Tag Archives: healthtech

How Digital Health, Insurtech Are Adapting

The COVID-19 pandemic has obviously accelerated the development of the healthtech and insurtech industries. Let’s look at these changes and certain corresponding innovations in more detail and see what we can expect in 2021.

Healthtech

In general, the existing healthcare system turned to various modern and necessary digital tools to perform the following crucial tasks:

  • make predictions concerning the disease’s spread;
  • collect and analyze vast amounts of data;
  • diagnose and treat patients remotely.

And due to the spread of COVID-19 pandemic, the sector has developed rapidly in multiple directions. Among the most notable are:

  • Remote monitoring;
  • Telehealth;
  • Artificial intelligence technologies.

It’s not surprising that providers advocate for integrating more data sources and new patient matching methods, from telehealth to big data analytics, to build effective coordination concerning COVID-19 tracing and valuable testing.

What trends await us in 2021 in healthtech?

1. Consumers will have dominant positions and will influence the sector in 2021. 

Healthcare will be restructured according to patient needs and expectations. More and more healthcare providers understand the necessity and even indispensability of digital and virtual healthcare in the post-COVID world. So, healthcare organizations will have to leverage technologies to help their patients in their day-to-day life – smart devices, omnichannel communication tools, intensive machine learning and many others.

Let’s look at a concrete example. In an article for Everyday Health, Vivian Lee, the president of platforms for Verily Life Sciences, describes cooperating with the federal government in the creation of Project Baseline, a tool to screen for coronavirus risks, while also working with universities and employers to create programs that provide detailed testing, competent symptoms’ tracking and data analytics. An app lets users to check any symptoms and schedule lab tests.

Such virtual systems extend beyond COVID-19 uses. For example, Verily’s technology has been used by Onduo, a virtual diabetes clinic that tries to help patients lower their A1C levels and develop vital health habits.

2. Expansion of virtual care services is widely expected.

In the same article, Deneen Vojta, the executive vice president of research and development at UnitedHealth Group, said virtual health will direct patients to more self-care. This may lead them to rely on doctor services only in more essential cases. 

According to Sarahjane Sacchetti, Cleo CEO (in an article in Fierce Healthcare), in 2021 we will see increased use and efficacy of virtual services that had been seen as in-person only: postpartum, maternity, pediatric. Understanding the necessity of virtual health services, employers will offer flexible and convenient benefits to support employees (and drive productivity).

Indeed, many companies are looking to expand healthcare service.

3. The industry will continue to gain public and private investment.

Digital health has already received a surge of private and public investment during the pandemic. At the same time, modern digital health companies are going to become more comprehensive, which will attract even more. 

4. 2021 will become a pivotal year for the rapid development of artificial intelligence, including machine learning. 

The healthcare industry will pay attention to the benefits of machine learning in highly scalable solutions. AI has a vital ability to identify trends and sequences in data gathering and analytics that human beings can’t.

Hospitals are going to become smarter, says Kimberly Powell, vice president, general manager of NVIDIA Healthcare, in the same article in Fierce Healthcare. Smart cameras and speakers will help them to automate many activities. This, in turn, will help to increase operational efficiency and to improve virtual patient monitoring.

See also: New Picture of Total Digital Health

5. The shift to the cloud and APIs will increase.

Modern, cloud-based systems give providers the opportunity to access necessary patient’s data practically anywhere. They also enable telehealth and much better care coordination.

Application programming interfaces (APIs) will continue to play a significant role in healthcare data exchange, improving data analytics while allowing for important medical research and innovative ways to access electronic health records (EHRs).

However, on top of technological challenges there is always a challenge related to regulatory policies. Colin Anderson, lead developer at Tactuum, told our chief growth officer, Timothy Partasevitch, in an interview:

“The past year, as terrible as it has been, there are some good things that have come out of it. And that is the NHS [National Health Service] and U.K. government as a whole, realized what they are missing out on by not embracing the technology. We have got the ability to implement more streamlined healthcare through technology, and we’ve got the expertise to do it really quickly as well.”

Colin added that a new winner in healthtech could be “having patient records being available to actual patients themselves, so they can have a secure app with all their records on it that can be shared with their healthcare provider, whether that be their local [general practitioner] or a surgeon.”

