3 Ways Technology is Putting Individuals Back at the Center of Population Health

3 Ways Technology is Putting Individuals Back at the Center of Population Health

Returning patients to the center of population health — and empowering them with the right tools — can help solve many challenges faced by population health programs.

 

Ever since Greg Stoddart coined the term “population health” in 2002, health organizations, providers and payers have been continuously learning more about its dynamics, the constant challenges that come with it, and how to overcome those challenges.

According to Stoddart, population health focuses on “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” This includes patterns of disease, treatment results and healthcare outcomes, as well as the policies that link them together.

A Diminished Role for Individuals – Until Now

Population health has been a hot topic among healthcare providers and payers for nearly a decade. But it’s been a non-issue for most consumers.

Nevertheless, the use of population health strategies by providers and payers have real impact on consumer health and healthcare costs.

It also doesn’t matter that individual patients know little about population health. By its very definition, population health was intended to be patient centric. Population health programs are supposed to focus on improving individual patient health, in the context of groups of consumers with similar conditions, environments or challenges.

The simple fact of the matter is that individual consumers have so much to offer population health programs. But this resource has often been overlooked by population health initiatives. Until now.

Technology is giving population health programs the tools to empower individual patients to drive improved population health results. With the increasing number of healthcare apps being added to online app stores every week, healthcare payers and providers now need to adapt to evolving consumer behavior and expectations.

Technology is giving population health programs the tools to empower individual patients to drive improved population health results.
 

It would be a mistake to consider this a challenge for population health programs. Technology-empowered consumers actually offer a golden opportunity or payers and providers.

Patient Participation

The primary challenge for population health has always been the evolving needs of each population demographic. Patients with multi-chronic disorders using high demanding services drive healthcare costs up. But there’s often only so much that providers and payers can do.

It’s now clearly understood that social and economic factors are more important in the rise of chronic illnesses in various populations. In some cases, it’s the low price of unhealthy fast food or less active lifestyle. In others, it’s environmental stressors or lack of awareness about healthier lifestyles.

Unfortunately, health systems have often been the active healthcare providers, while patients are the passive care recipients. Once the patient leaves the clinic or hospital, they too often fall back into their unhealthy environment without any real support for impactful change. Healthcare providers want to help patients change their behavior and improve their health, but they can’t be there to continuously monitor and guide patients.

Now, there’s an app for that. Actually, there are now hundreds of apps available to encourage and support patient participation.

Today’s apps and the more powerful ones emerging give population health programs the tools to provide more continuous support for individual patients. From nutrition apps to self-managed care apps, individual patients can now use readily available technology to make healthier daily life decisions – every moment of every day.

Dirty Data

Another major challenge facing population health programs is inaccurate or dirty data. This is found by providers in their patient’s health record, as well by payers in their member’s claims file. Incomplete or incorrect information in a patient’s personal health records can lead to medical management errors and could negatively affect their healthcare outcomes.

Correcting errors for each patient can be time consuming and costly, as each individual patient’s records may have different inaccuracies or errors. Most hospitals and health organizations already address the issue of dirty or inaccurate data by improving their digital records and training their employees on proper data entry.

But it’s often still not enough.

Once again, technology and increased patient participation offers new opportunities for addressing the challenge of dirty data. Through apps that give consumers direct access to their personal health records (PHR), individual patients can help clean up a lot of the inaccuracies and errors in their own records.

From there, machine learning systems can learn from those consumer-driven app-powered corrections to develop new rules to prevent similar inaccuracies and errors in the future.

Data Privacy Issues

Another challenge for population health programs is gaining permission to utilize a patients’ critical health data to generate impactful recommendations and conclusions.

We know we can use population data to find answers. But many patients are hesitant to allow sharing their personal clinical data between their healthcare provider and insurers for good reason.

They’ve heard about or directly experienced the impact of major security breaches to health systems in recent years. For example, Exellus Blue Cross Blue Shield and Anthem Blue Cross both suffered separate breaches in 2015 that affected more than 10 million and 78 million patient records, respectively.

With nearly all current medical records in the United States now being stored in digital form, it’s much easier to share data. But it also means that there are more ways for data thieves to get that data.

So how do we ensure that patient data is secure and their privacy concerns maintained?

Most health systems with digital records have already woken to the threat of data breaches. Fear of fines, penalties and damage to their brands have forced most payers and providers to improve their security, training and compliance monitoring.

