Innovation

Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — The Human Problem With Health Technology — is reprinted below. To see all of his blog posts, click here.

One of my favorite activities is taking a bike ride. It’s a wonderful way to experience nature and challenge myself. How many miles did I ride? How long did it take? Did I do better than my last time?

Cycling is traditionally an individual sport, so I use a Garmin device to answer those questions. My Garmin device provides me with details, but it’s limited when it comes to seeing how I relate to others who also love cycling. For that, I use the app Strava.

Strava is a way for me and others to see how we measure up to one another. Strava is not a device, but it’s designed to create a community by connecting fellow cyclists. You can follow anyone on it.

Despite the individuality of cycling, there is a need to connect with other people who share this experience. There’s a social aspect to the sport, and it reflects the challenge we face with technology in health care today: Technology must be easy to use and deliver the human connection to improve a person’s health.

And nowhere is this more critical than in America’s rapidly growing senior population—a large number of whom are grappling with multiple chronic conditions.

Addressing Loneliness and Isolation

America’s seniors could benefit greatly from more human-centered technology. Three out of four Americans aged 65 or older live with multiple chronic conditions, and 71 percent of the money spent on health care in the U.S. is associated with chronic conditions. And the baby-boom generation is steaming into retirement, with 10,000 people a day aging into Medicare.

But health isn’t just about the physical aspects. Research has found that 17 percent of adults age 65 or older are isolated, and 26 percent are at increased risk of death due to subjective feelings of loneliness. If a person is living alone, and dealing with multiple chronic conditions, he or she might become depressed. People also won’t eat right or be active if they’re depressed.

Our species needs to connect with other people. Yet millions of seniors are lonely; they don’t have adequate social connections. That innate need to connect, to be social, and to be loved and to love other people is not being met in a large part of the population.

Things like remote monitoring technology can help, but only if it incorporates a person’s lifestyle and the physician/patient relationship. Technology has to go beyond monitoring basic physical activity. Devices have to achieve true connections and address real chronic health problems, like the nearly five million Americans in the U.S. who have congestive heart failure (CHF).

An Example of Connected Health

In order to help our members with chronic conditions spend more time living their lives by staying out of the hospital, we launched a CHF remote monitoring pilot program to help them keep track of their condition.

When a person has CHF, his or her heart doesn’t pump strongly enough to move blood around the body. As a result, the person retains water – in places such as the lungs, legs or chest cavity – and can suffer from shortness of breath. If the person experiences a significant change in weight from the previous day, this could signal a complication, which might lead to a trip to the hospital.

At Humana, we’re all too familiar with CHF. Approximately 300,000 of our 3.2 million Humana Medicare Advantage (MA) members live with CHF, and they account for more than 40 percent of MA admissions. Here’s how the pilot program works, with a member we’ll call “Brenda.”

After being selected, Brenda met with her primary care physician and a nurse. She was shown how to use a smart scale that would send her weight to Humana every day. When Brenda weighed herself the next morning, the scale sent her weight to her nurse, who called Brenda to congratulate her on her first weigh in.

If Brenda’s weight were outside an established range, her physician and nurse would be immediately notified. The nurse could then contact Brenda to see if she needed a new prescription or a consultation with the physician, enabling Brenda to have her weight fluctuation addressed immediately without having to go to the hospital.

Ease of Use and Human Connection

Members who participated in the CHF pilot program weighed in 88 percent of the time during the first 100 days. So why has this program been successful? There are two core elements: ease of use and human connection.

The table stakes for remote monitoring is ease of use. Brenda’s scale has no plug, no buttons, and requires almost no instructions. She doesn’t need Wi-Fi or Bluetooth to use the scale, and she doesn’t need to register it anywhere. Her scale simply works right out of the box. To be certain Brenda knows exactly what to do with her scale, she used it in front of her nurse as soon as she received it.