6. Walmart (as well as Amazon and Alphabet) will redesign healthcare.

Andy Arends, vice president at NTT Data Services, says Walmart can establish great healthcare facilities within a reliable, low-cost and no-frills environment. As a result, Walmart could become not only a certain health plan but also the provider and create its own insurance distribution.

7. Social determinants efforts will change from aspirational to operational.

Megan Callahan, vice president of healthcare at Lyft, says there are predictable calls to action in the industry to form a more standardized approach to measuring and collecting data on social determinants of health.

Insurtech

Now let’s look at the predictions of different experts concerning how insurtech will grow and evolve in 2021.

Top trends for insurtech in 2021

1. Blockchain

Many experts are confident that blockchain technology will become a leading component of insurtech. Incorporating blockchain with encryption can better protect important medical records and other sensitive information against cybertheft.

Insurers will have to calculate all long-term environmental and economic costs. And, due to lack of regulation, an opportunity for fraud and scram could appear.

2. IoT (Internet of Things)

Internet of Things devices such as Apple’s smartwatch and Amazon’s Echo are going to reach an estimated $43 billion by 2023. Integration of IoT can help not only consumers but also insurers, by accelerating and simplifying the claims and underwriting process while reducing costs and expanding business. The technology can let insurers stay in touch with their customers, strengthening the relationship, and form partnerships with other companies to cross-sell services and products.

But smart technologies can be attacked by cybercriminals and hackers and require considerable investment.

3. Embedded insurance

In 2021, more insurance products will be embedded in the purchases and experiences customers are having online. Tesla, for instance, has announced its own insurance product, so all willing can purchase a car and insurance, specifically tailored to the vehicle, in one experience.

4. Discounting based on customer behavior

Many experts say that in 2021 we will see really creative programs, with smart technologies being used to offer customers special discounts according to their individual behaviors.

In an article for Benzinga, Brett Jurgens, co-founder and CEO of Notion, a Comcast company, says greater discounts could be offered for clients who use devices, such as modern smart sensors, in different water-prone locations or for better coverage across the home or whole property.

See also: 1 Million Digital Life Presentations

5. Virtual insurance

Insurers are ready to leverage augmented, virtual and extended reality solutions to meet their customers’ and employees’ needs.

6. API strategy and digital transformation 

With APIs, insurance companies can benefit from better internal systems and data integration, streamlining the claims management process and speeding the resolution of claims. APIs allow for flexible and powerful technology platforms, which can consume and share large volumes of data while linking insurers with a huge number of customers and partners. Insurers that fail to build valuable APIs into their platforms will not be competitive. 

Bryan Falchuk, founder and managing partner at Insurance Evolution Partners, said:

“I see the data in any system as having to be available to all other systems. This is table stakes today, and, as an industry, we are still lagging here. APIs are the preferred way to enable this if each function has a different system, but the industry is still struggling. There are new solutions coming out that can ride on top of legacy platforms or newer platforms that aren’t as API-friendly to solve the problems of standardizing data and making it available to other systems. They’re often built as low-code/no-code solutions, making hesitation in adopting them even harder to justify. Yet we do. This is where I try to help carriers I work with to see a) customers increasingly will not stand for re-entry of information or you not having a complete view of them when they come to you, and b) the means to solve for this exist today.

“For example, if you use a modern [customer relationship management system], based in the cloud, it can publish and consume data from many different sources through APIs. But what if those sources aren’t built to communicate that way? Or, what if they are, but the APIs aren’t very good (as I’ve often found to be more the case than a stark inability to use APIs)? We don’t need to stop there, and can instead see if there is another path to bring the data trapped in disparate systems together without having to go through a multi-year, multiple-tens-of-millions (or hundreds or millions) of dollars effort to replace a legacy system.

“Many carriers that were resistant have started to see on the back of pandemic-driven lockdowns and remote work that they simply must change. And the speed with which the industry virtualized its workforce was a good reminder that we can change much faster than we thought we could. Luckily, we also have the tools to get there now.”

So, obvious changes have occurred in healthtech and insurtech. And they will develop further in 2021. Modern healthcare and insurance companies must adapt.

