Healthcare IT Trends for 2017: Use of Blockchain

Blockchain has been traditionally associated with cryptocurrencies such as Bitcoin. It is now making its presence felt across several industries including banking, insurance and even healthcare.

A recent IBM survey reveals that 16% of healthcare professionals expect to have a commercial blockchain solution in 2017.

So, what is the major advantage of this technology that positions it as the next game changer for healthcare industry?

“Blockchain technology has the potential to transform health care, placing the patient at the center of the health care ecosystem and increasing the security, privacy, and interoperability of health data”

— Deloitte

Blockchain, also known as distributed ledger technology, can address one of the major problems of the healthcare industry- secure storage and sharing of healthcare data. With blockchain, data can be shared across multiple parties without the risk of tampering or theft of data, as it is extremely difficult to access or alter records on blockchain. It is virtually impossible to hack one block of data in the entire blockchain without hacking all the blocks which makes it extremely superior in terms of security. Healthcare professionals see significant benefit in terms of reducing risks, cost and timeframe in sharing data related to clinical trials, medical records. Data interoperability issues can be addressed with the help of blockchain. There would be complete standardization, transparency, trust and accuracy in terms of information shared across multiple parties.

Blockchain For Health Data and Its Potential Use in Health IT and Health Care Related Research - Linn, Koo.

With the help of blockchain, doctors, hospitals and pharmacies will be able to access the patient’s entire historical data without actually having to send data back and forth. The same common ledger will provide access to all the parties having permission to access the data.

A recent partnership between IBM's Watson Health artificial intelligence unit and FDA plans to explore the use of blockchain in oncology. Google’s artificial intelligence outfit DeepMind recently announced plans to build a blockchain inspired auditing system to track how every piece of patient data is used. Blockchain will help in integrating data from multiple sources to provide a 360 degree view of the patient. It can be a major enabler for personalized medicine as personal data can be securely shared with practitioners without any privacy issues which has been a major impediment for precision medicine. The health insurance sector can also benefit from blockchain applications in areas such as record keeping and claims. Further, pharma companies can benefit from it to prevent drug counterfeiting.

Even though the technology is so promising and healthcare IT companies are moving ahead with full force, critics argue that regulatory constraints will keep the innovation quotient of this technology muted. Critics also argue that the storage capacity of blockchain is unable to handle the huge volume of clinical data being generated. Further, as blockchain is public, identity is subject to being discovered even though it is cryptographically hidden.

Even with all the criticism, the blockchain is well poised to create ripples in the industry. It would be very interesting to see how real world use cases of the application continue to grow and prove the merits of the technology.

Healthcare IT Trends for 2017: Healthcare Wearables (including CES innovations)

Not so long ago, wearables such as fitness bands were just considered a fad that would lose its popularity in a short frame of time. However, in the recent times, wearables have gained strong traction and have evolved from simple fitness trackers to more advanced and innovative devices capable of monitoring the overall health of individuals. It would not be wrong to term these devices as mobile doctors now!

Recent innovations at events are showing the trend that manufacturers are not only making wearables more functional and integrated into our daily lives, but are also paying close attention to aesthetics and comfort. New features such as long battery life, compact size and the ability of the wearable to be part of the connected ecosystem have enhanced the popularity of wearable devices among consumers. These tiny devices, whether in the form of wristwatches, smart garments, or other forms, will have the capability to monitor and track different body functions, collect a host of data from different body parts, analyze such data with the help of machine learning & artificial intelligence and communicate such data to healthcare practitioners for proactive health monitoring of an individual.

Here are some of the notable health wearables showcased at CES 2017:

1. Polar Team Pro Shirt for performance tracking of team sports players
2. New Balance's wearable solution RunIQ for runners
3. Bodytrak In-Ear Thermometer/Body Monitoring Platform
4. TempTraq's 48 hour patch thermometer
5. Motiv fitness tracking ring
6. First wearable ECG monitor from Qardio
7. 2Breathe Sleep Inducer
8. Motio HW for Sleep Apnea from Kyomed and Neogia
9. J&J and Rest Device's Wearable Baby Monitor
10. Doppel's mood-changing wristband
11. Bloomlife's pregnancy tracking wearable
12. BAC alert wearable from Proof and BACTrack's version which measures the Transdermal Alcohol Content
13. Kaishi's Fetal Heart Monitor for pregnant women
14. Leti's wearable EEG device Relax
15. Lohas Tech's BioRF artery radar
16. Neofect's Rapael Smart Glove for stroke patients
17. Smart glasses for the visually impaired from Aira
18. Samsung's Creative Labs solutions including S-Skin for home skincare analysis

The central theme of wearables now is digitization and democratization of healthcare. It is moving beyond hype to become a mainstream healthcare application for monitoring of patients and individuals. The demand for wearable medical devices and remote patient monitoring systems is increasing, and the 2016 report by Grand View Research predicts that the global market is expected to reach $612 billion in the next seven years.

So, what is driving this phenomenal growth in wearables, especially health-related wearables? There is a growing need among healthcare professionals to gather more and more data for more coordinated and efficient healthcare delivery as well as offer personalized healthcare to individuals and patients. In addition, health insurers and their employer clients are covering the cost of health wearables due to the premise that it leads to better enrollee health and benefits all the players.

Wearables are well poised to become a key enabler to achieve these goals. We will still need our doctors, however, we will increase our reliance on these tiny mobile doctors embedded in our bodies for our daily healthcare needs.

Healthcare IT Trends for 2017: Addressing Pharmacy Costs

Pharmacy costs are putting a serious dent in the profits of health plans.

In a recent report, Segal Group, the benefits and human resources consulting firm, projected a continued double digit growth rate in carved-out prescription drug benefit cost trends in 2017 even though the health benefit plan cost trend rates were projected to remain similar for most medical plan options.

