The future of digital healthcare: Access, accountability and adoption

Written by Dr. Joseph Smith, President and CEO of Reflexion Health and Digital Health Corp. | March 27, 2019 | Print  |

The use of digital technologies to transform healthcare, long lagging their application in almost every other corner or our lives, is finally taking place. And slowly but surely, providers, practices and payers across the United States are beginning to pay attention (patients are, of course, already largely on board).

Access. One of the most heralded aspects of digital healthcare is its ability to break the tyranny of geography and extend care to patients independent of their physical proximity to top medical resources which tend to be concentrated in urban areas or university medical centers. In recent years, federal organizations like the VA and FCC have worked to expand telehealth access to rural areas, including a call for development of broadband to remote communities. For the same reason, the CMS has also expanded its reimbursement fee schedule to include a wider variety of remote care services.

Digital healthcare tools also give patients the option of at-home care when their physical condition makes transport to appointments difficult. My company’s Virtual Exercise Rehabilitation Assistant (VERA™) telerehabilitation platform, for instance, is designed to deliver premium, at-home physical therapy services for patients for whom traveling to and from a clinic or hospital as part of their recovery is physically burdensome or logistically challenging.

Accountability. As a nation, we not only spend far more of our GDP than other nations on healthcare (almost a fifth, in fact), but many of our key healthcare outcomes lag behind others who spend far less. In acknowledgment of this troubling fact, CMS is working to assure that we get value for money in our healthcare spending. The welcome shift from paying for volume (of visits, procedures, etc) to paying for quality outcomes is gradually taking place. As part of that transition to value-based care, CMS has been shifting its methods of reimbursement slowly but steadily towards bundled payments, in which entire episodes of care are reimbursed with a single prospectively-agreed sum. Such bundled-payment scenarios both allow and incentivize providers to innovate care pathways and utilize innovative digital technologies to decrease the overall cost of care.

Digital healthcare tools are uniquely valuable to help facilitate this shift, offering a means for providers to offer educational, communication, monitoring, and telemedicine services at a lower overall cost, while strengthening their connectivity with patients. This also works to enhance patient satisfaction and adherence, two critical drivers for improved outcomes.

Adoption. While the industry is beginning to shift, adoption of new digital healthcare technologies is slow and the much touted value-based healthcare system is a work in progress. Medicare backed away from advancing mandatory bundles in its CJR program in favor of elective bundled payment programs. This had an initially chilling effect on the pace of adoption of value-based care pathways, but with the expansion of BPCI programs and commercial bundled payment programs from commercial insurers, the drumbeat is picking up again.

Change in healthcare comes slowly – even change for the better. The digital transformation of healthcare means that workflows will change and the flow of funds will be affected. Every part of healthcare has an associated inertia which rejects change. Without substantial motivation in the form of either significant financial incentives or existential threats, change is often delayed or sidetracked. The good news for digital healthcare is that there is already widespread familiarity with digital tools in every other aspect of our lives, and now within healthcare, there is a growing body of proof that such tools reduce cost and friction while greatly improving patient convenience and overall satisfaction. And the breaking wave of value-based healthcare is providing the aligned financial incentives to drive adoption.

The bottom line? Not only is digital healthcare here to stay, but it’s increasingly being leveraged by forward-thinking physicians and practices to drive value by saving time, steps and money, maintaining connectivity independent of location, achieving excellent outcomes and delighting patients. Digital healthcare is no longer part of future of healthcare, it is here, now, and will quickly become such an expected aspect of healthcare delivery that we will soon drop the ‘digital’ preface -- it will just be part-and-parcel of the way healthcare will be delivered going forward.

About the Author:

As the president and chief executive officer of Reflexion Health and Digital Health Corp, Dr. Joseph (Joe) Smith’s expertise and passion lies in exploring the intersection of medicine and technology. His background includes serving as the founding chief medical and science officer at the West Health Institute, president of the West Health Policy Center in Washington, D.C., and manager of the West Health Investment Fund. He has also held executive positions at J&J, Boston Scientific, and Guidant Corp. served as a practicing cardiologist for close to 20 years. Dr. Smith holds bachelor’s degree from Johns Hopkins, a PhD from MIT, and an MD from Harvard Medical School.

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