But to keep weighing in every day, this new activity has to be bonded to something Brenda values: human connection. Because Brenda knows her nurse is on the other side of the scale, and is looking out for her health and well-being, she is more likely to weigh in each day. Additionally, we have found that group enrollment sessions help people like Brenda because they see other people with CHF taking action to monitor their condition.

The program only works if people like Brenda take a small action each day. Technology can make it easier for Brenda to take that action, but in the end she will do it because of deeper, more human motivations like connecting to others.

There are other elements that help enhance the effectiveness of health-related technology, in addition to ease of use and the human connection, such as the motivation that comes as a result of a person seeing his or her specific progress (personalized, real-time, relevant information, aka the “so what”). This can be a powerful hook for encouraging ongoing engagement and helping people become more knowledgeable, and confident, in managing their condition. For example, the CHF pilot also includes sending “certificates of accomplishment,” recognizing those who’ve reached various milestones and that receiving recognition for their effort seemed to be an effective way of keeping people engaged.

The Way Forward

Health-related technology such as remote monitoring and scales can help our aging population improve their health. But it won’t do so unless the technology brings together the lifestyle and clinical aspects of a person’s health in a way that makes it easy to get people more engaged in managing their health.

The integration of physicians and clinicians, as we’ve seen with our CHF program, is important; their recommendations carry influence, and they can ensure that the data is used to highlight moments of influence. The key is not just the utilization of the technology; it’s the design and integration of the program. There is a real need for deep clinical engagement, both in getting people engaged in their health and in helping physicians and other health care providers move beyond prevention and wellness and toward managing chronic conditions.

At Humana, taking care of seniors living with multiple chronic conditions is what we do best. The role of technology is only going to become more important. But let’s never forget that technology must make things easier and more human to make a difference in health.

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Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — How to “Defeat” Artificial Intelligence — is reprinted below. To see all of his blog posts, click here.

The advance of artificial intelligence, via the first wave of automation, could seriously disrupt life as we know it. It’s not a surprise, considering that computing power doubles every couple of years. Can we say the same for the power of the human mind?

This technology is certainly going to have an impact on our workforce. Take a recent report from Forester Research, which found that automation alone could eliminate 8.6 million U.S. jobs by 2021, or, as one media outlet put it, “the equivalent of Florida’s entire workforce.”

Yet while the U.S. unemployment is currently 4.9 percent and has been low the last five years, many high-paying jobs, high skilled jobs have been replaced with low-paying, low skilled jobs, and this is not truly reflected in the unemployment rate.

Our nation’s population is also growing, which means more people for fewer jobs. The challenge is that many new, high-paying jobs will require new skills. And fewer workers will be required in the digital economy. We have to empower the American workforce to adapt to these changes.

Before we try to solve this challenge, let’s go back a century to the creation of the internal-combustion engine, which led to the automobile industry, which has been an economic force ever since.

Think about the impact the internal-combustion engine had on our country. It even impacted fresh foods by connecting rural markets to the city. The internal-combustion engine also created numerous jobs because it wasn’t highly technical, creating opportunities for vocational schools and programs.

When the internal-combustion engine was invented, there was a sharing of wealth and numerous touch points. On the digital side, it begins to narrow. And in the sharing of wealth in the digital world, where much of our economic growth has taken place, it’s very narrow.

For example, fast forward to today. In the digital economy, there are fewer access points. An app can be created by a small team and reach millions. Just look at the Kodak vs. Instagram comparison:

· “Kodak was founded in 1880, and at its peak employed nearly 145,300 people, with many more indirectly employed via suppliers and retailers. Kodak’s founding family, the Eastmans, became wealthy, while providing skilled jobs for several generations of middle-class Americans. Instagram was founded in 2010 by a team of fifteen people. In 2012 it was sold to Facebook for over one billion dollars. Facebook, worth far more than Kodak ever was, employs fewer than 5,000 people. At least ten of them have a net worth ten times that of George Eastman.”

