If technology is finally catching up to people’s vision of its ability to transform the healthcare experience, then what’s the hold up?
Some say it’s fear. Fear that technology’s fuel — health data — is a commodity that people can’t understand and therefore can’t properly centralize, protect or share. Others argue that data has no inherent value until it is shared. So how do we solve healthcare’s data liquidity (and, seemingly, its transformation) conundrum?
As the digital enabler to the healthcare ecosystem, working with tech companies, health plans, providers, pharma, biotech and CROs alike, we have some solid ideas. But we wanted to know what a cross section of the healthcare industry thinks, so we asked a few of our Healthcare Summit attendees, including top executives from some of the country’s leading health plans (Anthem, Independence BlueCross and BlueCross BlueShield of Tennessee), the CEO from an Alphabet spinout (Cityblock Health), a PBM Chief Medical Officer (Magellan Rx), a Telehealth CEO (MD Live), and the leader of digital transformation for one of America’s most disruptive forces in consumer health (Under Armour).
Here’s what they said (in three parts):
- Data as Currency
- Data Enablers
- Organizational Focus and Mindset
“There is a mass of data out there. Some of it even has value.” David Frazee, R&D Executive Corporate Research, 3M
Part 1: Data as Currency
“I think liquidity, in part, means monetizing,” says Tony V. Coletta, M.D., MBA, EVP & President, Facilitated Health Networks of Independence Blue Cross, “And in order to monetize data, or to use it in business, the data has to have a purpose, and it has to come out of the various silos and merge with other data sets and become increasingly more valuable.”
So FHN, which spends more than a billion dollars a year paying for healthcare for its members in five counties in and around Philadelphia, took a decidedly different mindset in recent contract negotiations with the University of Pennsylvania Health System: it introduced data as a currency into the negotiations.
“The idea was, if you (providers) will agree to this basic economics of lowering the rate of rise of unit prices… we (health plan) will commit in the partnership to a transparent data exchange, interoperability and an interchange of data, in the beginning, between your EHR, your clinical record, and our claims database. There’s a tremendous thirst for that kind of information on the provider side,” Coletta says. “So it turned out that that level of commitment to transparent data exchange became a currency in the negotiation. They (providers) were more willing to potentially, it seems anyway, concede a bit on the up-front economics in return for a true partnership around data information that would help them understand their patients, our members, better through a combined effort.”
The result? So far, a dramatic drop in readmissions and continuing efforts at the health plan to deliver on the promise of that liquid data exchange. “I think one year later, we’re just scratching the surface in terms of the capabilities,” Coletta says.
BCBSTN’s Chief Data Officer Sherry Zink says context is key. “If you just give people data, they can’t do a whole lot with it. But if you take that data into context and give it to (people) where they can gain insight from it, and they can take action on it, and they can build a solution, then that’s when it becomes valuable, and that’s when it becomes liquid.”
Richard Popiel, Senior Advisor, McKinsey & Company, says there is always a clear understanding across companies he advises that no single company can solve the transformation conundrum alone.
“It has to be a set of partnerships that come together in an integrated fashion to provide that seamless experience to individuals,” Popiel says. “You want to partner with the right partners so that you can optimize and best serve the people that you’re trying to serve, whether that’s applications on your consumer platform or it’s technology partners that are going to enable you in ways that you couldn’t accomplish alone.”
Part 2: Enablers (the healthy kind)
In personal relationships, enablers can be good or bad, depending on the behavior they’re enabling. Healthcare partnerships are no different, says Under Armour’s Chief Digital Officer Paul Fipps.
Fipps says one of the fundamental things that healthcare organizations tend to forget when they’re building and launching apps or other digital solutions to engage consumers is just how difficult it is to do, especially at scale, and how difficult it can be to retrofit digital capabilities into non-digitally native organizations.
“At Under Armour, we’ve been through the whole lifecycle. I think what’s helped us is the acquisition of digitally born companies. You know, MyFitnessPal is based in San Francisco. Map My Fitness is based in Austin, Texas. And Endomondo was based in Copenhagen, Denmark, which gives us a massive global reach and scale across all three apps.