But the truth is that the weakest links are often not the data record storage system themselves, but the different access points to those storage. And as patient access to digital records is now the new rule, these vulnerable access points greatly increase the potential risk for electronic health records.

Again, however, technology and increased patient participation can provide solutions to privacy- and security-based challenges to population health. By providing patients with secure and intuitive apps, consumers will be able to better control how their data is accessed and shared.

This also helps address some of the privacy and security concerns that drive patient reluctance to sharing their PHR data. By giving individuals more control over their health data, population health programs can more easily gain permission directly from individuals in specific populations.

Final Thoughts

Traditionally, patients are only motivated to engage after being diagnosed with a disorder. Healthcare providers need to participate more in the community and activate patients to be more involved with their health and management plans.

To do so effectively, healthcare professionals should provide patients with the right set of information, as well as provide continuous support and an open dialogue. This will allow patients to make a more informed decision about their day-to-day decisions.

Again, there are apps now emerging that allow providers and patients to do this more easily and consistently.

Concurrently, healthcare organizations need to develop a sound and reliable technology infrastructure to make population health work. This technology should be flexible enough to allow intuitive and quick data entry, accessibility, and easy data retrieval. This technology should also be adaptable and evolve in alignment with the population’s shifting needs.

Allowing consumers access and control over their own electronic health records is a crucial part in making population health effective as well.

 

Allowing consumers access and control over their own electronic health records is a crucial part in making population health effective as well.

It simplifies the process of improving public health reporting and surveillance, enhancing the ability to prevent disease, and expanding communications between users and their healthcare providers. This can be achieved by using self-management mobile apps that consumers can obtain from their provider or independently.

The healthcare industry is in dire need for a reliable structure to manage population health and their data. In order to understand healthcare information; claims, clinical and personal health data should be used together rather than separately. In other words, healthcare providers and payers need to work together to take on the challenges faced by population health.

Call to Action

Since its emergence, population health has relied heavily on data and available technology to address the needs of specific population groups. But the individual patient’s participation was often missing, especially when looking at it from the population level.

Returning individual consumers to the center of population health – and empowering them with tools for more ownership of their PHR and health management – can help payers and providers solve many of the challenges facing their population health movement.

We invite you to join HealthChampion in this movement to empower individual patients and create a more people-driven approach to population healthcare.

Fahad Alsabhan

Fahad Alsabhan is a lead Medical Writer at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan
Why Isn’t Our Healthcare System Easier and More Transparent?

Why Isn’t Our Healthcare System Easier and More Transparent?

Today’s Health Consumers Want Easy Access to True Costs and Quality Services

When we purchase something at a store, we’re given the price before we decide to buy. But when we go into the doctor’s office, we’re provided a service where we may (or may not) pay out of pocket or we have a co-pay but rarely check on costs beforehand.

Sometimes we don’t even know the price until we receive the bill and rarely ever question the portion of costs paid by our insurance.

And it isn’t just healthcare costs that seem a mystery. Knowing where our personal health records are, how to access them, what is in them, let alone how to use that information with other personal health data to create an overall picture of health and improve personal health seems nearly impossible.

It seems backwards and outdated. Probably because it is.

 

While this has been the norm for decades, in today’s changing healthcare landscape, it seems backwards and outdated. Probably because it is.

Consumers are done with the old way. Today’s health consumers want easy access to true costs and quality services. They want a transparent healthcare ecosystem that allows them to shop for healthcare services much like they do other products and services, and they want to own their own records and the data associated with their health journey.

As the saying goes, you’re either part of the problem or part of the solution. In order to achieve this solution, we should understand some of the factors driving the movement for health transparency and why the consumer is at the center of making change happen.

Healthcare Consumers Have Evolved Into Healthcare Shoppers

In the employer-based health insurance system on which we’ve come to rely, most health consumers typically select a provider for themselves and their family and then see that provider at any time with either a slight co-pay or deductible.

As prices have continued to rise for care and deductibles grow, however, consumers have become more aware of pricing and the complexities that come with trying to track down pricing and determine value for services. As a result, today’s health consumer has been turned into a shopper – researching, making careful purchasing decisions, and ultimately buying health services and care.