Healthcare's Age of Agility Will Shuffle Market Leadership

Surgeon and author, Dr. Atul Gawande outlined how, at the turn of the 20th century, more than forty per cent of household income went to paying for food, and food production consumed roughly half the workforce. The drive to change that began in a small town in Texas where an array of new methods of food production were tested. The results were stunning. Today, food accounts for 8% of household budgets and 2% of the workforce.

As a swarm of small innovations led to the transformation of farming, so too is a rapidly building wave of innovative new care and payment models leading to similar breakthroughs in healthcare. The winners in the next epoch of healthcare will be those that have agility in contrast to the lumbering nature of traditional healthcare systems.

In old line models, attempting a new care or payment model meant long planning and development cycles. The cost and complexity of testing new models prevent many from being tried. Demonstrating how healthcare hasn’t experienced the benefits of modern, cloud-based software, the leading HealthIT vendor is known to charge $100 million and up for its software and it takes a year or two to start realizing any benefit. [See also Health Systems Spending Billions to Prepare for the Last Battle]

Iterative Testing And Refinement Will Prevail
There’s a striking parallel between the transformation of healthcare and what happened with advertising campaigns as a result of traditional media getting disrupted by digital media.

Once upon a time, because the stakes were high with large ad campaigns, 90% of the effort around an ad campaign was in the planning/building of a campaign — i.e., creating ads, focus grouping creative/promotions, planning where to place ads, etc. When ads were created and it was decided where to run the ads, marketers sat back and watched to see how it would play out with little ability to change the course of a campaign.

Today, as little as 20% of the marketing effort is done upfront before putting elements to the test. The Internet is much more effective at testing offers and ad creative than a contrived focus group. Likewise, smart marketers can tap very sophisticated tools to optimize their ad spending so that the actual place ads run can be radically different than what an ad director may have thought initally.

I’d expect a similar transition to happen in healthcare. As Dr. Farzad Mostashari (National Coordinator for Health IT) said, “what’s transformative isn’t just harvesting & analyzing Big Data — it’s instrumenting what we do, testing predictions, A/B trials…”

It’s well understood that the mega healthIT systems (e.g., a $900M implementation was announced not long ago in the Northeast) take a couple years to implement. The reason for the long implementation, in part, is due to all of the decisions that have to be made regarding customization. The stakes are high as it’s only logical to do system-wide changes when 100’s of millions are at stake, leading some healthcare providers to have weak operating results as a result of healthIT costs as Zina Moukheiber reported. The market leader is noted for its customizability. However, once customized, it’s also noted for its rigidity. That is, if a workflow changes, it’s a major project to change the supporting healthIT to support the new workflow.

Where processes are well understood and predictable (e.g., surgeries), applying a manufacturing mindset is very appropriate. It’s akin to setting up an assembly line at an auto plant at great expense. Once that is done, it can be used for a long period of time and is worth the upfront investment. The danger comes in when it comes to chronic disease management (where more than 75% of healthcare dollars are spent). With accountable models and recognition that the patient or family members have the greatest impact on outcomes (i.e., not healthcare professionals), setting up a rigid system is a recipe for disaster.

If there’s one thing we know for certain, it’s going to take iteration for many years to hone how to tackle chronic conditions as it involves complexity of the variety humans present to the healthcare system. In an agile system that has modern software economics (i.e., dramatically lower cost), it’s feasible to do smaller scale tests. If they prove successful, they can be expanded. Listening to a recent podcast from the Institute for Healthcare Improvement on reducing readmissions echo’ed this point — i.e., addressing an issue like this will take a series of changes vs. one silver bullet.

The rigid mega healthIT systems are a vestige of the “do more, bill more” model of reimbursement, particularly given that healthcare is a supply-driven market (e.g., MDs who own a stake in imaging equipment order scans at three times the rate of MDs who don’t). Spending nine figures doesn’t sound as bad when you have capital projects planned in excess of $1 Billion. Perhaps we should refer to the legacy model as the “build more, do more, bill more” model. Any health analyst will tell you that the cure for healthcare’s hyperinflation is NOT building more healthcare facilities. It would be as if a fire department argued that the way to solve a wave of structural fires was to buy more fire fighting equipment. Indeed, that might help, however there’s a much more cost-effective approach such as having buildings inspected for fire prevention capabilities.