“But I think what we’ve learned, and what we’ve done over the past 18 months,” Fipps says, “is truly integrated those digital-born companies across the organization. And then we’ve taken the opportunity to focus on our priorities, our strategic priorities and then kind of sprinkle that talent throughout those teams. We call it Team of Teams, to work on these initiatives and be digitally-led initiatives. So whether it’s integration with supply chain or thinking about our demand chain end-to-end and how we actually fulfill that from a supply perspective. I think that having these teams engaged has been very, very enlightening for us. And it’s starting to go from our technology initiatives into our business processes, which is really where you want to see it take hold.
“I think on the partnership side,” Fipps says, “there are three things that really matter:
- “First, is you have to focus on the strength of what each other does. And when you do that, I think you find the best. You find the intersection of what a great partner does really well versus what it is you do really well. And that’s the magic of partnership.
- “I think the second thing is, can you align with your value system, are your companies aligned just from a core value standpoint?
- “And the third is, can you actually elevate each others’ brands? We look for partnerships, and we’ve been very successful, particularly in the technology space because of our app communities, of elevating both brands in those partnerships and creating, I would say, exponential value.”
Instead of health plans and providers trying to build consumer engagement apps, Fipps recommends finding partners who can bring that experience into the health plan or provider.
“Scale is really important here,” Fipps says. “Healthcare is not (Under Armour’s) area of expertise. But what is our area of expertise is getting people to engage in apps around their holistic health and fitness. The growth opportunity there is getting people engaged who are proactively trying to manage their own health and lead a healthier lifestyle, and then combining that with your medical record information and the more detailed information that we all care about, and bringing that together with a holistic perspective of (a person’s) health. I think that’s how you get individuals to engage. And to do that at scale is really difficult on your own.”
Part 3: Organizational Focus, Mindset
Availity CEO Russ Thomas says people have “gotten a bit wrapped around the axle about data liquidity and focused on the wrong things.”
“I think people have focused on, well, what does it mean? Who owns the data? From a regulatory perspective, what are we able to do with the data? How can we commercialize very specific datasets? I think we need to come up a level and say, okay, well, those problems obviously have to be solved, but there has to be an underlying business reason to solve them in the first place, and where I think a lot of companies and really smart people have gotten sidetracked over my almost two decades now in healthcare technology is they focused on the technology first or they focused on the data first as opposed to saying, ‘Okay, what’s the problem we’re actually trying to solve?’”
Magellan Rx Management Chief Medical Officer Caroline Carney says that unless the leadership inside the company understands the potential that technology and digital solutions have to change healthcare, the tools in and of themselves will never get there.
“I’ve been a big proponent of wrapping humans around tools and there’s evidence to suggest in the behavioral health space that digital cognitive behavioral therapy is done better when it’s coupled with a human in the background ensuring that the individual who is using it is actually using it, getting feedback on the results and still having some of that human touch,” Carney says. “So, I’m a believer that these tools can get us very far, but they still need to take place in a system of care, and the only way that system of care will happen is if the payer understands and the provider understands and, ultimately, the patient understands the use of the tools and their place in their health trajectory.”
Anthem Chief Digital Officer Rajeev Ronanki thinks we’re finally at a point where technology is making it possible to serve member/consumer needs and realize growth and margin.
“I think both could be done. In fact, both could be done better by improving service and by tailoring more personalized solutions… We’re finally upon that age where technology makes that possible. There’s a lot more to it, obviously, the mindset and the culture and the systems, the processes… all that has to change in order for that to take hold at scale. But, I believe we’re at that tipping point where that change is going to happen at scale.”
FHM’s Coletta agrees, but is realistic about just how difficult it is to innovate.
“My own personal experience was as one of the first surgeons to do a laparoscopic gallbladder surgery using TV screens to do big operations through tiny little incisions. It turned out to be highly innovative, but it was risky, and it was very stressful,” Coletta says. “I was being told you can never do that that way, and I was like, ‘I think you can.’ But you have to gather the right people around you… It takes a lot of courage… you have to be forward thinking. It takes a lot of people around you to make it all happen. And that same principle, I think, applies to business.
