The intersection between rising consumerism and a growing retail orientation in the health care sector presents challenges, some unprecedented, for existing players. We explore three shifts that health industry players should respond to, and that can set the scene for greater consumer involvement.
Matching a buyer with a seller. On Angie’s List it’s simple: Consumers search, select, and schedule the services that fit their needs.
Could it ever be that easy in health care?
The cost of health care is high and rising. For the past 10 years, health care costs have exceeded US economic growth by an average 2.5 percent annually. The anticipated average annual growth rate of health care costs is 5.7 percent per year through 2023, well above gross domestic product (GDP), average wages, and productivity gains.1 Improving economic conditions, the impact of the ACA’s insurance coverage expansions, and an aging population are expected to drive health care expenditure growth.2 Average annual growth of out-of-pocket health care expenditure is projected to rise to 5.5 percent by 2023 from 3.2 percent in 2013.3
The health care system in the United States is edging toward a recalibration. Existing business models are being challenged to find and deliver new sources of value and to develop innovative approaches to make health care less complicated, and to improve outcomes:
Health care is moving toward value, not volume, as a central organizing principle. That impacts how patients are cared for, how physicians and hospitals are paid, and how life sciences companies approach the market.
Those paying the bills—employers, government, health plans, and increasingly, individuals—are looking for better value and better outcomes.
Entrepreneurs, retail organizations, and communications and technology companies see opportunity in the large and growing health care market. Taking advantage of developing trends, they are slipping across the industry’s increasingly permeable boundaries.
Health care access, affordability, and quality are problems all around the world and large numbers of individuals do not receive the quality care that they need. Mobile technology offers ways to help with these challenges. Through mobile health applications, sensors, medical devices, and remote patient monitoring products, there are avenues through which health care delivery can be improved. These technologies can help lower costs by facilitating the delivery of care, and connecting people to their health care providers. Applications allow both patients and providers to have access to reference materials, lab tests, and medical records using mobile devices.
Complex mobile health applications help in areas such as training for health care workers, the management of chronic disease, and monitoring of critical health indicators. They enable easy to use access to tools like calorie counters, prescription reminders, appointment notices, medical references, and physician or hospital locators. These applications empower patients and health providers proactively to address medical conditions, through near real-time monitoring and treatment, no matter the location of the patient or health provider.
In this paper, part of the Mobile Economy Project, Darrell West looks at specific applications and inventions, and discuss how mobile is transforming health care in the United States and around the world. He argues that mobile health helps frontline health workers and health care providers extend their reach and interactions – enabling them to be more efficient and effective in their provision of medical assistance. And in the conclusion, West recommends several steps that will speed the adoption of mobile technology in health care.
- Policymakers should encourage the use of mobile devices for health care. Moving to electronic systems for service delivery will save money, improve access, and provide higher levels of quality in both developed and developing nations.
- Nearly three-quarters of medical expenditures takes place on a small number of chronic illnesses including cardiovascular disease, cancer, diabetes, and asthma. We should encourage the use of mobile systems that monitor patient symptoms and provide real-time advice on treatment and medication because they have the potential to control costs, reduce errors, and improve patients’ experiences.
- We should work to remove barriers to adoption of mobile applications that aid in chronic disease management and make these tools much more widely available.
- With growing knowledge about diseases, genetics, and pharmaceutical products, the practice of medicine has become far more complicated. Health providers need access to as much accurate data as they can get on how to treat various ailments.
- One of the barriers to cost containment and quality service delivery has been the continued reliance in many locales on paper-based medical systems. In a digital world, one cannot imagine a costlier way to run a health care system.
- On the issue of government regulation, the FDA has finalized its guidance on how mobile applications and regulated mobile medical devices are to be treated in an effort to clarify some of the ambiguities and help further innovation. Having clear rules that encourage desirable behavior is the best way to move forward in mobile health.
Editor’s Note: This paper is released in tandem with the panel discussion: The Modernization of Health Care through Mobile Technology and Medical Monitoring Devices on October 22, 2013.
- Frost & Sullivan Examines the Future of On-Demand Mobile Personal Health Records (hispanicbusiness.com)
- Mobile Health Could Save developed countries $400 billion by 2017 (nextbigfuture.com)
- The Explosion In Health Apps, And How They’re Disrupting The Gigantic, Lethargic Health Care Industry (businessinsider.com)
- Better Living Through Mobile: A Patient’s Journey (blogs.sap.com)
- Next-Gen Nanotech Breath Sensor Could Change How We Monitor Health (medgadget.com)
- Leading Healthier Lives Through Mobile Technology (blogs.sap.com)
- Patient care appears to be catching up with mobile technology (kevinmd.com)
- Better Living Through Mobile: A Patient’s Journey (business2community.com)
- Finally, FDA tells mobile health app developers what it plans to regulate [GigaOM] (gigaom.com)
- FDA To Regulate Some Mobile Health Apps (cio-today.com)
Source: Institute of Medicine
Population Health Implications of the Affordable Care Act is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement.
Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health.
Population Health Implications of the Affordable Care Act looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the “doctor’s” office. Improving the health of the population – whether in a community or in the nation as a whole – requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action.
Rational Rationing vs. Irrational Rationing By DAVID KATZ, MD in the 13 September 2012 article at The Health Care Blog
n a system of universal, or nearly universal health insurance such as in Massachusetts, decisions about what benefits to include for whom are decisions about the equitable distribution of a limited resource. If that is rationing, then we need to overcome our fear of the word so we can do it rationally. By design or happenstance, every limited resource is rationed. Design is better.
In the U.S. health care system, some can afford to get any procedure at any hospital, others need to take what they can get. Some doctors provide concierge service, and charge a premium for it. Any “you can have it if you can afford it” system imposes rationing, with socioeconomic status the filter. It is the inevitable, default filter in a capitalist society where you tend to get what you pay for.
That works pretty well for most commodities, but not so well for health care. As noted, failure to spend money you don’t have on early and preventive care may mean later expenditures that are both much larger, and no longer optional — and someone else winds up paying. If you can’t afford a car, you don’t get one; if you can’t afford care for a bullet wound — if you can’t afford CPR — you get it anyway, and worries about who pays the bill come later.
But those costs, and worries, do come later — and somewhere in the system, we pay for them.
By favoring acute care — which can’t be denied — our current system of rationing dries up the resources that might otherwise be used for both clinical preventive services and true health promotion. Fully 80 percent of all chronic disease could be eliminated if our society really rallied around effective strategies for tobacco avoidance, healthful eating, and routine physical activity for all. But when health care spending on the diseases that have already happened is running up the national debt, where are those investments to come from? The answer is, they tend not to come at all. And that’s rationing: not spending on one thing, because you have spent on another.
Nor is this limited to health care. The higher the national expenditure on health-related costs, the fewer dollars there are for other priorities, from defense, to education, to the maintenance of infrastructure. If cutting back on defense calls the patriotism of Congress into question, then classrooms get crowded and kids are left to crumble. Apparently, it is no threat to patriotism to threaten the educational status of America’s future. …
- How Would You Like Your Rationing – Rational, or Irrational? (thehealthcareblog.com)
- U.S. health care system wastes $750B a year (cbc.ca)
- Waste and Promise Seen in U.S. Health Care System (nytimes.com)