As the year comes to a close, I can’t help but reflect on where we are in the connected health adoption journey. 2018 will go down in history as a pivotal year. It will be cited as a year when we started to see evidence of movement from early adopter to early majority, or, if you like, moving from the gradual slope of the adoption curve to the steep ‘hockey-stick’ phase of growth. This is due to a convergence of factors from market forces and new reimbursement mechanisms to better technology.
Here are some observations:
This is the year digital health became a ‘stay-in-business’ application for the majority of providers and payers. Everywhere I go, the dialogue is about implementing digital health in order to remain competitive. The days of lengthy interrogations from decision makers about ROI, liability, reimbursement, and workflow seem to have faded into the past.
The Centers for Medicare and Medicaid Services (CMS) is on board! New codes have been presented over the last couple of years and they have embraced them. These new codes are classified in such a way that they do not drag with them the geographic restrictions of legacy telehealth reimbursement. While the impact is not yet obvious, this will make a huge difference in time. I predict that adoption of these new codes in 2019 will be modest, but as third-party carriers follow CMS’s lead, their use will take off. This will act as a springboard for new care models such as asynchronous, patient-initiated evisits, remote monitoring for chronic illness, and brief online inter-professional consultations between primary care providers and specialists.
With crystal ball in hand, I offer several other observations and prognostications for the year ahead:
Because of the sheer PR power that Apple possesses, this was the year that consumer devices became medical devices. It is too early to know whether the cardiac rhythm features in the Apple Watch will make a difference, but the world was abuzz with conversation about these new capabilities.
There is also growing discussion and interest in treating the whole person — treating more than a single symptom or condition — which can lead to improved outcomes and lower the cost of care. For example, integrating primary care with mental health and substance use disorder can proactively identify patient needs and better coordinate care to address and resolve potential issues. Value-based care emphasizes collaboration between care settings; and combines community-based resources with clinical care. These themes are part of a tendency to turn away from the coldness of technology and a renaissance of the human aspects of clinical care.
We have seen the market moving towards more consolidation, including the merger of ‘strange bedfellows…’ think CVS Health and Aetna; AthenaHealth and Veritas; Amazon and PillPack; Amazon, JP Morgan, and Berkshire Hathaway. With these consolidations, we will also finally begin to incorporate some of the learnings from consumer organizations — like engagement and personalization strategies — into our healthcare system. These developments make it hard to render predictions, as they don’t really seem to have a common theme other than consolidation. In 2019, we’ll learn more about what Amazon has in mind, what CVS/Aetna can really bring, what Walmart is up to, etc. I, for one, am not predicting how all of this will unfold.
I’m pleased to note that more attention is being paid to social determinants of health, both within and outside of healthcare, to promote health and health equity. We know that the conditions in which people are born, grow, live, work and age can influence health, and there are a number of emerging initiatives to address these factors. Once again, it is difficult to say how this will shape the market and care delivery, but it is a welcome emphasis.
Similarly, the business value of diversity in our workforce is being recognized, as a diverse workforce leads to insight from multiple points of view. For example, diversity is one of the greatest drivers of innovation, creates a robust learning environment and a more inclusive culture.
At Partners Connected Health, we saw great progress on several fronts, including the launch of a new mobile app for our PGHDConnect program, a cloud-based digital health platform that allows patients to share personal health data with their care team seamlessly and securely using their own consumer devices, via the Partners eCare Electronic Health Record (EHR). Our new telehealth initiative is gaining traction; and in collaboration with Persistent Systems, we launched Pivot Labs, a new center of excellence focused on reimagining the patient experience. Our Partners Online Second Opinion (POSO) team created a new online experience, to help patients and doctors from around the world benefit from remote consultations by national and international leaders in medicine, research, and training at Partners-affiliated hospitals.
Dr. Cynthia Breazeal at the Connected Health Conference 2018 – Photo courtesy of Christopher Huang
In October, we served as the Organizing Partner of the Connected Health Conference, in partnership with HIMSS’ Personal Connected Health Alliance. This thought leadership event will again return to Boston in 2019, and I’m pleased to continue as Program Chair for this important summit. As part of our mission to educate, inform and inspire others in the adoption of connected health strategies, I also launched a new podcast series, Well/Connected. We recently concluded our first season, and have lined up a schedule of premier visionaries and innovators for the year ahead.
With great momentum and enthusiasm, we close out the year and look forward to 2019 and what promises to be another exciting year! I wish all of you a warm, healthy, holiday season filled with family and fun.