One of the biggest challenges globally that patient-facing digital health technologies face is finding ways to gain traction and to generate revenue within traditional reimbursement systems. In a previous post, I discussed best practices for adoption of technology by the healthcare enterprise. But the introduction of technologies is dependent upon other best practices. Many technologies offer tools which address singular technical or clinical issues. They might even prove to produce better outcomes (though precious few have done). Success in the marketplace however, hinges on a combination (some of which are interdependent) of proven results, access to the C-suite door, being attractive to the user (provider and/or patient), and providing a comprehensive approach to a clinical problem. Instead of focusing on how a technology can obtain reimbursement, I submit that a vision of becoming part of a total solution translating to better outcomes will undoubtedly ‘show the money.’ The phrase ‘point of care’ is popular now. I think that the technology version of this is ‘point of engagement’ (POE), where the opportunity for adoption of the tool lies. The POE is dictated by the clinical or workflow need. It might be the office visit, the hospital admission or discharge, or the time at home when the need for such a tool arises.
Business models which are designed with the POE in mind will find the best chances of success. It is where the shared desire of a patient and provider for a better outcome is greatest. It is where the highest concentration of empathy and resources are found. Combining the concepts of partnering and point of engagement is a recipe for both new care and business models in this sector.
A cardiac patient at the time of discharge from the hospital might be given an interactive app which has been shown to decrease readmission rates, blood pressure, and weight. The app contains educational content and tracking of vital signs. There might be other apps which are connected wirelessly to vital sign monitors and might also contain specific disease state educational content offerings. The content might originate from pharmaceutical or medical device companies (furnishing instructions about how to optimally use a product within the context of a comprehensive treatment approach), from one of a number of third-party digital health content providers, or the healthcare enterprise itself which might customize and/or brand provided content. Best of breed sensors (a combination of wearable and environmental) might be combined to monitor the patient. Both content and data can then be incorporated in the patient’s EHR or third-party portal.
Patient portals are themselves POE tools. They are accessed by patients and caregivers at a time when information is needed to be obtained or transmitted.
At the pharmacy, a patient or caregiver presents to fill a prescription. At the same time, an app describing how that drug is to be used is digitally transmitted by the pharmacist at checkout.
The patient visits the physician’s office for a follow-up appointment. In the waiting room a tablet is given to the patient to complete a patient satisfaction survey. Virtual glasses are given to the patient through which an educational video is transmitted about the discharge diagnosis. A login might be provided to an online patient support group.
See the pattern? A specific part of the matrix of the ‘usual technology suspects’ is relevant at different points of engagement. The matrix involves disease state education and management tools (via apps, digital content sent via email or patient portal), social media, the EHR, and peripheral devices (remote monitoring sensors/devices, smartphone, tablets, Internet). The ideal digital health business model involves the partnerships of technologies which are relevant and additive (either in a clinical or operational way). Consideration of the POE is critical for business development of tech tools in healthcare, both from introduction as well as adoption standpoints. A clinician team member or advisor is therefore imperative in the formulation of strategies built around points of engagement. I believe that thinking of this matrix in the context of clinical settings is paramount to success. ‘Build it and they will come’ is possible only with the POE in mind.