting. If you add machine learning to it and you add the cloud capabilities, all of a sudden you have all the elements to build a new, next generation wellness program. Most payors we talk to have old, static wellness programs. The programs may pay you to work out, but they have no way to track you, encourage you, or monitor your progress. We want to take it to the next level, supported by data, supported by the cloud, and build that next generation wellness program.

Chris Regan: The old adage, “an ounce of prevention is worth a pound of cure” is more relevant in today’s healthcare market than it has ever been. The New England Journal of Medicine estimated that 40% of US mortality is from preventable causes. Payors recognize that proactive wellness has greater potential to save money versus medical intervention. They’re now faced with how to work with consumers to encourage them to adopt healthy behaviors. It’s here that technology offers new, high impact options like personal health tracking, social encouragement, and health behavior gamification. 

This seems like a healthcare industry trend with huge, positive potential.  What opportunities can payors realize by embracing proactive wellness?

Chris Regan: Managing healthcare costs versus benefits is always a difficult balance. What is the appropriate amount to spend to save or extend a life or even improve the quality of life? It’s so much easier to choose to invest in preventing consumer/members from getting to that point. That is the ultimate promise of proactive wellness: saving money and resources by having consumers stay healthy and not become patients in need of costly medical interventions.

Trupen Modi: It’s the payors who have a strong interest in this because if people are well, they will have fewer medical expenses and that has a significant positive impact on profit margins.

Firas Hamza: There’s too much focus in the US on reactive healthcare. You get sick, you go the hospital or you have a procedure and your insurance company gets billed. Even if they have a wellness program, it’s static, it’s not data driven, it’s not intelligent. We want to empower the consumer and arm them with data and really create a better outcome and patient experience—before they become actual patients.

Trupen Modi: Access to data and healthcare business intelligence capabilities can provide a much deeper understanding of patient health, which lets payors and providers partner to provide much more precise treatment. That improves quality of care and timely intervention. They’re reducing the risk of the patient getting sicker, reducing the risk of higher expenses, and reducing risk of medical mistakes and ensuing lawsuits.

Firas Hamza: Additionally, I don’t think providers can afford to sit back and keep the power of all that patient data in their own hands. I think we’re headed to a new democratic healthcare system where the consumer shares power with the payor and the provider. The provider cannot just keep the status quo; they need to be part of the solution.

How does an organization begin to address this healthcare industry trend?  What are the first actions they should take as they build an intelligent proactive wellness program?

Firas Hamza: One of the first things in building a program like this is to pull data from different sources. Nine out of ten organizations are still building out the data portion, so the answer to ‘where do I start?’ is dependent on the organization’s maturity level. If they already have the data, then we start syncing the data and pulling it from different devices. The next step is to understand the data and build context so it will make sense to the user. The third level is to use machine learning to start looking for patterns. The last stage is to build the intelligent app that makes recommendations for the consumer.

Trupen Modi: There needs to be a recognition across participants in the healthcare system that post-illness intervention is not always the best approach, especially since so much chronic illness is preventable through education and lifestyle changes. Proactive wellness will require commitment, investment, simplification, and above all appropriate incentive-based plans for consumers.

Chris Regan:  Additionally, payors need to get to know their consumers without them being patients. This starts by creating a relationship with consumers “before and between the visits.” This gives you a single, complete view of the consumer the opportunity to develop a trusted communication channel with them.  

What are the biggest hurdles that organizations have to overcome in making the shift to proactive wellness?

Firas Hamza: The biggest challenge is building that platform—the data convergence hub that will create healthcare business intelligence. Many organizations are working on some kind of data convergence hub and that has to be the foundation of any next generation wellness initiative.

Trupen Modi: Organizations also have to very cognizant of security, privacy and compliance rules, as well as ownership of data.

Chris Regan:  Unlike managing costs, which payors control, wellness needs consumers to voluntarily participate and actively invest themselves. The payors have to look beyond the typical patient experience and learn, develop, or create new methods to influence consumers to participate in wellness. 

What would be your one last piece of advice?

Firas Hamza: Most organizations are looking into new, Digital Transformation initiatives, and sometimes it can be overwhelming—to the business managers and IT departments alike. Sometimes, they don’t know where to start or which initiative will show the highest value of return. My advice is the following: don’t try to boil the ocean. Start first with building an innovation lab and map out all processes for that.  In that environment you can learn to do rapid prototyping, fail fast, or succeed fast before building the entire solution.

Trupen Modi: For payors and providers, continuously engage with your customers. Educate, motivate and advise them about their own responsibility for their health.  The technology and tools you create should be there to empower them.

Chris Regan:  As in all good relationships, all parties have to benefit. Oddly, for consumers, living healthy and feeling better, is not always enough.  Payors and consumers need to create a mutually beneficial relationship where they both financially benefit from the consumer committing to and living a healthy life.

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