It’s a small but important distinction, because shoppers inherently want options, transparency, and honesty about the healthcare choices they are making and they most definitely don’t want their healthcare experience to feel veiled in secrecy or mired in confusion.

So, when we talk about the healthcare consumer today, know that we are referring to the emerging healthcare consumer: the consumer who assertively shops for the best care for the best value for themselves, their family, or the loved-ones in their care.

But let’s take a step back and get a closer look at just a few of the trends that have pushed consumers into a position to start demanding a more transparent healthcare ecosystem.

Cost Tops the List of Consumer Pain Points

An Experian Health study estimates that 20% of all consumer earnings will go to healthcare by 2025. People are worried about paying for their healthcare bills, with good reason.

In a poll conducted by NPR, The Robert Wood Johnson Foundation and Harvard’s T.H. Chan School of Public Health, more that a quarter of adults said than healthcare costs have caused them serious financial problems.

And according to a Becker’s Hospital Review article reporting on an Experian Health study:

“The top pain points for patients in their healthcare experience are related to payment. Specific dissatisfaction issues included: comprehending the amount of money they owe for care and whether those out-of-pocket costs are fair market price, as well as ensuring they are financially able to pay for their care, Experian reported. Patients also identified ‘determining what financial support is available,’ ‘ensuring that what is owed to the provider is accurate’ and ‘understanding the amount covered by their health insurance’ as dissatisfaction issues.”

Nearly Universal Adoption of High-Speed Internet in the U.S.

While there are still areas in the United States that don’t have high speed Internet, particularly in rural areas, most Americans do have access. In fact, more than 92% of Americans have access to high-speed Internet, according to the Federal Communications Commission.

This unprecedented access allows nearly anyone in the U.S. to research and learn about nearly any healthcare topic imaginable, from prevention to treatment.

Health consumers suddenly have instant access to…

  • Estimates for medical care pricing in their area, 
  • A variety of choices for seeking treatment,
  • Quality and patient satisfaction rankings and repor1ts,
  • Alternative medicines, and telemedicine, and
  • So much more!

This information is coming from everywhere. A recent Accenture report states that websites are still the top technology people use to manage health, but mobile, electronic health records (EHRs), social media, and wearable technologies, among others, are on the rise.

People are expecting to find exactly what they need to know at the touch of a button, but finding accurate, understandable healthcare information online is still a barrier with wide gaps in pricing for a single procedure and challenges determining value.

Health Technology is Rapidly Advancing

From EHRs and telemedicine, to wearables that track health and fitness levels, technology is upping the healthcare game on all levels.

  • Wearables are able to sense a variety of body activity, produce real-time data on caloric output, track both aerobic and anaerobic activities, and pass that data along to users.
  • EHRs grant what could be near instant access to patient records that are accurate and up-to-date.
  • Telemedicine is helping consumers reach healthcare experts in real-time from around the globe, giving rural consumers access to doctors if they are unable to get to one easily. Telemedicine also supports health consumers at home if they are unable to leave the house or need medical follow-up that doesn’t require being at a hospital or medical facility.

This is just the tip of the iceberg, but for health consumers, these technologies and others are setting the table for game-changing personal health opportunities and choices with maximum convenience.

The “Internet of Things” gives us unprecedented access to nearly unlimited data. The Internet of Things (IoT) is transforming the way consumers look at and use healthcare data for improving their own health. It is also changing the level of detail and types of data consumers are able to give their providers.

Additionally, providers are able to proactively collect and interpret a history of health and wellness data for care.

Wearables are the most obvious example, but we aren’t just talking about fitness trackers. Wearables are breaking new ground every day. Today’s wearables track newborn oxygen levels and temperatures, monitor blood pressure, measure insulin delivery, track caloric intake through contact with skin, and the possibilities are endless.

With all of this new health and wellness data available, how are consumers using it to improve health?

There are the obvious drivers – to lose weight, walk more, get fit. Then there are the life-altering examples – an urgent notice of low blood sugar or notifying medical personnel or loved ones of a fall. Now, technology is emerging that will allow consumers and healthcare providers integrate all of that IoT health data with the data from hospitals, medical records, etc. to alert you proactively of your healthcare needs.

Whether to remind you that it’s time to book a follow up doctors appointment, your child needs certain immunizations for school, or your blood pressure has been unusually high and you need to schedule an appointment, the pieces are now here to provide you immediate service.