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2017 Health Plan Cost Trend Survey Report

Health plans in recent years have stepped up their efforts to keep pharmacy costs under control, including entering into strategic partnerships with Pharmacy Benefit Management providers (PBMs) to curtail costs. The Value Based PBM is growing in popularity and has become a must-have strategic tool for payers to make US healthcare sustainable in the times of rising healthcare costs.

Some of the popular strategies that have been pursued include:

1. Strategic alliances with value based providers such as ACOs and Patient Centered Medical Homes.
2. Increased pressure on pharma companies to pursue value based pricing for drugs
3. Facilitating low cost primary care access via telemedicine, walk-in clinics, etc.
4. Providing financial incentives in wellness design
5. Opening their own specialty pharmacies
6. Strengthening pharmacy management programs

In this era of rising drug pricing, the above mentioned strategies pursued by pharmacy benefit managers can be utilized to their full extent with the use of latest technologies. For instance, a value based pricing and value based care approach can be achieved by leveraging cutting-edge data analytics tools.

Pharmacy benefit managers are mining their data to measure drug efficacy and make decision about coverage - Bloomberg BusinessWeek

Pharmacy Managers Unleash Big Data

Similarly, low cost primary care access can be facilitated by using telemedicine technologies such as video visits by doctors.

In addition to the above mentioned tools, numerous technologies have emerged and are being deployed by payers and their PBMs to not only improve the well being of patients, but also to save on costs. Digital pill reminders and digital drug dispensers ensure that patients are given the right drug at the right time and thus, significantly improve drug adherence and the patient’s health. Similarly, innovative digital health tools, such as mobile apps and wearables, are being promoted by payers to encourage patients to keep a close tab on their health as well as to motivate them to lead a healthier lifestyle.

The path towards a value based PBM can be realized if payers and PBMs actively integrate, modify their culture to become more innovative, develop a flexible and modular service model and leverage technology in the right manner. By putting data management and analytical capabilities at the forefront, the value based PBM approach can assess data provided by payers; apply predictive analytics to assess costs and outcomes. Such support from PBMs will allow payers to achieve both financial as well as care goals, i.e., save on costs as well as enhance care quality.

Healthcare IT Trends for 2017: Next Generation ACOs

Medicare Accountable Care Organizations or ACOs, as they are popularly called, can be defined as a group or network of doctors, hospitals, healthcare plans and other healthcare providers that collaborate to provide high quality, coordinated health care at lower costs to their Medicare patients.

The Centers for Medicaid or Medicare Services (CMS) has been promoting the Next Generation of ACO initiative which has seen an increasing participation of 45 ACOs, as compared to 17 in the previous year.

https://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/

“The goal of the model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.”

— CMS.gov

This new initiative provides a higher risk-reward ratio to ACOs who provide a high quality of care to patients at lower costs. The rapidly changing healthcare landscape in United States is paving the way from the traditional fee for service model towards a fee for value model, where healthcare providers do not focus on charging a fee on the volume of services delivered. They instead earn their reimbursements on generating more value for the patients.

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Healthcare providers are facing an increasing level of pressure from government authorities as well as payers to transition towards the value-based reimbursement structure with a population health approach, so that the best possible care can be delivered to patients at the lowest possible cost. 

This transition is not easy for ACOs. The Next Generation of ACOs are expected to not only change their mindset and culture, but also make increasing use of digital technologies, EHRs, data and analytics tools in order to make this transition a reality. Data and analytics, in fact, form the foundation of this whole transition process. Data driven decision making will aid ACOs in eliminating inefficiency, duplication of efforts and quality of care at each step of the care mode, be it diagnostics, treatments, re-admissions or monitoring of patients. A proactive data driven and analytics-based approach will go a long way in eliminating many of the pitfalls and problems surrounding healthcare delivery in the country.

The healthcare technology market has responded well to help in this transition and continues to innovate with solutions that are really revolutionary and slated to deliver the best possible efficiency, quality of care and collaboration among organizations in an ACO. However, such a technology focused approach triggers a tremendous level of investment, re-engineering and change management in processes, systems and overall culture of an ACO. Whether or not such solutions can really deliver the desired results and ROI for ACO is yet to be proven fully.

The plethora of new technologies and tools creates additional challenges related to integration, interoperability, data security and privacy - something that ACOs need to overcome with a well planned approach that not only allows them to transition from their legacy solutions but also creates a new tech enabled culture focused on cost containment, efficiency and well coordinated care delivery. ACOs have realized that the future lies in increased coordination, sharing of data and collaboration across the entire value chain and the definition of payer and provider is blurring. Technology which can support the entire value chain is in demand, rather than focusing on individual business entities. The individual entities within an ACO also cannot afford to act in silos and need to integrate well with their group members and collaborate closely to reap the benefits of technology.

The debate on whether such a transition towards the fee for value model from the current fee for service approach will be successful and really change the healthcare delivery landscape in US will continue but one thing is sure - the technology enabled healthcare delivery by ACOs looks definitely exciting. Imagine a patient receiving customized care delivery from his/her provider based on an extensive analysis of his/her historical data, or imagine a proactive care approach by providers for the high risk population based on data analytics. In the future, patients will not need to spend time and money on unnecessary visits, re-admissions or diagnostic tests as data analytics combined with remote monitoring tools, wearable and tele-health tools will allow ACOs to remotely manage, monitor and proactively deliver high quality care to their patients. Cloud based technologies will allow ACOs to provide value based care efficiently across the entire value chain.

Expectations are high but the road for ACOs towards this transition is full of challenges.

A sound technology strategy, backed by the support of executive management and coordination among individual entities within the network can help ease the transition towards value based care for Accountable Care Organizations.