If the Kodak vs. Instagram example has taught us anything, it’s that new technologies will require fewer resources and create fewer jobs. More industries will be disrupted, and the remaining jobs will require more advanced training.

Coal Mining to Coding to Call Centers

The irony is that many of the new jobs being created, in industries such as manufacturing, require people with certain technical skills that many employers simply cannot find. In a recent Wall Street Journal article about how more and more jobs are going unfilled because companies cannot find skilled workers:

· Amid anxiety about the disappearance of factory jobs, thousands of them are going unfilled across the U.S. The number of open manufacturing jobs has been rising since 2009, and this year stands at the highest level in 15 years, according to Labor Department data. Factory work has evolved over the past 15 years or so as companies have invested in advanced machinery requiring new sets of skills. Many workers who were laid off in recent decades—as technology, globalization and recession wiped out lower-skilled roles—don’t have the skills to do today’s jobs.

So what’s the answer for preparing an American workforce disrupted by technology? It’s education, training and redeployment…it’s about investing in people.

An amazing example of this retraining and redeployment can be found in the coal mining communities of West Virginia. Take Rusty Justice, who is retraining former coal miners in Appalachia to be app developers. It’s a fascinating story of an industry that has experienced massive layoffs. Mr. Justice’s program shows how someone who has solid intelligence, but who is stuck in a challenged field, can thrive with some workforce retraining.

And in Louisville, Code Louisville offers a free, 12-week training course to teach people computer software coding so they can get good-paying jobs in a growing industry. After meeting at a Code Louisville event at the Beecher Terrace public housing complex, several high school students created Beech Technologies as a venture to help small businesses improve their web presence.

Yet there are different sectors where retraining is more difficult. It’s not just industries like manufacturing and coal mining being impacted. Think about people who work in call centers. Given the automation that can impact these call center jobs there is a real need to help these employees retrain.

There’s a spiral of people trying to keep their heads above water, and their well-being is being impacted in an environment where learning and education are not easy; they start falling behind. When you start falling behind, you get left behind.

The knee-jerk reaction is to give people a raise. But when jobs get shipped over to India, or lost to automation, retraining and redeploying them to more productive opportunities is the better choice. It’s about investing in people so they are able to take new skills and training with them wherever they work or live.

For example, Comcast announced plans last year to retrain 84,000 of its call center workers who are on the front lines of customer service. In my company, Humana, we are using AI to support customer service representatives, as Forbes and the Wall Street Journal recently reported. This has required us to retrain many of our customer service associates.

We Have a Responsibility

Companies don’t always look at it as their responsibility to retrain, redeploy and move people to a different level. Some may view these positions as simply disposable, despite the fact that customer service is a highly critical function in today’s competitive economy.

We need to ask ourselves a question: what is our responsibility as an American business? American business has a responsibility to retrain its workforce. The job is not the issue; it’s the training and education and redeployment.

Some have proposed legislation that would raise taxes or distribute money to people who are impacted. This is a short-term solution. Instead, if wealth transferred through job creation and workforce education is pursued, many of these impacted people can make a long-term contribution to society and also be prepared for the next wave of disruptive technology, enabling their own long-term sustainability in the workforce.

Tsunamis generally come in three to four waves. The latter waves are usually the biggest. The wave of automation is building in the distance, and we can feel it. It’s going to disrupt entire fields. American business leadership has a moral responsibility to the employees it serves to prepare them not just for the first wave of automation, but the waves from Artificial Intelligence that will most certainly follow. Let’s do it together.

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Humana’s Busy Burr, Vice President of Innovation and Head of Humana Health Ventures, joined other industry leaders recently to discuss advances toward better health and well-being for everyone, including underserved communities.

The forum was the Fifth Annual Health Technology Forum Innovation Conference – titled “Common Good” – at Stanford University. Joining Busy in the opening keynote panel discussion were Ronald Copeland, M.D. – SVP, Kaiser Foundation Health Plan; Scott Mauvais – Director, Technology & Civic Innovation, Microsoft; and Pronoy Saha – Founder, Health Technology Forum. The panel was moderated by Neil Versel, Health IT reporter at MedCity News.