These are no longer out-the-realm possibilities but current and future technologies that can lead to better health.

The Healthcare Shopping Journey is Complex

The basic healthcare shopping journey, unlike a traditional product or service purchase, is quite complex.

Given the challenges that still exist in sharing records among health systems, it’s clear that there is a lot of work to do to create a transparent healthcare ecosystem for consumers. Integrating personal health data (such as from wearables) with medical records and data, and even being able to compare basic pricing among providers for the same visit or procedures can still take a lot of time and hassles.

The timing seems right as consumers are ready and able to take a more proactive and assertive approach to their personal healthcare journey.

 

That said, the timing seems right as consumers are ready and able to take a more proactive and assertive approach to their personal healthcare journey. But what might that transparency look like to the consumer during a typical healthcare experience?

There is a lot of research out there, but we’ve boiled it down to these:

1. Managing the Data From Your Personal Health Journey

From the moment you are born, you have a healthcare history, or health story.

As health-related technologies continue grow and expand, the data that accompanies that story will only increase and become more complex. The challenge here is effectively communicating that story: for the young and healthy with no pre-existing conditions, this doesn’t seem to be much of a challenge.

However, for a large number of Americans, the story is more complex. Data from the Centers for Medicare & Medicaid Services vary widely, but the estimate is that 19% – 50% of non-elderly Americans have some type of pre-existing health condition.

As we mature, our health story grows and finding ways to use technology to help manage years of medical history and health data becomes increasingly valuable and important. Additionally, tackling important, tough ethical discussions along the way is worth considering:

  • Can a health consumer manage which data is granted access to a payer or provider?
  • How can a doctor trust the data they are seeing?
  • Is the health consumer’s data secure?

2. Finding Out if Your Health Requires Intervention

What is wrong with me? How do I lose weight? Do I have a cold or the flu? Should I go to the ER? Is my blood pressure too high?

As mentioned earlier, Accenture recently reported that websites are still the top technology people use to manage health and find the answers to these and other health questions.

Generally, this is great for consumers. For example, infographics showing the difference between the common cold and the flu can help head off a doctor’s visit, saving time and money. But outside of simple Internet searches, what happens when an informed consumer tries to engage with the healthcare system. Suddenly complexities arise.

  • Am I seeing the right doctor?
  • What tests will they order?
  • Are those the right tests?
  • Where are the results coming from?
  • How do I get the results?
  • Would having data from my fitness or food tracking app help make a diagnosis?
  • How do I get that information to my provider?

Let’s revisit our shopper-oriented consumer. Can you imagine having a conversation your provider about these and other types of diagnoses questions, especially when you might already be feeling unwell or anxious about your condition?

There is so much to know and manage and none of us want to lose time with poorly informed or incorrect diagnosis. Technologies are beginning to emerge that can help the health consumer collect that data, provide analytics surrounding it, and inform a physician diagnosis based on that personal health story.

3. Health Treatment and Transparency

Once a diagnosis is reached, determining treatment options can become a daunting task. For the majority who have health insurance coverage, the first question revolves around what will the insurance plan cover and what will I pay out of pocket? Then the consumer will likely conduct research with his/her physician and on his/her own, which means entering the chaos of the Internet. Not only will consumers need to contend with evaluating the treatments recommended by their own physician, but what other options are out there? Trying to validate or find new treatment choices online is difficult. How do you determine fair market price and value?

4. Paying for Treatment

This new healthcare ecosystem must allow consumers to know costs associated with their choices. Given that 98% of people surveyed by Experian Health said worrying about how they will pay their medical bills as “a very important to extremely important pain point,” consumers are going to begin to expect to know how much a service is going to cost before receiving that service — just like purchasing any other product or service.

5. Determining Value

Which brings us to our final destination: did the quality of care received and payment paid align for the consumer?

Those of us who purchase economy vehicles have vastly different expectations than those of us who purchase luxury ones. Right now, however, our healthcare options rarely offer that same opportunity. This is not necessarily an outcomes-based discussion. However, there are consumer reviews available for care, polls, and opinions.

If there were a way to measure those against a transparent price and the consumer’s own personal experience, there may be a way for the consumer to determine if they feel they received good care value for the price paid.

The Need For a Transparent Healthcare Ecosystem is Clear

Healthcare in the United States is changing rapidly thanks to cost concerns, access to information, technology, and connectivity. Consumer behavior is also changing, and the shopper journey has already shifted away from its linear beginnings.

