Tamara StClaire, Chief Innovation Officer for Xerox Commercial Healthcare, was a recent guest on our TechnologyAdvice Expert Interview Series. The series explores a variety of business and technology landscapes through conversations with industry leaders.
Below are six of Tamara’s biggest insights from the conversation.
1. Mobile health must be part of healthcare delivery.
Did you know 98 percent of Americans own a mobile phone? It’s a staggering figure. And those people are used to completing transactions on those devices, too. This means mobile needs to be included in order to create a sustainable health delivery model for the future. The important part is making sure mobile health data is connected to physicians in a useful way.
2. “Mobile” means more than just mobile phones.
A lot of things can be included in the definition of mobile health. Certainly phones and iPads are included, but it’s also important to think about data collected from wearable devices. Soon, we’ll be collecting data from implantable devices. At Xerox, we have a relationship with HealthSpot, so their kiosks found in retail stores factor into mobile health as well. Anything that collects information that could be related to your healthcare is mobile.
Interoperability and aggregation of this data is going to be what makes mobile very successful. Take your Fitbit, for example: of course, it can influence the way you exercise. But for it to be really powerful, for the data to really have impact on healthcare, it has to be connected and aggregated.
3. We need to think about reimbursement parity.
It seems like every quarter there’s an announcement from CMS that favors telemedicine reimbursement. But you also have to think about customer satisfaction and customer experience. To work effectively, telemedicine has to be both affordable and convenient.
When you wrap all this up, it’s a change in the paradigm of healthcare delivery.
However you implement your mobile strategy, you have to think about change management. As we look at the adoption of any new innovation, there’s always a lag between introduction and transformation. Part of that change management is looking at how workflow and practices must be transformed.
4. Communication between patients and payers needs to increase.
Consumers want more transparency and affordability, especially now that there are high deductibles and they have more skin in the game. Public exchanges have made insurers more consumer-centric. There’s been a push for payers to engage with patients, now health plans are identifying methods for doing so.
They know they need to put technology tools in the hands of patients to encourage decision making, but they also need to think about the top line and the bottom line: retention and growth. So now we’re seeing consumer portals, and we’re seeing payers with mobile strategies. There is a lot of opportunity for growth here.
5. The healthcare payer industry was built on silos.
Every healthcare transaction came about from a very siloed perspective. When you think about a payer marketing for enrollment, you think about enrollment claim, adjudication, subrogation. These are all very siloed sets of transactions. Our payers understand that for them to be efficient and actually create additional transparency in information, they have to think about these transactions as a platform.
They need to think about how they continuously integrate the interactions and transaction, as well as the information that comes from them. Zappos, Amazon, and other online retailers know everything about a customer every time they make a transaction. We believe that healthcare payers need to make that leap as well. There’s all that information with every single transaction you make in your payer system.
6. Over 70 percent of health outcomes are predicted by social, not clinical determinants.
To determine what types of data you need, you have to ask how you want to stratify the data. Do you want to look at the disparity in care? Do you want to look at care gaps? Hot-spotting? At-risk populations?
Data helps you answer so many questions. You need to look at data on the impact of a condition. But not just financial data, you want to look at mortality, quality of life, and maybe stigma that’s associated with it. Then you need data on the outcomes and return on investment of evidence-based programs.
It sounds like that could be data overload, but you have to boil it down to determinants.
For example, we have a social-needs index where all community needs are described by the social and economic factors that are strong determinants of health outcomes. The socio-needs index takes these and generates the value from 0 to a 100 for all of the factors and then we can correlate it with prevalent hospitalizations and premature deaths. So you need to think about what you are trying to do with the data, but you should also distil it down to what the key determinants are.