A Call for the Human Touch in Digitizing Health Care
Part one of five in a series of ‘Growing the Collective 5P Value Pie in Health Care’ articles
NECESSITY IS THE MOTHER OF INVENTION
Did you know that on average we touch our faces 23 times per hour ?!
I stumbled over this puzzling piece of research in the beginning of the Covid-19 pandemic. Since, and amidst all the other disruptive facts that this global public health crisis has revealed — showcasing the vulnerabilities of our societies, economies & healthcare systems at large — I had forgotten about it.
Meanwhile — and on a positive note — this pandemic has ignited a plethora of novel cross-sector collaborative partnerships. Triggered by the need to action, accelerate & scale solutions in the fight against Covid-19, we have witnessed a series of new interrelationships. Occurring across borders of geographies & industries some of them couldn’t be imagined previously nor weren't maybe thought to be necessary. First, within the healthcare community, it accelerated & deepened the much needed interconnectivity between the key stakeholders — which I refer to as the ‘5Ps’ — patients, providers, pharma, payers & policymakers. Exemplified by the multiparty coalition under the hospices of the NIH (the US National Institute for Health), where the two largest policymakers FDA (the US food & drug agency) & EMA (the European Medicines Agency) as well as a plethora of pharmaceutical companies came together in the race to find an effective vaccine & treatment against Covid-19.
Second, this global pandemic has sparked an incredible transfer of technology, engineering & digitization expertise into the healthcare sector. Take the success story of the CURA initiative which has turned the use of shipping containers into mobile ICU units. It took Italian architects, the MIT & American electrical engineering companies, in a new mix that mingled tech- with healthcare-expertise, to tackle an over-boarding healthcare capacity emergency. Utilizing modern telecommunication channels & leveraging existing supply chains, this novel partnership was able to scale & quickly deploy mobile treatment facilities to anywhere from mega-conference centers to temporary buildings.
Yes, we need Digitization & Tech solutions as Tools to Accelerate a Value-Based Transformation in Healthcare
Reading about this fascinating CURA coalition that has been linking hardwired tech engineers working hand-in-glove with healthcare professionals in the fight against Covid, I was reminded of the complementary software element that is also needed for any successful transformation. It is the story of Immutouch — a wristband connected to a smart device — that in a short period of time has evolved into a blockbuster solution of its own kind. Because: it makes people stop touching their face. Remember? 23 touches on average per hour. Multiplied by, let’s say 16 hours, that is a lot of potential touchpoints to become infected in one day alone. Hence, this new technology (which starts buzzing as soon as your hands approach your eyes, mouth & nose) turned out to be a simple & effective measure to help reduce the spread of Covid-19. Initially, a tech start-up by the name of Slightly Robot out of Seattle had designed this wristband to stop another harmful type of touching, unrelated to infectious diseases. Upon the early days of the pandemic unfolding, the team rapidly re-programmed their digital solution to meet an increasing demand for measures to cut through the exponential Covid-19 spreading. Since its launch three months ago, the uptake has been substantial including the use by front-line healthcare workers & companies who want to protect their employees.
Truth to be told though, healthcare as a whole has been late to the show. For the most part, it has remained largely static in how the patient navigates the provider sector, analog in the way it processes data and transactional in the nature the key 5P players interact within the healthcare ecosystem. In order to fix our broken healthcare systems, what we need is a threefold transformation:
- a system’s transformation;
- a digital transformation; and
- a customer experience transformation at the same time.
AND, WE NEED THE HUMAN TOUCH
From a system’s perspective, both scholars & practitioners alike agree that a collaborative value-based healthcare system that focuses on patients, health outcomes & quality of care delivery bears the potential to generate value for all parties to the show. Put differently — it allows for growing the collective value pie for all, rather than dissecting the pie and destroying value. Further, when it comes to adopting the power of modern digital solutions & the value of the customer experience, there are many learnings that healthcare can pull from other industries.
Although healthcare delivery always has to fit the needs of local markets, regulations & cultures, there are many principles & learnings that can be leveraged globally. Think Global. Act Local. As we have seen on the example of the CURA initiative, cross-fertilization between industries in addition to cross-fertilization between continents there has enabled innovative and fast problem-solving. We are likely to see even more disruptive solutions that will be reimagining supply chains for drug & healthcare delivery. Involving and adapting existing networks of providers such as Amazon, Google and others will lead to an even broader complexity in the healthcare ecosystem. Tools like drones, digitized smart devices as well as AI & machine learning are able to modify the modus operandi of how we will be developing & delivering new diagnostics and novel treatment options.
