Mike Pacolay on the current state of healthcare price transparency.

Digital Health

The Promise of Digital Health

The National Academy of Medicine published a first-rate roadmap for digital innovation that stood out for its well articulated overview of the state of healthcare transformation as well as its author list filled with dozens of leading industry voices.

“The Promise of Digital Health: Then, Now, and the Future” wasn’t short on word count or insights, and delivered plenty of each on the potential for innovation in areas such as ensuring care continuity and partnering with individuals to support self-management.

The article begins by making the case that despite important gains over the last two decades, the promise of digital health remains illusory. User interfaces of inpatient care systems are often clumsy, health data is still difficult to aggregate in a meaningful way, and there’s plenty of work to be done to incorporate SDoH factors into care plans.

• Although there are thousands of individual applications that could have been used to explore digital health’s path toward making improvements, the authors provided a useful visualization of twelve application arenas creating the biggest impact.

Foundational infrastructure requirements were a key discussion point to help bridge the gap between digital health’s future promise and its current implementation. Of particular interest for focused efforts were individual engagement, equity and ethics, interoperability, AI/ML, and workforce.

• This graphic presented the essential infrastructure requirements for progress, and the authors stressed that each area must be carefully addressed to establish a complete framework for durable improvements.

The paper concluded on an optimistic note with tactical actions for achieving the promise of digital health. At the top of the list was a call to create a panel to develop recommendations for engaging individual healthcare consumers that follows the adage “nothing about me without me” to ensure equity and transparency as a first principle.

• Other line items included “rational, right-sized, risk-based regulation,” sustainable reimbursements from the CMS to ensure equitable access to new digital tools, and a full implementation of data standards from the ONC.

The Takeaway

Like most blueprints for changing healthcare, the reality is more difficult than the brochure, but the benefits far outweigh the challenges. Digital health promises to improve medical diagnoses, treatments, plus everything in between, and thought leadership papers like this one are a good step toward making that future a reality.

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The Wire

• Payor Rates Disclosure: The US’ federal Transparency in Coverage rules went live on July 1, requiring all payors to publish their rates via machine-readable files and eventually create tools that allow members to get real-time estimates of their benefits. Turquoise Health spent its holiday weekend looking out for “machine-readable fireworks” and published live updates for those interested in seeing which major payors were first to comply (hat tip to Humana) or those that are running late to the party.

• Seeking Psychotherapy: A new study from Trilliant Health found that the number of patients diagnosed with anxiety or depression increased by 11.1% to 10M between 2019 and 2021, with a higher proportion of patients now being treated with psychotherapy rather than solely medication. Trilliant attributes the shift to new telehealth platforms improving access to psychotherapy at a time when the pandemic helped lessen the stigma surrounding mental healthcare.

• Regard Series A: Clinical decision support tool startup Regard, formerly known as HealthTensor, secured $15.3M in Series A funding to expand the development of its AI-enabled software that integrates with EHRs to help physicians with diagnoses. Through partnerships with both Epic and Cerner, the CDS tool analyzes patient history data to recognize close to 50 common medical conditions to inform treatment decisions and help health systems with coding and billing.

• Production Line Work: An NEJM perspective piece argues that today’s care delivery practices sacrifice the “solution shop” work of physicians (helping patients and building relationships) for “production line” work (data entry and managing inbox messages). It notes that quality metrics disproportionately track production line work in the EHR since those tasks are easier to measure, and that careful consideration needs to be given to reengineering these metrics to make sure physician workflows either match their skillset or delegate processes to lower-level staff when appropriate.

• NexHealth Universal API: Fresh off a $125M Series C raise to bring its “Universal API” to healthcare, NexHealth posted an overview of some of the ways its developer partners can use its software to drive innovation. The article highlights use cases enabled by the API such as upfront payments and booking referral appointments at the point of care, all of which help provide more clarity to the ambitious goals NexHealth laid out in its funding announcement.

• Patient Data Access: While the majority of Americans want easy access to their data, a DrFirst survey of 1k healthcare consumers found that nearly half of patients report trouble getting their records from a portal or from their provider during a time of need. More than half also said managing their health records is difficult, which explains why 46% keep printed records, 17% have a copy saved on their computer, and 32% decide not to store them at all.

• Watson Health Becomes Merative: IBM Watson Health’s healthcare data and analytics assets acquired by Francisco Partners earlier this year are now relaunching as Merative. The new standalone company will be led by longtime healthcare exec Gerry McCarthy and is organized into six product families, including Health Insights and Clinical Development. Francisco Partners revealed plans to “provide Merative with significant resources” that will support new “investment, acquisitions, partnerships, and growth,” suggesting that this might give the ex-Watson units the fresh start they probably needed.

• Physician Turnover Rates: A CHG Healthcare report found that nearly half of physicians changed jobs during the pandemic as they look for more flexibility and to improve their work-life balance. Out of 534 physicians surveyed, 43% switched jobs since 2020, 8% retired, and 3% left medicine to work in a non-clinical career. The average annual turnover for physicians is 6-7%, and while the 43% turnover from CHG’s report represents a two year period, it still highlights how significantly the pandemic disrupted the physician workforce.

• Ria Health Raises $18M: Virtual alcohol use disorder treatment company Ria Health raised $18M in Series A funding to expand its care-delivery capabilities to meet the rising demand from health plans and multi-state employers. Ria provides medication-assisted treatment, virtual recovery coaching, and access to their app which can be used to track results from a connected breathalyzer.

• Online Presence: Doctors want to play a bigger role in their online presence according to a Kyruus and Wakefield Research survey of 200 physicians, with 94% saying they want to be more involved in creating an online profile that will facilitate patient loyalty. Although 87% of respondents say they’re satisfied with their public profiles, the authors say involving providers in the creation of the profiles would boost support for digital engagement.

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Personalized digital experiences drive better outcomes for patients and providers. Explore how Nuance is using AI automation to advance the quality of service across the care journey here.