Innovating for the chronically ill

Consumer preferences around health are changing as the U.S. population grows older—and sicker. People want to be independent and remain in their homes as they age.  How can the health system respond to consumer desires for family support, care planning, and 24×7 clinical support?

Patients with chronic conditions and comorbidities are not always best served by acute, episodic care.  Instead, there is an opportunity to proactively engage patients and their providers and collaborate to bring about improved health outcomes.

Two Humana executives spoke recently to an audience of hospital finance administrators and other healthcare senior leaders.  Stefani Benefield, VP Innovation, and Dr. Phil Painter, Chief Medical Officer for Humana at Home, together presented a talk titled “Delivering Innovation for the Chronically Ill” at the Healthcare Financial Management Association’s (HFMA) annual conference in Orlando.

“The health system is costly, inefficient, complex—  just imagine how this shows up for people who are chronically or seriously ill and are dependent on every aspect of the healthcare system at a time when they are not at their best to navigate.” Stefani said during her talk.  “It’s time we all ensure these patients are not figuratively and literally lost in this system.”

Consider these facts:

• The Medicare population (65+) is projected to double by 2050. Ten thousand people age into Medicare each day

• According to the Centers for Disease Control and Prevention (CDC), 75 percent of seniors have multiple chronic conditions

• Caring for patients with chronic conditions costs five times the average cost for those without chronic conditions (to say nothing of corresponding functional limitations and behavioral health implications)

• 80 percent of people prefer to remain in their homes (SOURCE:  Dartmouth Atlas of Health Care).

The strategy is Integrated Care Delivery

The HFMA presentation made the case for payers and hospitals partnering with providers to manage health holistically, instead of episodically.  Dr. Painter said, “The answer to disruption is in collaboration and partnerships with those who know care best:  physicians and hospitals.”  An integrated care approach brings simplicity and connectivity to the healthcare experience.  It looks like supporting patients in managing their health to build trust.  Clinical programs at the intersection of healthcare and lifestyle meet consumers where they are—and help them at key moments of need

Patients and their families are taking control of their diagnosis and treatments, supported by increasingly powerful consumer technology fed by a growing focus on health in all industries.  Stefani pointed out that “the Innovation we need is already in our pockets, on our wrists and in our homes.”  Recent advancements in wearables, remote sensors, video, machine learning, and big data are enabling waves of understanding and insight to shape patient behaviors and conversations with clinicians, resulting in better treatment plans.  One approach to innovation that Humana pursues is integrating existing solutions to create an end-to-end experience that works for the patient.

All of these technological advances enable remote monitoring, diagnostics, personalized care and coordination.  As reported in The Economist, one telehealth pilot suggested that remote monitoring of patients healing at home could reduce hospital admissions by nearly half and cut costs by one third.  In addition to helping keep healthcare costs manageable, Humana is focused on slowing the progression of diseases and chronic conditions, keeping patients at home, and generally increasing quality of life for those we serve.

Increased connectivity and simplified experience drive value

A new mode of interaction, voice, provides an always-on, persistent and human way to support our care strategy in the home.  During the HFMA presentation, Chris Reitz from the Innovation team demonstrated how a wireless connected scale for patients with congestive heart failure could be paired with an Amazon Echo to create a new kind of interface.

On its own, the connected scale is limited in the data it can collect and the feedback it can provide.  Integrating Amazon’s Alexa for additional dialogue provides a means of providing positive reinforcement to incentivize interaction and help shape desired behaviors.  This Alexa “skill” – similar to an app on your cell phone – was developed by Humana’s Digital Experience Center to explore ways of communicating directly with members in a more personal way.

After initiating the Healthy Heart by Humana skill, Alexa responds “Good morning.  It’s nice to hear your voice again.  Thanks for weighing yourself today.  Your weight looks normal and there’s nothing to worry about.  Would you like me to check your symptoms or contact your care manager?”  Asking to have one’s symptoms checked prompts a series of questions to identify potential issues related to fluid retention, shortness of breath, and changes to medications that may not have been shared with the physician.  Daily check-ins are critical for detecting small changes in a member’s condition that may require intervention.

This is just one example of Humana’s rapid prototyping approach informing how we can be more present with our members by meeting them where they are.  This new, cohesive experience layer builds trust by helping maintain the member’s connections with their care manager and loved ones in a way that is integrated with daily routines.

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