Over three trillion dollars is spent on (what we call) healthcare in the U.S. every year.
However, the reality is that the vast majority of that money is being spent on “sickcare” – trying to make people better after they have become ill.
But by only considering an individual’s health when they’re sick, we’re not considering many significant factors. Only 30% of the drivers that determine an individual’s health are clinical or genetic, whereas 70% is determined by lifestyle and environment.
As an industry, we’ve spent a lot of money addressing the 30% of “sickcare” spend. The healthcare system has been built around incentivizing people and institutions to get sick patients well rather than keeping people healthy or helping them improve their health status. We also see the same parallels in the healthcare IT industry where investment has primarily been focused on solutions that manage risk, process payments or track episodes of care.
However, we’re finally making strides to better support individuals in making smarter health-related decisions so that they can live healthier, happier lives. Over the past few years, there has been a significant increase in investment dollars going into this area. And as the industry increasingly moves towards reimbursing clinicians based on value, not just the volume of services performed, the interest in and need for technology that looks at the world from the perspective of a healthcare consumer (not patient) will only increase.
And the timing couldn’t be better. We are seeing advances in mobile technology, analytics, artificial intelligence and machine learning that are now making it possible to create more personalized, engaging experiences with individuals to help them get and stay healthy.
Getting ahead of health
First, we are seeing advances in analytics that help to understand people as individuals, not as populations. While this may not seem novel, this is a huge step away from the “one size fits all” mentality the healthcare industry has followed. The addition of consumer variables such as demographics, shopping behavior and even voting records, in addition to clinical and claims data, are creating a more robust picture of healthcare consumers that is far more predictive of future health behaviors than simply using retrospective clinical data. In addition, advanced analytics can help organizations move beyond simply identifying someone’s risk for illness to understanding receptivity and impactibility – better identifying and targeting the right people with the right programs, which results in much better outcomes.
We are also starting to see more innovative players in healthcare take inspiration and learnings from non-healthcare companies, like Amazon and Netflix, to create better consumer experiences. Health organization are starting to leverage advanced analytics to create more curated experiences for individuals around their health. They are making it easier for people who want to be healthier by offering up the right programs and services based on their interests and motivations, as well as what others like them may have found useful or helpful.
Engaging everyone, everywhere
The benefit also extends beyond consumers and clinicians to other industry stakeholders, like payers and employers. For example, two employees at the same company may see very different health and well-being program options based on their health status, their health goals, and what other people “like them” have found to be beneficial. Recent research show that engaging just 10% more of a population in their health can drive significant savings for health plans ($134 million for an average commercial health plan with 1 million members) and employers ($3 million for self-insured employer with 10,000 employees) due to medical cost reduction, improved outcomes and greater employee productivity (link).
Changing behavior is extremely difficult, but the good news is that most people want support to be healthier. In fact, a recent survey by Welltok and NBGH showed that the majority of employees want and expect their employers to support them in their health (link). The biggest challenges to participation, however, were lack of program awareness, lack of program relevance and lack of time. Mobile technology, artificial intelligence and advanced analytics are breaking down these barriers to create truly personalized experiences that help people (not just patients) live healthier, happier lives.
We are still in the infancy of cognitive computing and machine learning, but I believe this area has the ability to fundamentally change how we guide individuals to achieve their optimal health.
Early efforts in healthcare focused on the clinical realm, but efforts are now underway to use machine learning and artificial intelligence for prevention and well-being. Imagine having a technology like IBM Watson that knows where you are, what time it is, what your health goals are – and then makes recommendations for dinner, physical activity or other health related programs. It’s like having your own health concierge, 24x7 – and it’s closer than you think.
Image source (fht)