Can Consumers and Patients Be One in the Same?

In a recent post by Dr. Michael Hodgkins, AMA’s CMIO, he cited the consumerization of healthcare as one of three digital health trends that are transforming patient care. Earlier this month, Health Affairs analyzed ‘the ups and downs of expecting patients to act as consumers’. Further, the NEJM Catalyst Insights Council revealed that the majority (96 percent) of its members responding to a recent patient engagement survey said the healthcare industry has a lot to learn from consumer-facing industries.

So, this past Valentine’s Day, I had the pleasure to host a day-long event at HIMSS Global Conference, sponsored by the Personal Connected Health Alliance (PCHAlliance). The focus was consumerization in health. I was pleased with the level of attendance, and more so with the exceptional line-up of speakers and panelists. It was a day full of fun, insights, and differing points of view on the most important issues facing connected health right now. The initial kick-off was by Jennifer Sargent, who gave a talk that was a springboard for the entire day. Her presentation touched on the trends in workplace health, and employers’ desire to provide conveniences and support for employees, to help them stay on track with primary care needs — what she called ‘whole health engagement.’ Jennifer also highlighted the successes Vera Whole Health has had in getting people to adhere to recommended therapies and show up for doctors’ appointments.

Panels moderated by Kaveh Safavi and Jane Sarasohn-Kahn followed. There was a recurring theme of, what do we call recipients of healthcare? Interestingly, this debate has been going on for some time, with providers digging in their heels, insisting on ‘patients’ being the correct term. ‘Consumers’ still generates some discomfort with many folks. One panelist added a new twist, advocating for the term ‘customers!’ While I understand the controversy between terms like patients (too paternalistic?) and consumers (too commercial?), I have not heard much of a groundswell for the term customers. I’m really torn on this one. I can’t separate the ‘new age’ me from the provider who relishes the special relationship I have with my patients.

During the next panel, moderated by Sunita Desai, Chex Yu presented some very interesting data on consumerization in health. A JMP Chase Institute study of Chase customers and their out-of-pocket (OOP) healthcare spending habits illustrated the need to consider this when structuring healthcare options and payment options. Chex shared several important observations from this study, including the following:

• High income families had the highest spending, but low income families had the highest burden of spending;
• People made larger healthcare payments when they had a higher ability to pay (thus people are foregoing care);
• OOPs increases after tax refunds (thus people are delaying care until immediately after they get a refund).

As a board member, I was pleased to hear Kristen Valdes’ perspective on how her company b.well is helping consumers aggregate and understand their health data.

Another theme of the day was the conundrum around data ownership and value, which was discussed by Grace Cordovano’s panel. So many important questions were raised, but remain unresolved. What is the best way to encourage data transparency for consumers? How should we set values for consumer health data and create tools that allow individuals to share their information knowingly and gain some value for it? Thorny issues to be sure. Maybe blockchain is part of the solution. I think it’s clear that the scales are currently tipped away from patients, in terms of deriving value from data, with monetization controlled firmly by longstanding commercial interests. I could also argue that if raw data means nothing, value can be derived when data is aggregated and analyzed with proprietary algorithms and made useful through interfaces designed for clinician or patient consumption.

Admittedly, I am biased due to my unbridled enthusiasm for the power of patient-generated data to engage people and aid in behavior change, but I really enjoyed Drew Schiller’s afternoon keynote. He shared several compelling stories of how folks who monitored their health data gained insights that allowed them to change behaviors and overcome barriers in the management of a chronic illness. We’ve seen evidence of this at Partners Connected Health. There is one small caveat: some individuals need a good chunk of external motivation to pay attention to the numeric trends served up by their wearable devices.

After that, the focus switched to emerging technologies. Jody Holtzman led a panel that talked about the power of robots in the context of aging, something I care deeply about and covered in my most recent book, The New Mobile Age. This panel included a demonstration of ElliQ, a social robot, whose impact on attendees made the point that robots can be appealing and evocative. The field of social robots continues to evolve rapidly, and with each new entrant and form factor, seems to get closer and closer to the vision where these tools are a ubiquitous part of our lives.

Steve Mitchley from the Vitality Group gave a compelling talk on making prevention trendy, demonstrating it’s possible for preventive care to succeed and stick.

Steve Wretling, CTIO of HIMSS, led a provocative panel on the use of immersive technologies in health. We heard from JoAnn Difede, Kyle Rand, and Anthony Sossong, experts in virtual/mixed and augmented reality, on the latest evidence, consumer, and healthcare trends, and the potential for immersive realities as tools for health promotion. The message across panelists was that devices have become better and more affordable, and they see VR as having real value in healthcare in the future. This group is doing some fascinating research in PTSD, overcoming social isolation/loneliness, and improving social skills. In fact, we believe this is such an important topic, we’ve already invited this panel to present at the 2019 Connected Health Conference in October.

To cap the day, we staged an interview with Ted Fischer, CEO of Ageless Innovation, during which we were joined on stage by three robotic pets from Hasbro, Checkers the Cat, Socks, another cat, and Rover the dog.

Ted’s story fits in well with the panel led by Jody Holtzman. The Joy For All Companion pets, simple but adorable/cuddly robotic pets that retail for about $100, play an important role in our efforts to combat social isolation and provide services to folks with mild cognitive impairment. He was articulate and the pets were a boatload of fun!

Our day-long symposium focused on consumer behavior insights and the role digital health technologies can play in shaping a more pleasing and engaging care experience. Our goal was to shed light on the drivers for change — from new insights and better decisions enabled by data science and artificial intelligence, to the science of behavior change and the urgent need to rethink health to care for an aging population. No doubt, we have made great progress in putting the consumer at the center of their care. But we still have miles to go to achieve a future in which consumers and patients are one and the same.

What are your thoughts on how we can successfully create knowledgeable, empowered and engaged health consumers?

[This piece was originally published on The cHealth Blog by Joseph Kvedar, MD, VP of Connected Health at Partners HealthCare. Follow him on Twitter at @jkvedar.]