Healthcare 2019: Expert Expectations for the New Year, continued from page 16 plained. “It’s become imperative to retrain and reskill employees to get the most out of investments in technology.” It’s something employees are willing to undertake. In fact, 75 percent of those participating in the PwC survey said it was ‘very’ or ‘somewhat’ important that an employer offer training in emerging technologies, and 74 percent said they were more likely to stay with an employer that offers upskill programming. Walker noted, “You have to have a workforce that’s able to move with you.” This is true across the spectrum of healthcare employees from administrative staff to providers. He added, “Clinicians are going to have to learn to work closely with technology to get the most out of it.” Another key takeaway on the changing business model is the push to create a ‘Southwest Airlines’ culture in healthcare where value and transparency play a prominent role while still meeting customer expectations. The report points to other examples, including Costco and Uber, as companies that have successfully created a ‘value line’ of products or services. “Those companies have optimized value, lowered cost, and most importantly have still figured out how to turn a profit,” said Walker. “Southwest was a disrupter in the industry,” he noted of the upstart Texas company that turned the airline industry upside down. While healthcare continues to be on a slow journey to greater price transparency, consumerism and efficiency, Walker said there has been significant movement over the last few years. “The interplay between regular industries and healthcare is greater than it’s ever been, and that’s also driving lower cost and greater efficiency,” he stated. “We know so much more now than we did about healthcare cost. We’re engaging the consumer in more efficient ways to deliver healthcare.”
Drilling Down on the Disruptors Technology: “If you’re a healthcare service delivery organization, you are thinking about the portion of the population you address, the comorbidities they have, the patients at high risk, those at moderate risk, and how you become more relevant in the context of being a real solution or more important component part for that population as a whole and in a more integrated way,” Dashiff said. “To do that effectively, you have to tech-enable your business, and you are seeing the necessary investments by traditional services companies and companies with new business models.” He continued, “The pace at which technology is moving is resulting in some pretty accelerated capabilities that just frankly didn’t even exist three to five years ago.” Telemedicine and artificial intelligence are two areas where he said there is a lot of excitement for all the right reasons … both from an investment perspective and the possibilities to improve health and outcomes. Telemedicine is not just an IT play,
he noted, as it spans across health technology and healthcare delivery. “There has been capital that has poured into that marketplace over the last five-plus years,” he continued, adding the business is morphing beyond initial direct-to-consumer expectations. “What you’re now seeing is that telemedicine, in a lot of ways, can be more of a B2B solution as well, in terms of creating integrated delivery models and leveraging virtual care as a way to get at addressing the broader needs of a population.” He added the virtual care component also offers a solution for key clinical areas where provider shortages exist. “If you’re going to try to be in the population health management business, you better have some telemedicine solutions wrapped around behavioral and other specialties because you’re never going to have the feet on the street to do all of that,” Dashiff noted. Just as telemedicine is gaining traction, the use of artificial intelligence has taken off to help quantify where a population currently stands, predict risks from both clinical factors and social determinants, and recommend early interventions to change the trajectory. “Everybody has sort of talked about artificial intelligence for a while. It’s becoming a reality, and you’re going to see a lot more of that in ’19 and even more in ’20. There are very real companies that are doing some very compelling things in enabling healthcare
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organizations to do more transformative health service delivery,” said Dashiff. Walker noted investors pumped $12.5 billion into digital health ventures in both 2017 and 2018, which is a 200 percent increase in funding compared to five years ago. Like Dashiff, Walker said actionable data allows healthcare professionals to intervene earlier and allocate resources based on risk profiles. “It directs care to areas where it’s needed more,” he said. Walker added wearables and other digital engagement offerings have gained acceptance among providers and the public. “A majority of consumers surveyed are interested in FDA-approved apps or online tools to treat their medical conditions. I think that’s a change from three to five years ago,” he said. Walker added the PwC survey found 56 percent of physicians are now incorporating digital therapy discussions in their interactions with patients, highlighting an increasing comfort level with data-sharing technology. Byproducts of sharing information at greater rates include the need for solutions to improve interoperability across the continuum and enhance cybersecurity measures to protect data flow. Employer-Sponsored Healthcare: Underscoring an earlier point, Dashiff said transformation often happens in the private marketplace where there is more flexibility and a direct value proposition. An example is the worksite clinics
that employers have historically used to improve productivity and reduce absenteeism. “What’s happened over the span of a couple of decades is you have employers, particularly self-insured employers, who are probably the most in control of their destiny as it relates to improving outcomes and bending the cost curve. They are probably the most motivated party participating in the healthcare delivery system to pursue significant change,” said Dashiff. He added their position allows them to look at the unique intersection of the patient, provider, and ultimate employer payor coming together in a way that can use the onsite or shared-site clinics as a hub to serve an entire population health management strategy when wrapped with the appropriate analytics capabilities and tech-enabled solutions for engagement and virtual care outside the walls of the clinic. While worksite clinics have been around for decades, Dashiff said what has changed is the ability and desire of self-insured employers to be able to bring the various component parts of a population health strategy under one umbrella, coupled with the technology to stratify risk and identify employees and family members who might benefit from specific interventions. The beginning of last year saw Amazon, Berkshire Hathaway and JPM(CONTINUED ON PAGE 18)
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Birmingham Medical News
JANUARY 2019 • 17
Birmingham Medical News January 2019