The goal was to “take a deeper look into health and wellness enhancements for the masses made possible through technology and the framing and implementation of key health policies.” Discussions were aimed at “next generation technology, the importance of compassion and innovation in care, best practices in public health, community care and sustainability.”

Busy explained that elements of the triple aim – improving quality of care, lowering costs, and increasing patient engagement and satisfaction – are interrelated. What’s needed is a holistic look at the system and individuals.

She noted that the health care system has evolved from one built to address episodic care, to one where we spend 75% of health care dollars on chronic conditions. To the extent that we can stop disease progression, we take money right out of the system, and we increase patient satisfaction.

“We’re shifting to a consumer-centered system and moving away from a health care system where forces were in opposition to one another,” she said. “And when forces are in opposition to one another, you’re not going to get the best outcomes in the health care system. The only way that we’re going to move to where we need to be is to create a sense of balance and collaboration. And that means a holistic view of the consumer.”

Key to that is moving away from a return on investment and moving toward what Busy called a “return on health.”

“If you think about the system we’re moving from – fee for service, claims-based – which put finance at the center, we have to change that so that health is at the center of everything we do,” she said. “And that means we have to be an organization that’s purpose-driven and has compassion at the core. It means that when we sit down in meetings, we’re thinking about our members – what makes them healthy and how we can be aligned with their goals and their needs.”

“If you start from cost, you might or might not impact health. But if you start with health, you’re definitely going to have a reduction in cost,” she said.

Busy also talked about Humana’s Bold Goal and our effort to measure progress with the CDC’s Healthy Days score.

“It fundamentally changes the way we work,” she said. “Because in order to make it easy for people to achieve their best health it’s more than just about innovations and clever technology gadgets or cool data-analytics algorithms. … Every person at Humana is focused on our members’ best health.”

Busy Burr addressed the crowd at the Health Technology Forum. Joining her on stage were, from left, Pronoy Saha, Scott Mauvais and Ronald Copeland.
Busy Burr addressed the crowd at the Health Technology Forum. Joining her on stage were, from left, Pronoy Saha, Scott Mauvais and Ronald Copeland.
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Humana President and CEO Bruce Broussard is among the “Top 100 CEOs on Social Media,” as compiled by Xinfu and Hootsuite.

He’s in good company, with leaders like Elon Musk of Tesla Motors, Tim Cook of Apple and Marissa Mayer of Yahoo also making the list.

Bruce was praised for his “consistent & interesting posts on the role of innovation in the future of healthcare.”

“In an increasingly social workforce, it’s clear that CEOs need to do more than just be on social—they need to lead,” the reviewers said. “One of our biggest measures for who to include was decided by answering the question: Who is creating true value-add content for their followers? We measured this in terms of each CEO’s originality, industry leadership, and insight into their own organization.”

See the entire list and read more here.

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Humana’s Chief Innovation Officer, Chris Kay, sat down last week with Richard Angus of Innovation Enterprise for a Google Hangout to discuss the changing landscape in the health care industry.

Humana’s primary objective, Chris said, is to bend the trend on health by providing consumer-oriented solutions that help people lead a better life while slowing the progression of disease. The goal is to innovate across a customer’s health journey; when there’s a barrier, we help come up with a solution.

Chris talked about our Bold Goal and the importance of moving away from episodic care and toward holistic care. He talked about helping customers manage complex chronic conditions, or even multiple chronic conditions.

He explained Humana’s partnership with Omada Health, which recently showed that seniors can engage online and successfully manage their health. And he talked about our work with Livongo Health, providing cloud-based, real-time management of diabetes.

It’s all about what Chris calls ROH – Return on Health. We’re helping people invest now for a healthier future.

You can watch the interview here.

 

 

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