Patient.Journey.Digital.2016.jpgIn previous generations, the Healthcare Professional (HCP) was the initial and primary point of access for the diagnosis and treatment of medical conditions.

The HCP acted as a “gate keeper” between patients and healthcare companies. This B2B model between healthcare businesses and healthcare providers limited direct interaction between patients (consumers) and the healthcare industry. However a shift to a B2C model, driven by a number of market factors, is slowly occurring.

The frustration over the cost and quality of healthcare has been increasing - the cost of Healthcare in the US alone has been estimated at $3 trillion, 40% of which is estimated to be spent on inefficient and antiquated market practices and policies - for decades.

Changing the entire “ecosystem” of patient care has generally been seen as akin to stopping a supertanker.

It has been easier to just let it keep moving in the direction it’s going in and make incremental changes, if any at all. This was true largely due to an adherence to legacy policies and practices. However, as the cost of the care increases and regulatory factors have shifted, greater opportunity to identify and take advantage of previously untapped efficiencies has increased.

Market analysts have been reporting on these trends for some time. However, there is an increasing acceptance that through the implementation of new tools and services, increased reliance on data-driven marketplace intelligence, and an evolved relationship between the greater healthcare universe and the patient, that costs will decrease while the quality of health outcomes will increase.

This is being realized via a convergence among marketplace readiness, technology capability, and available capital.

Others have written reams of articles and white papers describing this trend, and cited examples of pockets of change occurring in the marketplace. But only a handful of companies have initiated the policies necessary to institute enterprise-wide change, or adopted the culture that challenges long-held views on the B2C relationship.

Tackling Process Improvement

Some are tackling process improvement and harmonization across business units and functions. Others are identifying ways to bolster core business models or diversify across markets and channels. A few are looking closely at the ways they engage with and support the health outcomes of patients.

One thing is true, regardless of the means or the parties involved: The convergence of technology enablement, regulatory pressure, and marketplace demand is impacting all players from research and commercialization, to payers and providers. The entire healthcare landscape offers opportunities to increase the quality of health outcomes for patients while simultaneously reducing the cost of production and distribution. Data Is Key

All across the healthcare value chain, opportunities exist to collect, analyze, and utilize data as a means to optimize how the larger healthcare community interacts and supports patients’ health outcomes.

The aggregation and analysis of interaction data among the healthcare industry, HCPs, and patients are maturing and opportunities exist to review trends in care and in health outcomes via data analysis. Additional data can be derived via biometric devices and patient surveys in order to more effectively and efficiently support patients’s health goals. All of this can be performed while engaging patients as partners in their own care, and enabling service providers with the tools required to interact more efficiently with both patients and suppliers.

In the past, the ability to personalize and or proactively target these interactions has been limited. However, with the increasing use of mobile devices and other Internet-connected biometric devices, suppliers, providers, and patients will be able to collaborate on the patients’ health goals, while reducing reliance on cost-inefficient legacy tools and practices.

insurance.payer.trends.2016-4.jpgPatient-Driven Change

As the current marketplace ages and increases their interactions with the larger healthcare community, they are asking themselves a number of questions:

  • Why is it so difficult to engage with an HCP?
  • Why doesn’t my HCP have the same access to my day-to-day health data as I do?
  • Why am I still filling in paper forms?
  • Why don’t I have more choice in providers and services?
  • Why isn’t this whole interaction and transaction as simple as Uber or Amazon?

This is equally true for HCPs who are continuously challenged with doing more with less resources. Systems and processes previously thought of as a de facto necessity of patient care, are being re-thought from both the patient’s point of view, and the medical practice’s perspective.

Read Also: Patient Consumerism Drives Today's Patient-Centered Approach

DIA.GMP.quality.reference-3.jpgOther factors driving the rethinking of the entire patient journey include:
  • Personally Collected and Managed Health Data: What has been referred to as the “Quantified Self,” reflects the ability of consumers to collect and manage a form of their own electronic health records (EHR). An expanding array of biometric tools and services help patients collect health trend data previously unavailable to most consumers, and even most HCPs outside of a clinical study, an ER, or an ICU. This includes daily blood sugar readings, heart rate data, and even sleep cycle monitoring all via a mobile device.
  • Online Social Healthcare Sites and Marketplaces: Similar to sites that help you compare and shop for, well just about anything, there is an increasing reliance on web-based portals as the first line of inquiry and self-diagnosis for patients. These sites are also used to locate medical providers and facilitate engagement between HCPs and patients. Additionally, this includes reputation management and provider rankings by patients, which has increased transparency in an industry that has occasionally suffered from Doctor-Patient Confidentiality abuses.
  • Increased Capital Flowing Into Disruptive Tech: Investors are listening to analysts and seeing that where there is so much money spent on inefficient processes, there exists tremendous opportunity to disrupt the system and monetize the result. So, startups are springing up to fill niches and capitalize on the tech ubiquity.
  • Regulatory Changes to Healthcare: There is so much happening in the US and other markets that is being driven by healthcare reform initiatives, we don’t have time to record it here. Suffice it to say that this is a huge factor driving change across the entire landscape.
  • HCP Interactions: Decreased access to HCPs, caused in part to increased transparency around HCP interactions, has life sciences companies rethinking the traditional channels and refocusing on the patient as the primary point of contact. In the EU alone, face-to-face interactions with HCPs has dropped over 40 percent.
healthcare.payer.communications-9.jpgMoving forward, here are some critical components to keep in mind:
  • Understand the marketplace and capitalize on market factors. 
  • Engage a blended team of internal and external resources to capture and leverage data - optimize real-time data analysis.
  • Implement new policies and systems.
  • Institute organizational change.
  • Deliver value to stakeholders and consumers. 

It might seem overwhelming to consider all the possible opportunities to optimize the entire continuum of patient care, especially if you don’t have the data and the tools to analyze, prioritize, and act on the data.

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