The current state of the healthcare ecosystem is ripe with opportunity to meet the consumer’s needs (and, quite frankly help improve provider’s lives while we help improve patient care). We’re working to reshape the conversation and ignite the movement toward more transparency, and we think the healthcare consumer is ready to join the movement.

 

 

Fahad Alsabhan

Fahad Alsabhan is a lead Medical Writer at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan
Getting Personal With Healthcare Accountability

Getting Personal With Healthcare Accountability

Under our current complex healthcare system, costs have spiraled out of control and consumers are increasingly disconnected from the providers and services they need to manage healthcare for themselves and their families. People-driven health seeks to empower and encourage consumers to take ownership of their own health journey. We believe it can be the solution to better, more affordable healthcare for all.
While most consumers want to take responsibility for their healthcare, they don’t have the tools and information they need to make informed decisions.  
But this also requires a new level of accountability from everyone within the health ecosystem. The main challenge we face is that while most consumers want to take responsibility for their healthcare, they don’t have the tools and information they need to make informed decisions. What’s getting in the way? In the current healthcare ecosystem, payers and providers hold all the cards in a setup that’s complex, confusing and lacks transparency. Technology could change all that by powering a people-driven healthcare system that puts consumers in control.

Healthcare Costs Have Skyrocketed

In 2018, the cost of healthcare for a family of four in the U.S. reached an all-time-high of $28,166. The good news is that costs of inpatient, physician, pharmacy home healthcare and ambulance services have grown at a slower rate. However, during the last decade healthcare costs for a family of four rose an average of $100 per month when you factor in premiums, deductibles and out-of-pocket expenses. Even with employers bearing some of the cost of health insurance, employees have shouldered much of the increases in health plan premiums.

Why is it So Hard to Keep Costs Down?

In part, it’s because healthcare consumers have little access or insight into how healthcare works and how much services actually cost. Consumers are also frequently unaware of the close connection between their health-related choices, the consequences of those choices, and the subsequent impacts on costs and quality of care.

Healthcare is Complex and Confusing

It takes significant time and effort to navigate our current healthcare system. An Experian Health study of 1,000 consumers and select providers identified 137 distinct jobs associated with a typical healthcare experience. When bucketed into broader themes such as shopping for a plan, preparing for doctor visits, managing a diagnosis, shopping (again) for the right treatment, managing prescriptions and paying for it, the study reveals a consumer journey that could take any number of twists, turns and detours. Not surprisingly, the study also identified that the biggest consumer pain points center on the financial and administrative aspects of healthcare. People are especially frustrated with the number of complicated tasks related to paying for care, from shopping for health insurance to understanding provider pricing to paying their medical bills. Today’s healthcare system is not only frustrating, it’s confusing. There are multiple tiers of payers, and numerous plans and programs offering a complex array of services. Prices and coverage vary widely between providers, and plans can change dramatically year to year. There’s no standardized system to help consumer conduct apples- to-apples comparison shopping. So consumers are hard-pressed to sift through all the details to determine the lowest-cost, highest-quality choices. In the face of all this confusion, people leave decisions up to their doctors, who often consider convenience over cost when ordering services like tests and procedures. As a result, consumers frequently use higher-cost services that aren’t necessarily higher quality. For anyone who has tried to seek price differences among testing facilities knows that often the facilities themselves aren’t sure how to break out pricing options for a consumer outside of the typical, often over-priced, insurance price. Additionally, price isn’t the only opaque part of the system that can baffle consumers. Many are unaware that they have rights to their personal health data – rights to request, see, and secure copies of their health records under HIPAA. For many health consumers, this information may be available through their provider’s patient portal, but even with the availability of patient portal access hitting 52%, only about half of those even access the data… for a total of about 28%. Even fewer of those accessed that information independently – the vast majority of them had to be prompted by a payer or provider. Not surprising when you consider the massive amounts of portals, passwords, and health interactions a typical health consumer has to engage with.