Last but not least, many other industries, from hospitality to travel, from entertainment to consumer goods and IT, have long recognized the essential role that a personalized consumer experience plays as a key to success. Not only because enhanced customer satisfaction is driving demand, but also because it enhances efficiencies & profitability, and because it is simply the right thing to do. Translated into the realm of healthcare: the customer is the patient. Isn’t it ironical that healthcare can learn from the tech-, entertainment- and IT-sectors on how essential the focus on the customer — i.e. the patient — is? Somehow though, along the way of building healthcare systems & developing breakthrough medical discoveries, we have lost the touch to the patient. Transactions of products & services for money — in a so-called fee-for-service system —was defining a process that slowly disconnected the patient from the value chain. For much, this is considered to be one of the essential root causes of what became a vicious upward cost spiral, coupled with decreasing quality of healthcare delivery & reduced quality in care. On the way of integrating digital and tech solutions into the healthcare transformation, however, we must not lose the focus on the human touch.
CONNECTING ANALOG PEOPLE WITH DIGITAL SOLUTIONS — THE EMPATHIC TECH TRANSFER
Have you lately been among those who have experienced ‘Zoom-Fatigue’? I certainly have. Some say that the smartphone has been such a success factor for the 4th industrial revolution because it responds to this deeply ingrained need of the human species to touch. However, the screen we touch and the screen we see, won’t replace our physical experiences. Interacting with others using all of our senses in space and in time. Psychologists and research have long taught us that we need the human connection as vitally as we need bread & water and the air to breathe.
Essentially, and in many ways, we are analog creatures. We are not digital aliens. So, in this day & age of digitization, how can we make sense of it all and leverage the tech enablers to the benefit of our collective lives in general, and in healthcare in particular? Collaborating across multi-disciplinary areas, we can benefit from the respective expertise and interrelationships between the 5P to cross-fertilize innovative advances for the benefit of all.
Before closing today’s first blog in a series of five, let’s explore a few examples on how an empathic tech transfer with digitization can strengthen the interconnectivity and innovate healthcare delivery — from the perspective of each of the 5Ps: patients, providers, pharma, payers & policymakers.
PATIENTS —The insights of the customer experience together with digital smart devices such as phones, wristbands or watches, provide a unique opportunity to fundamentally rethink the role of the patient within the value chain of healthcare. It is about empowering patients to own their personal health and lifestyle choices. Additionally, this pandemic has propelled the use and utility of another tech tool. The one of telemedicine functionalities. Although this virtual degree of connectivity cannot fully replace the human touch between a patient & their caregiver, it bears the potential to effectively complement a patient-centric, value-based healthcare model that focuses on quality & outcomes and a home-based care delivery system. “COVID has enabled us to create virtual health as a new normal. Not only in terms of remote monitoring and acute medical care, but also for advanced care at home. For example, electrocardiograms can be done on a smartwatch to diagnose heart failure or to measure potassium,” notes Dr. Gianrico Farrugia, CEO of the Mayo Clinic.
PROVIDERS — Hospitals & care facilities are finding new ways to connect with patients & employees as the use of technology in delivering healthcare solutions is accelerating. In order to deliver care more efficiently, and as patients are becoming more the owners of their health journey over time, hospitals are likely to evolve into potential network centers for care coordination while consolidating direct care delivery into acute & episodic care. This was provocatively debated during a recent panel discussion on ‘the Future of Hospitals’ which involved a series of providers from various geographies. Further, Dr. Kelvin Loh as the leader of a large hospital chain in Southern Asia & the Middle East phrased his views of three persisting trends in a post-Covid era: “The first is to provide healthcare where possible by digital means, the second is that healthcare consumers will demand greater transparency, and the third is the need for better public-private partnership and collaboration.”
