Healthcare reforms are igniting debate across the United States; policymakers, clinicians, and care recipients and their families alike all have differing, yet valid opinions about what needs to be done in order to avoid bankrupting the federal government and devastating family budgets.
As costs become increasingly unsustainable, further efforts to control costs are inevitable; legislation like the HITECH Act and provisions such as Meaningful Use are two examples of this. Regardless of varied opinions, most parties can agree that improving quality of care and efficiency of interventions are key platforms as we move forward with solving the current healthcare crisis.
But How Do We Ensure Our Interventions Are Working?
And equally as important, that they are also efficient? Whether an intervention adds value to a patient’s life should be the deciding factor to ensuring high-cost interventions provide high-value to a patient’s quality of life. Several organizations have stated that proving interventions add quality of life years both at the time of said intervention, as well as downstream costs associated that follow, have been difficult to verify.
Measuring downstream costs (which can be very substantial), such as follow up appointments, additional interventions that occur as a result of the first intervention, and/or any costs that have only arisen because the initial intervention was performed, is difficult yet necessary if we are to succeed in avoiding economic and healthcare disruptions.
In order to collect appropriate data regarding quality of life years from high-cost interventions, we will need to implement technology that is able to capture data at the point-of-care and can be fed into an archive which is accessible by the entire care team. Electronic Health Records, which are being funded to a total sum of $19.2 billion because of HITECH, are a step in the right direction, but do not meet the requirements needed to show interventions are working.
That is why at Mozzaz Corporation, we are diligently working to bring Mozzaz Care to market next month. Mozzaz Care, which is currently in use in its Beta phase by several organizations, captures all pieces of patient-centered data and uploads it to a Cloud that permitted parties are able to engage with. Leveraging this data allows checking of compliance against care plans as well as whether or not interventions have proven fruitful – both at time-of-intervention as well as downstream of the initial intervention.
This data is of the utmost importance because it can provide considerable value to engage clinicians, policymakers, and patients in efforts to promote high-value care.
And high-value, quality care that connects a patient to their care provider and gives clinicians the tools they need to prove their care is effective, is what we advocate for.
In a recent mind-blowing slideshow produced by Sparks and Honey, all the ways healthcare is evolving were beautifully highlighted in such a way that is – and should be – read(able) by everyone.
Among the many fascinating insights into technology and healthcare’s hybridization is the fact that the cost of sequencing a human genome in 2001 was $100m USD, and today, a mere 14 years later, is $1,000 USD. This shows just how far we’ve come with modern technology.
Another compelling trend highlighted is the need for individuals to be empowered. This is happening through what Sparks and Honey refers to as ‘The Mobile Hospital;’ which is when a care recipient uses technology to stay informed and to also keep the healthcare provider informed from a mobile location outside of the hospital, such as their home.
With 70% of all organizations adopting consumer-facing mobile apps, wearables, and remote health monitoring tech, the time to take control of your own health is now.
Technology is advancing at a rapid pace and is enabling patients to be empowered like never before. We’re excited to see that more organizations are starting to recognize that tech-empowered patients means a more efficient circle of care and healthcare system.
That’s exactly what we do at Mozzaz – we give everyone involved in the care circle the tools they need to be empowered.
Managing a chronic health condition is an ongoing struggle, as anyone who has one—or has a family member who suffers from one—can tell you. For too long people with complex healthcare needs have been treated on an appointment basis: you enter the room, tell your M.D. what symptoms happen to be the worst that day, and then voila! You’re fixed!
But that’s not the reality of living with a chronic condition, is it?
The stark truth means weeks, even months, of suffering while waiting for your doctor to see you. Often, the appointment covers the surface of what you’re facing but doesn’t get into your daily struggles or challenges you face just going about your day-to-day routines.
But the future is bright.
“We need to do a better job of managing everybody on a continuum, which is the reality of the way people experience their disease and conditions,” says Martin Entwhistle, director of the Druker Center for Health Innovation Systems. When things aren’t working, he’s the person who figures out why, and then actively pushes to improve existing conditions for healthcare professionals and care recipients.
In a recent interview, he talks about using modern mobile technology to create a lifestyle solution for managing chronic healthcare conditions. Instead of touching base with your physician on an appointment-by-appointment basis, you can now track your everyday happenings.
“Our original focus was more on disease management, with the recognition that we needed to help individuals drive toward better goals and outcomes, but at the same time manage a wider population that may have chronic diseases like hypertension or diabetes,” he continues discussing why clinicians originally pushed for data collection on patients.
We think he is right on the money: people’s lives exist on a continuum, not inside the constraints of a 20 minute physician’s appointment. So why not treat the condition in a way that reflects the individual’s lifestyle?
Luckily, thanks to new legislation, and people like Martin Entwhistle, the path forward is clearly curving towards healthcare on a continuum—not a 20 minute box.
Some good news for ALS patients, families and supportive lawmakers who pushed the government hard to reverse its decision on blocking Medicare reimbursement for speech generating devices and communication tools that would have taken effect December 1, 2014. ALS patients had aggressive support from Congress on the question of speech generating devices. Some 200 members signed a bipartisan “Dear Colleague” letter in September, asking CMS to respond to patients’ concerns. On Tuesday, Rep. Tim Murphy, R-Pa., sent the agency another letter.
Speech generation equipment is critically important to patients with ALS and similar neurodegenerative disorders – conditions that limit their capacity for movement and speech. At Mozzaz, we have seen some positive results as ALS patients start to lose their ability to speak and communicate effectively.