Healthcare Costs and Coverage Options are not Transparent

Another barrier to personal accountability is a lack of transparent pricing. Financing in our healthcare system consists of complex arrangements between employers, third-party payers, the government, providers and patients. When consumers are cut out of the process by third parties, who negotiate prices and pay providers on the patient’s behalf, it’s hard to identify or question the actual costs. To make matters worse, healthcare prices vary depending on who is paying. The result is that it’s almost impossible for providers to create a standardized, consumer-friendly price list that reflects what patients would reasonably pay if they were billed directly. In addition, many people are limited to employer-provided plans that encourage a “set it and forget it” approach. Some plans do offer comparison tools to help determine how much coverage is needed. But no one can predict the future need for services like doctor visits, diagnostic tests, or emergency care. Finally, don’t forget to factor in-network and out-of-network coverage, prescription drug coverage, vision and dental! It’s not realistic to expect that anyone can accurately balance the costs of a family’s routine and preventative care, plus unquantifiable future healthcare needs, with-out-of-pocket payments like deductibles, copays and coinsurance. That’s why most people take the path of least resistance, which contributes to higher costs.

A People-Driven Healthcare Approach

In a better world, healthcare would be a people-driven system. In this world, consumers would have the tools and transparency to take ownership of every aspect of their healthcare. From determining how much they pay, to how they partner with providers, to managing their fitness and nutrition, consumers would have easy access to the information and resources they need to manage their healthcare. Consumers would have access to technology that enables data-driven decision-making, allowing them to gather health information, view electronic health records in real-time, and enable analytics to manage and maintain a healthier lifestyle. Additionally, imagine that all of that data and analytics would also prompt you to be a more proactive participant in your own health and wellness. Not only do you have access to the data, but it proactively alerts you to appointments, immunization needs, health incidents that require immediate attention, and possible health needs of children or elderly family members in your care. As consumers take more accountability, providers and payers would also have to shift to new models that make it easier to be engaged in the process. This type of healthcare ecosystem would help promote lower costs, provide the opportunity for better, more personal care, more involved follow up, and give health providers better data off of which to base diagnoses and treatments, perhaps even eventually leading to improved outcomes.

Healthier Lifestyles Save Lives

According to the Centers for Disease control (CDC), up to 40 percent of deaths from heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries are preventable. The CDC studied deaths from each of these five leading causes between 2008-2010 and found that between 20 and 40 percent of deaths could have been avoided by making changes to personal behaviors. The study also noted that the five leading causes of death have many common risk factors including high blood pressure, high cholesterol, lack of physical activity, and obesity. If given the information to be aware of these risks in their own personal health profile, consumers could proactively make changes like improving their eating habits, quitting smoking and limiting alcohol intake in order to improve their health and prevent premature death.

Active Healthcare Management can Save Money

Prices for the same in-network procedure can vary by over 500% depending on the provider, so chances are patients are paying way more than they have to for procedures. More importantly, the higher-cost procedure doesn’t necessarily guarantee higher quality. But it never occurs to most patients to monitor or question prices because a third party HMO or PPO is often the one paying for everything upfront. Consumer engagement and comparison shopping can be powerful tools to drive down costs. In a people-driven healthcare system, patients could factor in out-of-pocket costs when deciding which providers they will see and which services they want to receive. As more consumers demand pricing information, healthcare providers would be pressured to price themselves competitively without compromising quality. How can technology help? Technology plays a central role in people-driven healthcare.
  • Consumers can use data and insights to connect the dots between their behavior, healthcare consequences and costs.
  • They can then make better choices that benefit their health.
  • As consumers gain more control over their journey they also become more engaged, and this oversight helps keep prices in check and promotes higher quality.
Virtual reality, augmented reality, artificial intelligence, and wearables are just a few of the technologies and devices that could combine with data-sharing and predictive analytics to give people useful health information and treatment options.
  • Consumers could work on their own or partner with doctors to proactively prevent, diagnose, and manage chronic conditions outside of traditional healthcare settings.
  • Personalized data from connected devices that track steps, physical activity levels, diet and sleep patterns, and calculate measurements such as weight, blood pressure and glucose, could be automatically integrated with electronic health records, in near real-time.
  • Having the big picture would inform better decisions about a person’s plan of care and potentially improve coordination and communication between providers.
  • Using digital assistants and other tools on a smartphone, tablet, or mobile device can help consumers stay on top of their health information and set up reminders for medications, tests, and appointments.
Reminders and alerts using personalized, real-time data can also be great motivation for people to make better choices and prevent health issues. For example, a diabetic may see a high glucose alert on their wristwatch and take immediate action to avoid a dangerous and costly health crisis. Additionally, new technologies are emerging to improve data security and enable interoperability of devices to share data that creates a more complete health picture of the consumer. But while technology holds a great deal of promise for helping healthcare consumers manage their overall health journey, there are still barriers that keep the process from being transparent or simple. Interoperability issues still arise among technologies, apps, and other data sources. Once a consumer secures his or her family’s health records, where are those records kept, how are they shared, are they secure, who gets to see them, and how are permissions granted? And how can someone access all of those different data points to get a clearer picture of overall health and wellness and take the steps necessary to improve their health and the health of those in their care?

