With the spotlight trained on new buzzword mechanisms like blockchain and augmented intelligence, disruptive innovation and transformative technologies in healthcare were the subjects of lively debate and discussion at this year’s HLTH conference.
Held for four days in early May in Las Vegas, HLTH presented an expansive forum for healthcare professionals, companies, and policymakers to discuss new advances and challenges confronting the healthcare ecosystem. Drawing representation from the healthcare continuum, such as health payment and delivery, the event also offered insights into how the industry could leverage ongoing disruption toward providing next-generation healthcare.
Below are notable points to consider from this year’s show.
The underlying technology behind cryptocurrencies like Bitcoin and Ethereum, blockchain holds promise for more efficient transaction management in the areas of precision medicine, patient approvals, and better revenue cycle management (RCM). In precision medicine, for instance, blockchain can enable the inclusion of personal buying history and information from the electronic health record (EHR) to add contextual awareness about a person’s health.
At the show, a panel also discussed how blockchain’s distributed ledger technology could eliminate middlemen during the next 10 years in processes involving EHR data management, RCM, and eligibility-benefit inquiries. The panel, comprising PokitDoc, Doc.ai, and VSP Global—all based in California—said that the current business models of the middlemen will inevitably change.
Of interest to healthcare professionals is blockchain’s open and decentralized nature, which has the potential to resolve challenges involving data interoperability underlying healthcare systems today. Given blockchain’s distributed ledger system, the “blocks” that record transactions can be easily distributed and shared across networks, rather than being housed in an isolated central database. And blockchain is secure: Each block is an indelible record that cannot be changed, deleted, or modified, requiring validation by the block’s network of users before the block can become a part of the transaction chain.
These key attributes make blockchain a viable technology for many transactions that involve sharing and securing electronic health data across the full spectrum of healthcare stakeholders—a broad coalition that includes patients, physicians and caretakers, pharmacies, medical researchers, healthcare providers, and institutional entities.
Blockchain could also benefit healthcare in other ways. For instance, the technology could lend itself to the creation of a master patient index that ties patients to their data, not to their identity. Moreover, blockchain could be tapped to automate adjudication—to either pay or deny a claim without human intervention—via so-called “smart contracts,” which are software programs in blockchain that can be deployed to validate an authorization process.
For more information on blockchain, see our take on the technology and download the IHS Markit white paper on blockchain.
A small group comprising xG Health Solutions (Geisinger) of Maryland, South Carolina-based Verge Health, and New Jersey’s CitiusTech, along with the American Heart Association, focused on the technology known as augmented intelligence.
Unlike the other “AI”—artificial intelligence, which attempts to imitate or reproduce human intelligence—augmented intelligence seeks to expand human intelligence, especially in health imaging. Reinforced with augmented intelligence, enterprise imaging can help deliver faster screening results of serious healthcare issues, including cancer, chronic chest diseases, neurological ailments, musculoskeletal disorders, and other clinical pathologies. AI systems are helpful not only for speedier initial diagnoses but also for follow-up monitoring after treatment to help track possible recurrence.
But even though AI may help prevent serious medical errors, there is still difficulty in pushing data to EHR, and incorporating analysis into workflows remains a problem. The panel noted that large employers and payers have the money to lead change, and should begin leading by example.
Multi-variable demographic profiles
An important issue underscored at the show was the convergence of health and non-health data, as well as data liquidity, across the health ecosystem. Several organizations advocated the use of tools and services to better understand the impact of demographics on health, and how demographics could be marshaled to improve health outcomes.
Among such advocates were New York-based Softheon, Welltok of Colorado, Wisconsin’s Redox, and California-based HealthVerity, together with the Integrated Healthcare Association and the US Department of Health and Human Services.
By utilizing consumer spending habits, income data, hobbies, and personal interests—and then combining those with medical claims, EMR data, and pharmacy transactions—it becomes possible to gain a better understanding of the demographic factors behind patient behavior. The Rand Corp. and Facebook observed that a person’s geographic location, education, job, and community relationships likely have more to do with positive health outcomes than DNA.
Important initiatives unveiled
Worth noting at the conference were three major announcements from Qualcomm Life, Geisinger, and Walmart, on a range of issues that included remote monitoring, patient satisfaction, and provider entitlements.
A collaborative effort among six companies—California’s Qualcomm Life, ForgeRock, and Sparsa; Texas-based US TrustedCare; UK semiconductor maker ARM; and Philips of the Netherlands—OpenMedReady seeks to enhance data from medical devices as well as enable trustworthy data sourcing and consented patient-information sharing. The joint endeavor advocates increased use of remote patient monitoring (RPM) to lower readmission rates to care centers and to slash related healthcare costs.
Building on existing RPM initiatives, such as the Continua Design Guidelines, OpenMedReady addresses five critical areas in clinical RPM: patient identity (fingerprint biometrics), device identity, data integrity, patient privacy, and consent. Karthik Ranjan, healthcare strategy director at ARM, noted that the new initiative “enhances remotely acquired data by increasing its provenance, bringing us closer to the reality of closed-loop health systems.”
IHS Markit forecasts that the number of remotely monitored patients worldwide will grow from 1.5 million in 2017 to more than 6.1 million in 2021, representing a compound annual growth rate of 40%. The patient numbers also include those being monitored for chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and mental health.
Three years ago. David Feinberg, the CEO of Geisinger Health System, launched an initiative that allowed patients to request refunds of up to $2,000 if they were dissatisfied with service, an unusual option with little precedent anywhere else in the industry. To the surprise of many, Feinberg’s initiative has resulted in increased satisfaction rates among patients, in-depth feedback from patients on hospital operations, and no significant false claims.
Geisinger, based in Pennsylvania, is also ahead of the medical establishment by offering DNA sequencing as part of routine care to the patient, at no added cost. Beginning with a pilot program of 1,000 patients, and funded by donors and Geisinger’s insurance company, the plan provides all Geisinger patients with opportunities to sequence their DNA free of charge. DNA sequencing will be important in the shift toward value-based care, since catching diseases earlier benefits the patient’s quality of life while also reducing cost among providers.
The world’s largest company by revenue wishes to limit the tremendous variation currently present in American healthcare for its associates and customers. How will Walmart do this? Perhaps by acquiring health insurer Humana of Kentucky, the latest in a series of M&A activity that is transforming the US healthcare industry.
Humana had attempted in 2017 to acquire fellow health insurer Aetna at the same time as two other US health insurers—Cigna and Anthem—were seeking to merge. Both deals fell apart after the US Department of Justice raised objections, citing anti-trust concerns. Since then, insurers have been looking to partner with companies outside of the healthcare space.
The prospective acquisition of Humana is important owing to Walmart’s scale, and because the Arkansas-based titan is yet another name in a growing list of traditionally non-health related companies branding themselves more prominently in the healthcare ecosystem. Acquiring Humana could boost Walmart’s clout in the healthcare industry. Already, Humana’s large population of Medicare beneficiaries is a core customer of Walmart Pharmacy, the country’s fourth-largest, and which has also begun operating primary-care clinics. In turn, an in-house insurer could lower the health insurance costs shouldered by Walmart for its massive labor force, which numbers in the millions.
Note: Aside from the HLTH conference discussed here, another healthcare show was recently in the news. For more details on that event, see my previous Market Insight, “Healthcare attracts many big tech names at HIMSS 2018.”