CMS spokesman Aaron Albright said the agency “is committed to beneficiaries’ access to needed technologies to improve their quality of life, including the coverage of speech-generating devices for individuals with a severe speech impairment.” He added that CMS is assessing the evolution of that technology since 2001.
Let’s hope CMS and funding agencies can keep up to speed with technology and all of its innovation.
I recently met with the Life Sciences team at Toronto’s MaRS Discovery District as a partner in their Transforming Health initiative. Emily and the team have put together a fantastic paper with concept that can really apply to healthcare systems around the world.
Here are a few tidbits. I would encourage you to read the full paper.
The report investigates two interdependent thrusts that underpin radical transformation:
- Decentralization: Moving care outside of provider settings and into the home and community
- Connectivity: Open data sharing and communication across users and healthcare providers
Why? The current healthcare delivery model is just not sustainable – both from a cost and quality of care perspective.
Health spending as a part of GDP continues to grow but raises the question “Are we maximizing our return on investment in healthcare?”
System under Pressure
Four challenges that are putting pressure on the current healthcare paradigm—the first two are largely population driven, while the latter two are system driven:
- managing the ubiquity of chronic illness
- caring for an increasingly aging population
- the increasing cost of labour; and
- the adoption of new medical technologies
Shifting Left toward Community-Based Healthcare
In place of formal, institutionalized care, health systems are now making a more patient-centric “shift left” toward settings where the care goes to the patient, instead of the patient going to the care.
The path forward calls for an integrated community-based health delivery model with a promise to improve citizen’s health while keeping costs under control.
Great work MaRSDD team! We’re proud to be a partner and part of the conversation in transforming healthcare.
There are many potential use cases for big data analytics (‘BDA’) in health care. BDA can be used to: help researchers find causes of, and treatments for diseases; actively monitor patients so clinicians are alerted to the potential for an adverse event before it occurs; and personalize care so precious resources associated with a treatment are not administered to a patient who cannot benefit from the intervention.
Now that we have our data analytics engine built in Mozzaz, we’re starting to gain new insights derived from big data analytics that will serve to advance personalized care plans, improve patient outcomes and avoid unnecessary costs. Here are some innovative ideas and solutions we envision in harnessing BDA:
- Clinical decision support – BDA technologies that sift through large amounts of data, understand, categorize and learn from it, and then predict outcomes or recommend alternative treatments to clinicians and patients at the point of care.
- Personalized care – Predictive data mining or analytic solutions that can leverage personalized care in real time to highlight best practice treatments to patients. These solutions may offer early detection and diagnosis before a patient develops disease or behavioral or mental health issue.
- Public and population health – BDA solutions that can mine web-based and social media data to identify triggers and help predict behaviors or outbreaks based on consumers’ search, social content and query activity.
- Clinical operations – BDA can support initiatives such as wait-time management, where it can mine large amounts of historical and unstructured data, look for patterns and model various scenarios to predict events that may affect wait times before they actually happen.
- Policy, financial and administrative – BDA can support decision makers by integrating and analyzing data related to key performance indicators.
Another great piece of visual artwork that conveys the message.
With health care reform encouraging greater consolidation among health service professionals and organizations, the trend is toward integrating mental health, behavioral health and substance use services in all kinds of treatment settings. But whether integration takes place in primary care or at the health system level, the “triple aim” goals are the same: enhancing the experience of care, improving the health of populations and reducing costs.
The Commonwealth Fund has put out a great paper, State Strategies for Integrating Physical and Behavioral Health Services in a Changing Medicaid Environment:
“States across the country are promoting integrated care delivery as part of their efforts to deliver high-quality, cost-effective care to Medicaid beneficiaries with comorbid physical and behavioral health conditions. The Medicaid expansion authorized by the Affordable Care Act (ACA) brings greater import to these efforts, as millions of uninsured low-income adults, many at increased risk for behavioral health conditions, gain coverage and states are required to provide behavioral health services and meet federal parity laws.”
“Drawing on a review of the literature and interviews with diverse stakeholders, this report explores strategies states are deploying to address or eliminate system-level barriers to integrated care for this medically complex and high-cost Medicaid population.”
I would encourage checking out the SAMHSA-HRSA website as a resource for integrated health care models and guidance. http://www.integration.samhsa.gov/ .
At the Health 2.0 fall conference that was recently held in Santa Clara California, Kaiser Permanente CEO Bernard Tyson believes three major trends are driving changes in the healthcare system. Those include a shift to holistic, lifelong care; the rise of the patient as an active healthcare consumer; and the decentralization of healthcare.
“Eventually, as we disrupt the healthcare system and as others on the outside get into healthcare, there is no question that the healthcare system is going to evolve from its current state of a ‘fix me’ system, to its future state as a total health system,” Tyson said. He added that most of our system’s spending on a person happens right before death. Creative opportunities lie in ways to “move and shift resources toward maximizing the healthy life years of individuals.”
The second trend arises out of patients becoming more empowered and having more choices around their care. “In most of the industry, coverage is provided by the employer and then the government,” Tyson said. “But as the patient is now paying more and more, they are starting to behave as an active consumer. They’re asking very different questions of the industry now, questions focused on health and maximizing value and volume.”
To illustrate the third trend, Tyson provided some concrete examples of steps Kaiser is taking. He described this trend as “the move from ‘you go to a place for healthcare’ to healthcare being distributed to multiple areas in a person’s life,” and, as an example cited the 14 million e-visits that were done through Kaiser last year.
“In the end, we’re going to end up being able to actually personalize each individual’s care patterns,” he said. “The question of ‘Who am I?’ is going to be a very different question in our future.”
Read more on Mr. Tyson’s keynote here.