Tim Davis, CEO and Founder, Exco InTouch
NOTE: The content below contains the first few paragraphs of the printed article and the titles of the sidebars and boxes, if applicable.
The step-change towards healthcare consumerism means that healthcare providers are increasingly targeting their products towards patients to help them become more engaged in their own healthcare decision-making along their journey as a patient, focusing on quality and convenience. With this in mind, healthcare stakeholders must adjust to new ways of patient engagement to accommodate their needs.
The healthcare industry is currently changing due to intense pressure from rising costs. With estimates that chronic conditions account for more than 75% of healthcare costs in the USA, the traditional healthcare model is reacting by becoming less of a business-to-business model, and shifting towards business-to-consumer, in an effort to increase patient engagement. This step-change towards healthcare consumerism means that healthcare providers are increasingly targeting their products towards patients to help them become more engaged in their own healthcare decision-making along their journey as a patient, focusing on quality and convenience. With this in mind, healthcare stakeholders must adjust to new ways of patient engagement to accommodate their needs.
A Look Back to Look Ahead
Before we examine how consumerism is changing the way healthcare providers engage with patients, let us look back at the historical problems facing patients trying to control and monitor their conditions. It became clear that improvements were not only needed — they were essential. The facts laid themselves bare: a basic lack of patient engagement; the inability of the patient to access their medical data; the patient not being supported with the right information at the right time; little or no transparency on their conditions and what their treatments would require; and poor access to the healthcare professionals. If healthcare consumerism is here to stay (and we see no reason to think otherwise) it is for the benefit of not only the patient, but the entire healthcare industry that these mistakes are eradicated, and that steps are taken to approach the treatment of chronic conditions in different, more innovative ways.
The numbers involved are quite staggering. Taking diabetes as an example; in the US alone, there are around 24 million diabetes sufferers. While 18 million of those are diagnosed, only 15 million actually receive treatment.
Of that number, as little as 6 million patients are well controlled and feel as though they are on a journey that will lead to them taking charge of their condition. Clearly, this is not healthcare consumerism as we know it, and this is not just a concern for patients, but also the healthcare professionals (HCPs) and payers. It is estimated that increased patient engagement could decrease care costs of the US diabetes patients from as much as $8,867 to $4,570 per year, resulting in a $4,297 saving per patient. Simple economics show us that by engaging with the patient in a way that will help them understand their condition and empower them to monitor it remotely, not only can the patient take charge of their own lives — and become the consumer, but this cost will come spiraling down.
Enter mHealth — The Key to Viable Healthcare Consumerism
If we are to embrace the era of healthcare consumerism head on, then we need to realize that mobile technology is ideally placed to help meet this challenge. Access to mobile and digital technology has seen huge growth in recent years; there are estimated to be 6.9 billion mobile subscriptions globally and 96% of the world population is now said to have access to mobile technology. Alongside this growth, the use of mobile technology has changed dramatically across the globe; from checking bus timetables through to highly regulatory activities such as mobile banking, we expect to use phones to find information and complete transactions as part of everyday life, and healthcare is no exception! As a result, mobile technology is being implemented across the world to help patients manage their conditions, with the mHealth market estimated to have reached $4.5 billion in 2013.
The term ‘mHealth’ is often used to describe the rapidly growing market for health and wellbeing apps. This market is predominantly consumer facing, and typically consists of relatively basic services with a singular focus; activity tracking, diet monitoring or providing condition specific information. As a result, these limited scope apps can often be static and research has found that user attention span is relatively short-lived with an average of only 3.7 uses per week, and less than a third of users are retained for 90 days.
So, if mHealth is to truly revolutionize health outcomes, there needs to be a paradigm shift in what it can achieve in terms of patient engagement. mHealth is not simply about patients downloading apps to their mobile devices which do nothing more than display simple metrics; it is all about providing dynamic programs that help patients as they become consumers of healthcare to manage their conditions and improve health outcomes. The key to a successful mHealth program is to engage patients over extended periods of times. This can be done by building integrated systems that use a variety of input materials (medication tracking, medical or lifestyle device data) and patient assessments – diaries and questionnaires – to tailor responses, which, for example, could be dashboards, content on a portal or automated alerts to HCPs to make the service interactive and personalized in order to engage the patient over extended periods of time.