PHARMA — One of the most challenging obstacles we are facing in healthcare is to sustain innovation at a pace & cost that is affordable to patients & societies as a whole. Drug development timelines that are lasting over a decade and investment costs that equal several billion dollars add to what is an extremely high attrition rate of only 1 product coming to market for over 10'ooo new molecules discovered in the lab. There is a high urgency to fundamentally transform the way innovative medicines are being developed. This is true both in pharma & in academia. Nevertheless, it is believed that ‘Industry 4.0 tools’ can cut manufacturing costs by up to 20%, improve quality & increase flexibility while making deliveries more reliable as outlined in a recent overview issued by Bain & Company. Entitled Digital Manufacturing Is (Finally) Coming to Pharma it provided a crisp overview of the top actions that need to be taken: “The first wave of solutions will improve production transparency, equipment effectiveness and throughput; Advanced planning tools can boost quality and increase supply chain flexibility; Key Industry 4.0 challenges are: integrating new and existing IT systems and building digital skills.”
PAYER — Generating value is a key mantra for an effective transformation of our healthcare systems. Starting with a clearly defined unmet medical need, and subsequently tailoring specific diagnostics & therapeutics to this need, are the cornerstones to consistently increase the quality of care. In other words: providers & patients need to identify the right procedure for the right patient at the right time. This holds the promise to effectively master exploding costs and to eventually generate value for all 5P constituents. In the example of lung cancer, a multitude of novel disease entities have been classified over the past decade based on newly discovered molecular markers. Every year, new treatments have been emerging specifically targeting each of these disease subtypes, which in & on itself represent only a small fraction of all lung cancer patients. However, without deploying widespread molecular testing, digital measures to process ‘big data’ and a collective effort across providers in the public & private sectors, insurers & patients, there remains widespread under-diagnosing and hence under-treating — as outlined in a recent German newspaper overview.
POLICYMAKER — Most importantly of all in my personal experience, the policymaker is often under-appreciated in their role within the healthcare ecosystem. Historically considered a ‘service provider’ for new drug approvals or drug surveillance matters, the relationships between regulators and pharmaceutical or academic drug developers have been mostly transactional in nature. However, this represents an enormous untapped potential to turn a previous binary relationship into more of a pro-active & strategic multifaceted partnership. The introduction of new digital solutions, AI and machine learning with human data as well as any other changes in healthcare regulations are only effective if they occur through early engagements with policymakers. We need to fundamentally rewire the way we think about involving policy in healthcare. The Covid-19 pandemic has been a wake-up call to improve not only infrastructure, but also the relationships that we foster among the 5Ps with particular emphasis on the policymaker. As the Swiss government has summarized within their DigitalSuisse initiative: “Corona has revealed our vulnerabilities in a number of ways. Legislation does not yet cover all areas of the digital world, which we need to address as a society. Without trustworthiness & IT security, sustainable digitalisation cannot succeed.” One country that has been the rising star among governments, who have propelled a fully integrated & digitized healthcare system, is Estonia. Branded as e-Estonia, they are consistently ranking top of the list when it comes to show how digital health connectivity is doable & effective to anchor healthcare in the overall society —in Estonia, a centralized data capture for each individual established years ago led to a massive reduction in duplication efforts and hence increase in efficiencies in health care.
In conclusion: 2020 is the most important year of them all
During these past turbulent months, I am sure many of you may have felt similarly, wondering some days, whether we couldn’t simply skip this year? Or, as Leslie Dwight wrote “What if 2020 was canceled?” in her post that was very popular a few weeks ago. However, if you think about it — and as we are emerging from this unprecedented global public health crisis — this year is a unique opportunity for us as a society to implement real, long-lasting change. Addressing some of the deepest gaps and shortcomings in our systems and infrastructure. It takes leadership and determination coupled with societal and political will to sustain the good changes: Growing the digital transformation into a modern healthcare system akin to the 21st century — with a human touch.
“We have to make a difference this time. We can’t afford to go back to our old lives, where we allowed people and relationships to slip to the side and be lower priorities,” says Vivek Murthy, the former US surgeon general. Also, he states:
“You’ve got to keep people at the center.”
“It’s going to take real leadership, both from government and the private sector, to keep us in an uncomfortable place, so that we can keep moving and not stay in the place where we are.”
So, let’s not slow down nor scratch our head (so we won’t get our wristband buzzing). Instead, let us keep moving. Together. Collaboratively. Set your imagination free — what are your ideas to connect tech & digital solutions with the human touch? Let me know. Share your ideas. I am looking forward hearing from you.
