2018 was the year of the consumer, and there’s no sign of a change any time soon. The smartphone has paved the way for direct-to-consumer (DTC) marketing, driving refinements in marketing tools and redefining consumer expectations. Consumers increasingly value experience over product, and have come to expect personalized, targeted experiences—radically shifting the focus of the business marketplace.
The healthcare landscape is no exception to this shift: it is increasingly driven by the needs and desires of patients. Thanks to the rise of high-deductible health plans and premiums, patients are shouldering a greater portion of healthcare costs than ever before. This increase has positioned patients as consumers at the center of operational changes across the healthcare marketplace.
But innovations in digital health look different than those in DTC technology. First of all, health tools are not about “cutting out the middle man.” Instead, they are about reinforcing and improving the relationship between patient and provider that is fundamental to care. And they come with a unique set of challenges.
The stakes are much higher when consumer health is the product: patient safety is an imperative. Additionally, the wealth of data that is required for the success of many digital innovations raises serious concerns about data security and patient privacy, and the rapid growth of tech innovation complicates regulation.
As technology becomes more sophisticated, however, these concerns are being mitigated. And as consumer demand continues to dominate the marketplace, the healthcare industry—supported by the policy makers—is increasingly on board with tech innovation. Here are some things to look out for in the coming year:
Patient engagement has been a coveted label for apps and digital health companies from the get-go, and in the age of the consumer it is only increasing in importance, with rumors swirling that Amazon will leverage information it has learned from its 100 million+ users to roll out Prime Health. A recent survey conducted by SERMO found that three quarters of physician participants linked improved patient engagement with digital patient engagement tools, and 95% of participants had some form of digital education tool in their offices on the strength of this belief.
For doctors, a group that is traditionally reluctant to adopt innovations, that is a staggering number.
However, the label of “patient engagement” has been problematic—ambiguously defined and unregulated, it is impossible to quantify. Patient engagement isn’t going away, but we are learning how to determine its limits and place a value on it. Engagement cannot be measured by the initial reaction to an app—ultimately, if engagement is to be effective, it has to be sustained, and sustainable. These metrics rely largely on clinical concerns: automation, workflow integration, and provision of actionable data.
Mobile is here to stay
Mobile health devices have bridged the chasm between early adopters and early majority to firmly entrench themselves in the healthcare marketplace. They have quickly pervaded both clinical and operational spaces, catalyzed by recent breakthroughs in the government’s acceptance of mHealth and telehealth technology like three new CPT codes for reimbursement of remote patient monitoring in the 2019 Physician Fee Schedule and Quality Payment program. Mobile is old news. The innovation to watch for is artificial intelligence (AI): more specifically, conversational user interfaces.
Conversational User Interface (UI)
Conversational UI has been in the marketplace for a minute, but its increasingly refined Natural Language Processing (NLP) abilities that can identify a speaker’s intention are positioning it for widespread adoption. Hands-free, voice-activated interfaces such as the smart assistant Notable can reduce time spent searching through documents, making a phone call, or inputting info into a mobile app; and with NLP, can potentially be taught to anticipate needs of a doctor or patient.
A conversation with a chatbot can replace the tedious and time-consuming preliminaries of a doctor’s visit, and virtual visits for certain conditions could potentially eliminate the need for seeing a doctor altogether. Chatbots such as Buoy and Babylon offer real-time medical advice, facilitate booking appointments, and guide users toward the proper steps for care. Its learning capabilities position conversational UI to be a major player in the care continuum, particularly in the field of mental health, where virtual cognitive behavioral therapy that preserves anonymity, like that provided by Woebot, has already been successful in addressing anxiety and neutralizing risk.
Last year, Forbes touted 2017 as the “year of the API economy,” and healthcare is getting on board. Interoperability is a major player in digital tech innovation: patients will always receive care across multiple venues, and secure data exchange is key to providing continuity of care. Standardized APIs can provide the technological foundations for data sharing, extending the functionality of EHRs and other technologies that support connected care. With interoperability, data can be aggregated across multiple providers. Complete access to EHRs for patients and providers is an essential step in the push toward value-based care, providing a holistic picture of the patient’s health profile to themselves and any provider, and thus enabling targeted health outcomes. With major players Apple and Google making their health kits available to developers, we are going to see major strides toward these goals in the upcoming year.
Internet of Things (IoT)
The benefits of remote patient monitoring have been widely accepted across the healthcare sphere: the ability to monitor vital signs and assess reactions to treatments without the necessity of being in the same physical space as the patient is essential for delivering care to populations that lack immediate access to a provider and enabling real-time analyzation and intervention without time-consuming office visits.
IoT devices have extended their capabilities by leaps and bounds in the previous few years. The first FDA regulated “smart pill” was introduced to the market in November 2017. Ingested like a regular pill and releasing active medication, smart pills are also equipped with monitoring technology that relays information back to a sensor worn on the body, helping to regulate dosage and monitoring internal reactions. We are also going to see an emergence in wearable RPMs that provide a non-invasive alternative to managing care—like the connected contact lens conceived by Google and Novartis that monitors a diabetic patient’s glucose level by analyzing their tears, relaying the levels back to an insulin pump and alerting the patients. These innovations hold a lot of promise, but have met with mixed reactions from the healthcare community; for example, the electrocardiogram feature on the Apple Watch, though supported by the president of the American Heart Association, ignores recommendations of the US Preventative Task Force, and its roll out prompts many questions about the benefits of a user’s increased insight into their own health.
Blockchain is still a largely unknown entity across all industries, but healthcare visionaries are tapping into its potential. As a tamper-proof public ledger, blockchain could provide the perfect solution to issues of data integrity, accessible medical records, and consent management.
With an incentive-centered design, blockchain could also be used to facilitate patient engagement, supporting the patient’s active participation in their health and wellness through a reward system and allowing providers to modify and expand incentives.
Healthcare is likely still years away from any true breakthrough in the use of cryptocurrency or the chain as a decentralized way of transacting in healthdata. We will first see use of bitcoin (or other coins) as an incentive system to engage and motivate users.
These trends in digital care show an important shift in the industry, and a significant development in how we connect with patients. Going forward, consumer-focused strategies will set the standard for creating solutions to patient-provider connectivity, improving care and driving outcomes.
Anish Sebastian Bio founded Babyscripts, which aims to transform how doctors and patients think of and use technology to improve their care.