Technology Can Also Help Lower Costs

Financial tools that use a consumer’s own personal health data could help them understand the complete costs of everything attached to their care, from doctor visits to services to ongoing management. It also enables tools that allow consumers to activate payment plans, apply for financial assistance, estimate the cost of care, and review insurance benefits. All of these can give consumers greater transparency and control over costs while helping them avoid the financial pain points.
Empowering people to take ownership of their healthcare experience for themselves and their families will go a long way toward driving down costs.  
No one said that creating people-driven healthcare would be easy. But empowering people to take ownership of their healthcare experience for themselves and their families will go a long way toward driving down costs and creating a more complete health picture that consumers can use to improve health and wellness. As we will address in future pieces, a more transparent, people-driven health model is inching us closer to overcoming the numerous barriers facing consumers as they try to assume more ownership and accountability of their health records and data. Using today’s technology, people can personalize their healthcare experience and get the clarity they need to take part in the process, take control of their care, and help make quality care more affordable for everyone. If you want to be part of this movement to reorient the healthcare system, join us today to be a true health champion.    

Fahad Alsabhan

Fahad Alsabhan is a lead Medical Writer at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan
We Need People-Driven Healthcare Now More Than Ever

We Need People-Driven Healthcare Now More Than Ever

“Sir, Maybe You Should Be More Responsible For Your Own Healthcare.”

As many of you know, I’m a serial entrepreneur. But that’s not why I’m launching HealthChampion.

The impetus for this new adventure came a year ago as I underwent a familiar struggle for many healthcare consumers. “Sir, maybe you should be more responsible for your own healthcare.” That is what the administrative worker at my doctor’s office said to me after I had just spent 20 minutes trying to find out if the results of my MRI had been received and read by my physician.

Maybe she was partly kidding. But the irony wasn’t lost on me.

A Personal Healthcare Experiment

I embarked on a three-month experiment, during which I started to see what it would be like to navigate the health system with no insurance. I became a cash-paying consumer in the complex labyrinth of the U.S. healthcare system.

I became a cash-paying consumer in the complex labyrinth of the U.S. healthcare system.

 

It was an unusual exercise – to purposely remove an entire family from the typical employer-based insurance plan with which many of us have become comfortable and come to rely. We did keep catastrophic insurance for the worst-case scenario. But from a health insurance standpoint, I took my family “off the grid” to see what would happen and it was eye-opening.

We Became Instantly More Aware of Choices and Price.

Without the comfort of a familiar co-pay or the knowledge that we were nearing our deductible for the year, our entire family suddenly thought more carefully about seeking medical treatment.

That didn’t necessarily mean that we avoided treatment. We just did what we would do in any other typical consumer shopping scenario: we went online to research our buying options. Typically, we would have instantly sought treatment with our primary care physician and not pursued a price conversation or other options, but I had recently moved and didn’t have a physician-of-choice in our new state. So when I had a minor medical concern pop up, I browsed my choices:

  • A physician who would be in-network with our future insurance plan?
  • An urgent care clinic?
  • A nearby medical center or practice?

We also researched pricing online and found those numbers varied wildly from facility to facility.

I Also Became Instantly More Aware That Rarely Did Anyone KNOW the Price.

As I began to call to ask about appointments and confirm pricing, it became quite apparent that few medical organizations were prepared to deal with someone without insurance AND who was interested in discussing an actual cost and direct payment for services.

Typically, the people I interacted with had a two-stage process for dealing with my direct payment approach.

