Hone Health Co-Founder and COO Stuart Blitz

Patient Engagement

Why Healthcare Needs a Flywheel

Big tech took a week off from major healthcare acquisitions, giving us a rare chance to highlight some of the thought leadership coming out of Providence’s Digital Innovation Group.

A new blog post co-authored by Sara Vaezy and Doug Grapski – DIG THIS: Why HealthCare Needs a Flywheel – lays out how incorporating business flywheels into health system strategies can lead to lower churn, higher capacity, and a better patient experience.

Vaezy is Providence’s newly appointed CDO (she also spices things up with an awesome craft hot sauce side gig), and Grapski is the Director of Digital Strategy within the innovation group (unclear whether he likes hot sauce).

For those unfamiliar with the flywheel concept, it’s a business mechanism that pulls consumers to a platform and drives continued use, thereby adding stability and increasing momentum much like a mechanical flywheel. Notable examples include Amazon’s Prime membership and Starbucks’ loyalty program.

Despite their success in other industries, flywheels are seldomly implemented in healthcare, and most patients rarely interact with their providers outside of moments of individual need.

• Vaezy and Grapski emphasize that a portfolio of modalities (3rd party apps, care navigation, personalized experiences) is needed to create flywheels that are effective at providing proactive healthcare experiences.

• By integrating these tools in a single platform, health systems can begin eliminating the gap between “sick care” and “healthy care” – especially important for those in value-based arrangements.

Providence’s flywheel revolves around leveraging various data sources to deeply understand its patients as consumers with identities outside of their clinical data, allowing it to create highly personalized engagement programs.

• This 360-degree view of its consumers lets Providence operate more like a D2C startup than a giant health system, with strong direct relationships that draw people to its services and keep it top of mind between visits.

• Only once this flywheel is in place would the authors suggest augmenting it with non-traditional offerings such as a durable medical equipment business or concierge-level care.

The Takeaway

The consumerization of healthcare is one of the biggest trends in digital health, and it makes sense that forward-looking health systems will be borrowing plenty of plays from the consumer-tech playbook. Flywheels are the foundation of some of the most successful consumer businesses, and Providence’s digital health leaders make a strong case that it’s time for healthcare to start putting them to use.

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The Wire

• Salesforce RPM Features: Salesforce Health Cloud rolled out a suite of new “care from anywhere” features including Remote Patient Exception Monitoring, which allows providers to set target metrics for patient data collected from RPM devices then chart a course of real-time engagement. Other additions included Intelligent Appointment Management to let patients schedule available appointments from mobile devices, and a medication management tool to let providers manage a consolidated list of patient medications.

• Traumatic Injuries as Chronic Conditions: An NEJM viewpoint makes the case that traumatic injuries should be reclassified as chronic conditions, broadly defined as conditions that last over a year and require ongoing medical attention. Traumatic injuries currently face multiple barriers preventing effective longitudinal care (namely the absence of a standardized patient tracking system), but reclassifying them as chronic conditions could help address SDOH factors impacting recovery and better align reimbursements with high-value care.

• Babylon Denies Acquisition Rumors: Babylon’s stock was put on a trading halt on Monday after speculation of a possible takeover caused shares to soar 20% in minutes. This prompted the value-based care company to issue what might be the shortest press release we’ve ever covered to announce that it has “not engaged in nor has it had contact or discussions with any potential acquirer.” Judging from the stock’s immediate plunge, this doesn’t seem like the news shareholders were hoping for.

• Telehealth Impact on Burnout: An EHR-based study of 2.1k physicians at NYU Langone found that telemedicine might be leading to more after-hours work and increasing clinician burnout. After adjusting for clinical load, heavy telemedicine users saw an average of ~14min of after-hours work per appointment during the pandemic (versus ~9.5min for infrequent telemedicine users), suggesting that telemedicine as it’s currently delivered may be significantly less efficient than in-person care – at least from an after-hours work perspective.

• Abridge Scores $12.5M: Medical documentation startup Abridge raised $12.5M in Series A-1 funding to expand the adoption of its AI-enabled scribe tool that transcribes conversations in appointments then automatically summarizes important details in the EHR (conditions, symptoms, next steps). While it can be used in specialty care, Abridge says its focus is to decrease documentation burden among primary care providers.

• DPC Focus Groups: A small focus group study out of Florida Atlantic University investigated patient perceptions of direct primary care (DPC), identifying common themes in many of the responses. The most commonly mentioned positive traits of DPC involved good communication (20%) and personable providers (14%), while most of the negative references involved high out-of-pocket costs for specialists due a limited number of in-network options.

• Stony Brook’s Telehealth Strategy: New York-based Stony Brook Medicine recently gave an overview of the telehealth strategy that allowed it to scale its virtual care program from a few dozen visits per month to approximately 20k per month at the height of the pandemic. The health system employed a combination of Microsoft Teams, Teladoc’s virtual care platform, and 200 LTE-equipped iPhones that it distributed to patients in need of remote patient monitoring.

• AI Identifies Diabetes Using ECG: India-based researchers published a promising proof of concept for an AI algorithm that predicts diabetes and prediabetes using ECG data. After training and testing the algorithm using ECGs from 1.3k people (no external validation yet), the model could predict whether an individual belonged in the no diabetes, diabetes, or prediabetes cohorts with 97.1% precision, 96.2% recall, and 96.8% accuracy.

• Minnesota Nurses Strike: More than 15k nurses represented by the Minnesota Nurses Association have voted “overwhelmingly” to authorize a strike at 15 hospitals following months of working without a formal contract. While tentative agreements have reportedly been reached on workplace safety initiatives, economic issues such as wages remain a sticking point.

• AFib Screening Wearables: Wrist-worn wearable AFib devices may help prevent stroke while also being cost-effective. Mass General and Harvard researchers evaluated 30M simulated older US adults and found that AFib screening through wearable devices is cost-effective compared with either no screening or AF screening using traditional methods, carrying an incremental cost of $58k per quality-adjusted life-year.

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