In their book, The Innovator’s Prescription, Clayton Christensen and Dr. Jason Hwang point out how applying technology into old business models has only raised costs. Thus, buying new technology isn’t a silver bullet if it’s put into an old business model. Rather, the new technologies need to go hand-in-hand with agile, new processes. The organizations who optimize their approaches for a more agile model will prevail.

Plugging new technology into old business models has caused health care costs to rise rather than fall

Images are courtesy of Jason Hwang, M.D., M.B.A. Co-author of The Innovator’s Prescription.

Dramatic Gains From New Care And Payment Models
Innovators such as Iora Health, WhiteGlove Health and Qliance rethought the care delivery and payment models from the ground up. Their results have been impressive. For example, Qliance has Net Promoter Scores higher than Google or Apple, while reducing the direct costs of healthcare (i.e., their service coupled with a high deductible wrap-around policy) 20-40%. More impressively, they have reduced utilization of the most expensive downstream costs (surgical, specialist and emergency visits) 40-80%. Iora has reported similar outcomes with some of the toughest patient populations out there. [See “David Clause” in Obamacare Ready to Slay the Healthcare Cost Beast for more on the outcomes Iora and Qliance have reported.]

The next wave of innovators are taking advantage of second-mover advantage as the wave of healthtech startups provide them off-the-shelf software that is an order of magnitude less investment than the first wave of innovators. It’s a couple orders of magnitude less expensive than legacy healthIT. More importantly for the innovators is the speed that they can not only stand up the new technology but also easily iterate based on real world experience. Rather than months or years, it’s hours or days. This is a key component of IT agility. They also make the most of investment others make rather than be threatened by them. A simple example: WebMD is used by over 100M consumers per month. Clinicians can curate information that they think will be useful for patients from WebMD and others (e.g., medical societies) who’ve made large investments in consumer-friendly content. Healthcare can no longer afford to reinvent the wheel. [See Khan Academy Approach to Solve Wicked Problem in Healthcare for examples of new approaches taken.]

Change is already happening faster than many expected. Oliver Wyman’s recent paper highlighted the rapidity of the market shift in The ACO Surprise (PDF). When I was presenting to the Pioneer ACOs over the summer (see summary here), it was already apparent to the pioneering organizations that their new models required new systems. They went on to state they didn’t expect to get anything for the new requirements from their traditional healthIT suppliers for at least the next two years. Meanwhile, the market shift is taking place much quicker than that.

New York Digital Health Accelerator Is A Model To Emulate
Zina Moukheiber highlighted a program that is a key plank of perhaps the largest effort in the country to reinvent healthcare delivery and payment.

The New York Health Home program was designed to make obsolete the traditional uncoordinated and unaccountable “system” that has cared for Medicaid patients in New York. Managing a $50B budget gives Dr. Nirav Shah (NY’s state Commissioner of Health) the clout to attract hundreds of companies that want to enable the reinvention of healthcare. Dr. Shah and other leaders in New York’s public and private sector recognized that with an entirely new set of objectives a new set of technology requirements naturally emanates from that. Through the New York Digital Health Accelerator (NYDHA), they are supporting the growth of agile startups to meet these new requirements. [Disclosure: My company was one of the 8 companies selected for the accelerator program.] Just two months into the program, there are pilots and deployments with the accelerator companies underway in the leading healthcare providers in New York.

The graphic below depicts the transition from the slide rule to the mainframe and then back out to mobile devices. Dr. Shah’s comments in the video above echo’ed the shift from an old “mainframe” method of healthcare delivery to a more distributed “smartphone” model.

Centralization followed by decentralization in computing

New business models require new technology. As David Whitlinger (head of the New York eHealth Collaborative) highlighted in the video above, his organization has built a state health information network but what it needs are the applications riding on top of that network to realize its full value. The startups in the NYDHA will be the first to get access to the statewide network due to their agility in taking advantage of the state’s health information exchange.

A new ecosystem of disruptive business models must arise