  • Phase 1 was disbelief. This part of the conversation would last at least a few minutes as I convinced the person on the other end of the line that I was indeed without insurance and wanted to pay cash. There would be moments where the person helping me would repeat multiple times how much my hypothetical co-pay might be and how much would be billed to my non-existent insurance until it finally sunk in that I was indeed planning to pay out-of-pocket.
  • Phase 2 was uncertainty about direct prices. Once we established that I would be paying them directly, it wasn’t unusual for my request to be escalated up the management food chain to find someone who could handle my unusual inquiry. The outlier here was the urgent care clinic I visited where pricing was completely transparent, my request was treated as a typical shopping experience, and paying efficiently for quick and affordable care or treatment seemed to be business-as-usual.

There Were Interoperability Issues and a Lack of Education About How to Use Them to the Customer’s Benefit

Because of my change of official residence and the fact that I had a primary care doctor in one state but was seeking services is another state, it was obvious how convenient it would be if physicians or clinicians in both states could see the same records.

Thankfully I had enough experience in healthcare technology to know that when the team in my new location asked me to have records sent to them, I urged them to find those records on the common medical record system I knew they both used – Epic. And while it should have been a simple solution to access those from the new facility, it did take some effort on the part of the staff and with quite a bit of prodding from me to push it through.

For the average consumer, it would be tremendously helpful to have people-driven healthcare, to be able to own your own records and data and share that with all of your medical relationships, but for right now, it would be optimal to at least be able to have disparate medical organizations be able to see and share your data with each other with the patient’s permission.

I Had to Get Comfortable With Asking Tough and Uncomfortable Questions

I also gained from this experience a deep empathy for those without health insurance – whether as an intentional decision or due to financial constraints. The amount of discomfort I felt trying to explain my situation and that I was between insurance coverage and pursuing direct payment options seemed unnecessary.

I was once boldly asked “Why don’t you have insurance?” The obvious reply was “None of your business.” But as a cash-paying customer, it was important to me to ask a lot of questions and know exactly what was included in the price of the service or treatment. I also needed to understand how and when those records or outcomes would be delivered to my out-of-state physician, and if the price they were quoting me was in line with other clinics or medical centers in the area.

So, after this months-long experience as a responsible, engaged, active healthcare consumer, it took some patience not to react strongly when someone from my physician’s administrative team challenged my efforts.

When I was told “Sir, maybe you should be more responsible for your own healthcare,” after we discovered the test results from a clinic sent to my physician’s office were lost somewhere in the ether, my reaction was, “She’s right,” but not in the way she intended. I had made every effort to be more personally accountable about my healthcare costs and options, and repeatedly found the system in its current state makes that nearly impossible.

I had made every effort to be more personally accountable about my healthcare costs and options, and repeatedly found the system in its current state makes that nearly impossible.

 

But if consumers had access to the right tools and had more transparency into the system and processes, we could all be more informed health consumers and be more responsible for our own healthcare costs and experiences. After all the frustrating calls, price discussions, and arguments along the way, I became energized and empowered knowing that, through HealthChampion, my team and I were poised and ready to empower consumers so they can take greater control over their own health journey and destiny.

People-Driven Health: Putting the Consumer in the Driver’s Seat

At HealthChampion, our mission is to put the consumer at the center of the health ecosystem and overcome some of these chronic healthcare challenges.

You will hear us talk a lot about “people-driven health” and its ability to help consumers make smarter, more insightful healthcare decisions for themselves and their families.

This isn’t a consumer vs. healthcare provider and payer issue. By giving consumers better ways to inform their healthcare decisions using people-driven health, they will be able to work more collaboratively with their providers and insurers in a way where everyone in the ecosystem can benefit.

Ultimately, HealthChampion will help consumers along their healthcare journey to be healthier, spend less on healthcare, and get the value they expect from all parties in the healthcare ecosystem with people-driven healthcare.

What’s Next?

The challenges facing the U.S. healthcare system are complex, numerous, and took decades to evolve. We don’t expect big change to happen overnight, but we have a vision of how consumer empowerment can drive the right kind of change that benefits everyone in the healthcare ecosystem.

Over the course of the next weeks and months, we will be posting new, though-provoking content to engage with health-conscious consumers, people-driven health thought leaders, and those who agree that an empowered, educated consumer is the key to improving the way the U.S. consumer approaches their healthcare experience.

If you would like to be the first to know about HealthChampion’s latest news, content, or product developments, please sign up here. We look forward to working with you to make people-driven health a reality.

 

 

Fahad Alsabhan

Fahad Alsabhan is a lead Medical Writer at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan

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