“I expected to go into business (I was part of a startup that was a joint venture for Independence called Tandigm Health) where innovation would flourish. Well, it’s there, and it has its impact, but I’ve learned it’s incredibly harder than people realize to gather that collective genius, to ask questions around the way things are happening. It’s difficult to innovate while at the same time having to make sure that your PNLs are hitting the numbers every year, and sort of the basic needs of a business, while at the same time ensuring that you’re always thinking differently and solving problems that maybe you weren’t even aware existed previously, and getting those ideas from the right people. Innovation is this sexy term,” Coletta says, “but in reality, to bring it to fruition in a business is incredibly difficult.
“I think it requires leaders to continue to push. It requires looking for the people with the glimmer in their eyes, not the bags under their eyes, to help make it happen… . But when you get it right, I mean, that gallbladder operation now is the gold standard… so when you get it right, especially in health care, I think you can get it dramatically right.”
Indeed. Our own research on the topic of Digital Transformation Readiness found that senior healthcare executives are warming up to enabling operational transformation and business transformation through technology.
“There’s a growing awareness among healthcare organizations that digital is an enterprise-wide business mindset and not just a series of siloed digital projects and pilots,” says Saurabh Sinha, founder and CEO of emids. “Our research confirms that if you really want to impact cost then you have to design for it. That starts with a vision of your future state so that you can reverse engineer systems and solutions to reach that goal. Even more important to digital success is an embedded culture of innovation across the organization, supported with investments that enable that journey.”
Unprecedented technological advances and consumer demand for simplicity are forcing out healthcare’s old ways and mindsets.
Turning (OK, maybe peering around) the Corner
Cityblock Health CEO and Co-founder Iyah Romm says we’re just now “peering around the corner” in terms of mindset.
“I think we still fundamentally have to recognize that if one believes, which I do, that the innovative delivery models that are starting to emerge are the way of the future, we also have to recognize that they care for less than a third of a percent of all people in this country right now. And so when you think about the totality of folks who engage in traditional models versus new models, we’re just starting to scratch the surface.”
MDLive CEO Rich Berner says despite the good work spent over the past two decades automating and optimizing and, for example, incorporating genetic information into the personal health record, we still fundamentally haven’t disrupted healthcare.
“It’s my belief, and MDLIVE’s belief, that telehealth represents the first real opportunity we’ve had in a long time to disrupt healthcare,” Berner says. “But in order to do that, we have to start by reimagining what healthcare should be like, from the consumer perspective. Think about it. We do online shopping. We do online banking. We book our travel online. We do online dating, and a lot of people find their life partner online. Why in the world would anybody think that consumers don’t want to get their health management and care online? What better place to meet your doctor and build a relationship?”
3M’s Frazee says the key is a seamless flow of data that is owned by the consumer.
“Data liquidity in this context is the fact that it’s seamless in the sense of, I don’t have to be a data scientist to understand how to use data to advance my business or my application of this in healthcare,” Frazee says. “In other words, the data that lives with me, that’s associated with me about my healthcare, should be seamlessly integrated with the data around my demographics and my family and where I live and how I behave with my fitness and my diet regimen and things like that. These are not two separate or three separate islands of data, but they are flowing between, and it’s more of a question of what data do I need to make a judgment? What data do I need to decide how to either provide treatment or to take treatment myself? That data is taken care of by the scientists and engineers, and I don’t have to know about that mess that’s underneath that.”
Which is precisely where emids comes in. We believe the digital transformation journey is about unlocking the gridlock of data to transform the experience into something that delights & heals the consumer while at the same time making the data actionable to end users. We also believe that health plans, in particular, have the opportunity to harness the true power of data, to help the healthcare industry transform the way it operates.
Want to learn more about how our healthcare data and technology experts can help you navigate your digital transformation journey without fear or loathing? Subscribe to our EVOLVE with emids newsletter.
Michael Hollis, President Strategic Business at emids, oversees the company’s marketing and sales operations. He is responsible for overall sales effectiveness, business development and client relationships, as well as for articulating the company’s service offerings to prospective clients and industries. Michael is an active member of Nashville’s professional and nonprofit community, serving on several advisory boards and as a committee member of the Nashville Technology Council and the Nashville Health Care Council’s Leadership Health Care initiative. Be sure to connect with Michael on LinkedIn.