From patient to consumer – healthcare in the digital age
Are digital health platforms set to make a greater impact than the majority of molecules developed over the past 20 years? Nick de Cent investigates.
“Pharma has been investing billions in finding new molecules or new uses for old molecules, but the impact of software is as great or greater than 90% of the medications developed over the past two decades.” It’s a bold statement but Rick Lee, Chief Imagineer at Hickory Ridge Capital, speaking to eyeforpharma ahead of his presentation at the Value Added Services Conference, reckons we’re at the start of a seismic shift in the health landscape.
That transformation is the move towards individual patient empowerment and engagement through a consumer-centric model, rather than the current system that focuses on physicians “dictating” to multiple patients about their healthcare. It’s bringing healthcare into the digital age.
Changing the model
“This is a great change in mindset,” says Rick. He’s the man behind the pioneering Healthrageous health management initiative that served employers and four major US health plans before its sale to Humana in September 2013. The idea behind Healthrageous is to offer consumers with chronic health problems the ability to self-manage their conditions via the web and a mobile app. It is also equally applicable to healthy individuals seeking to maintain or enhance their fitness and wellbeing.
“Individuals need different approaches. We all learn differently, comply differently and engage differently,” Rick explains. “We’re changing the model from a provider-centric to a consumer-centric model.”
The system is built around a proprietary platform that “incorporates personalized goal setting, health journey maps with gaming dynamics, timely biometric feedback and interactive digital coaching”. The digital coach itself is based around multiple tools such as inspirational messages, recognition and incentives, challenges, social networking, trackers and reminders, and interactive educational content – all of which seek to inspire an individual to take action to improve or manage their health by being rewarded for achieving relevant goals.
Because the Healthrageous solution can be customized – interacting differently with different people – and because it is also reactive to data, it enables consumers to make their own healthcare decisions and take part in managing their conditions to improve their own outcomes. Rick emphasizes that this contrasts with the “one-size-fits-all approach” still prevalent in the healthcare sector whereby the physician delivers the same message to different patients and assumes they are all going to understand and comply equally.
For instance, because people with chronic conditions are motivated in specific ways, they need tailored approaches in order to achieve the best health outcomes. For some, fear may be a powerful motivational factor, while others may need encouragement. If you’re a runner and a “type A” personality, a little competition with your peer group may be all that you need to get motivated, perhaps to cut down on alcohol consumption for example.
Taking the example of cancer treatments, terminal patients often have very different attitudes towards how they want to approach the remaining time they have: some may want to fight to the end to gain time, while others may wish to avoid treatment side-effects in order to enjoy the best quality of life possible over a shorter period. According to Rick, it is the doctor’s role to find out what the patient wants to do rather than to impose a treatment regime.
In the US we’re becoming much more accustomed to self-management. Why not bring this to healthcare?".
”One doctor is incapable of corralling all those approaches to ensure people follow their treatment. What you’re trying to do is to delight people into enjoying their own health,” says Rick.
Similarly with a person tending towards type 2 diabetes, empowering that individual may lead to all sorts of benefits and improved outcomes. Rather than simply putting the patient on an early-stage oral medication, for instance, the doctor could take a step back and probe the patient’s motivation around living with the condition. By asking the question “Do you want to make an effort to avoid getting diabetes?” and using a suitable digital platform designed to encourage weight management or reduce alcohol consumption, the doctor may be able to empower the individual to contribute more to managing their own condition.
“In the US we’re becoming much more accustomed to self-management,” explains Rick, citing airlines and banking as examples. “Why not bring this to healthcare?”
As the former CEO, he acknowledges that Healthrageous made mistakes during the development of its product, not least an early decision to target healthier individuals. Such self-activated individuals – or the “quantified selves” as they are known – simply represented too small a market. In 21st century America, older, less healthy, less motivated individuals make up a much more lucrative segment.
For this group, lifestyle management – that the individual, not the doctor, can control – is key. Healthrageous was able to incentivize a whole spectrum of behaviors, ranging from controlling weight and alcohol consumption to boosting exercise, sleep and water consumption – all factors that are important to emphasize in this context.
When individuals set challenging but achievable goals, they tend to be motivated (in different ways) to reach them. Furthermore, changes in routines can be accomplished in 3-4 months, so meeting a 90-day goal could change their behavior long-term. Harnessing the power of biofeedback loops is a game-changer, says Rick. “They are the single most powerful tool to educate the consumer without a doctor having to call up the patient”.
So how does this benefit healthcare providers, payers and the pharma companies? For a start, outcomes are improved; this is a big win not only for the patient but all concerned – society, pharma and payers. The major gain for payers such as insurance companies is in reducing the cost of providing for the chronically sick, while individuals also benefit through the discounts provided by “High D” health plans – consumers get less “first-dollar exposure” to medical costs. Meanwhile, pharma companies also benefit as a result of increased compliance or adherence to medications; non-compliance is a major drain on revenue.
There are further applications for pharma companies, too, for instance in the context of research. Digital platforms such as Healthrageous afford the potential to facilitate clinical trials, via an encrypted closed-loop model; this not only maintains the veracity of the data but also offers greater convenience to participants.
The rise of digital health platforms is beginning to change the entire healthcare landscape. In today’s value-focused world, pharma is in the business of improving outcomes rather than selling drugs. “We need to have interventions that are more than just pills or oral compounds,” Rick concludes.
Rick Lee will be speaking at Value Added Services 2014 in London, September 17-18, 2014. For more information, click here
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