How mHealth is Spearheading Healthcare Consumerism
Traditionally, the support offered to patients trying to manage their own conditions — to become consumers — was somewhat limited. Not any longer. mHealth can create a condition-specific care plan using a modular approach to select the most appropriate tools for each program, including data capture, education, alerts and goals. Each solution is adaptive, meaning that data summaries are tailored to each patient, and this capability can be expanded to enable the solutions to evolve over time as the condition progresses. Apps and connected devices can be integrated, such as blood glucometers, bar code scanners, activity trackers and other wearable technology, enabling patients to participate using devices that fit with their lifestyle.
The growth of mHealth is enabled by the adoption of a “bring your own device” (BYOD) approach, which promotes user familiarity and integrates healthcare regimens into a patient’s everyday life, enabling them to use their own communication devices. Consequently, mHealth services are now able to deliver phenomenal value for healthcare payers without the cost burden associated with traditional telehealth services that have previously been implemented to provide patient support and monitoring. However, to safely implement the use of patient’s own devices, payers must ensure that Personally Identifiable Information (PII) is protected in accordance with the regional data privacy requirements, such as HIPAA, Safe Harbor and EU data protection guidelines.
By taking advantage of these mHealth solutions, patients are able to personalize the service through goal setting to create true cost transparency and consumer engagement for both payer and patient for example reduced days off work or sleeping comfortably through the night. This can also be used to build reward through community activity, such as patients working together to walk the distance from Paris to Rome, often a more rewarding achievement than simply setting a personal goal of taking 10,000 steps a day.
Case Study: ‘Me&MyCOPD’
Having recognized the opportunity to immerse themselves in this new wave of healthcare consumerism, AstraZeneca are pioneering the development of ground-breaking integrated health programs having announced their strategic initiative, Intelligent Pharmaceuticals, which will be implemented across a number of key therapeutic areas globally. The first program to be announced publicly is Me&MyCOPD, which is initially being rolled out in the UK to support COPD (chronic obstructive pulmonary disease) patients. Me&MyCOPD is an integrated health solution designed to support each individual patient towards better medication and lifestyle management, providing personalized self-management tools for the patient which responds to the individuals needs in the right way, at the right time. The program uses a mobile and internet based platform to capture information, manage medication and support the patient’s existing COPD care-plan, integrating HCPs into the end-to-end process. Ultimately, Me&MyCOPD empowers patients to take control of their condition and self-manage to improve their health outcomes.
Information provided to the patient can be accessed in a variety of ways, whether through internet portals or mobile devices. This real-time interaction means that not only can the patient’s adherence to treatment regimens be monitored, but the patients themselves can be assured that, if their condition does worsen, they will receive further support and guidance and, when necessary, an intervention can be staged, and referral to their HCP can be made.
The Me&MyCOPD program not only improves the long-term engagement and the pro-active management of COPD among individual patients, it provides a comprehensive system to all of the stakeholders within the healthcare system, including caregivers, HCPs and healthcare payers. The program is the first to employ a personalized, truly mobile approach to monitor, support, and empower patients to take control of their condition, utilizing their own communication devices. Moreover, the program ultimately allows AstraZeneca to focus their efforts to deliver new medicines that will address unmet needs by expanding their understanding of how patients use and respond to various treatment options. This underpins the ‘Intelligent Pharmaceuticals’ strategy adopted by AstraZeneca and is a leading example of how optimized treatment can improve patients’ quality of life and health outcomes.
Contributed by: Tim Davis, CEO and Founder, Exco InTouch. Exco InTouch is the leading provider of patient engagement and data capture solutions for clinical research and healthcare providers. For more information, visit exchointouch.com.
mHealth — Bringing Together Payer and Patient
As we have seen, the emerging market for mHealth services holds within it the potential to revolutionize how the healthcare industry can adapt to the business-to-consumer model. Patients need — and want — access to information; they need to feel connected, to better understand their condition, be empowered and ultimately to enjoy better health outcomes. The shift from the supply side to the demand side of the healthcare industry represents a huge challenge for stakeholders. However, by utilizing mHealth to increase patient engagement, the promise of truly connecting consumers to the need to decrease healthcare costs is coming closer each day.