Empowered care: Enabling people to manage their own healthcare
New digital offerings are giving citizens powerful tools to play an active role in managing their own well-being and healthcare.
With recent advances in technology, the digital economy is now able to deliver a wide range of ‘living services’. These living services – intelligent digital services that respond contextually to the user’s needs – have applications in healthcare. Not only can these living services empower citizens to manage their own healthcare, but they could also play an important role in preventing the onset of chronic conditions such as diabetes.
Empowered care is one of four themes that we believe will be central to the digitization of healthcare over the next decade. The other themes we examine are smart care, care anywhere, and intelligent healthcare enterprise.
Patient engagement at scale
Living services are now also starting to appear in the healthcare industry. Discovery Health, a health insurer in South Africa, has launched the Vitality program, which rewards policyholders for leading healthy lifestyles. Starting with an online test, the program includes a personalized well-being plan, health checks and fitness assessments. By visiting the gym, buying healthy food at the supermarket and taking part in running clubs, policyholders can earn reward points. So far, Discovery says it has paid out ZAR1 billion (approximately $80 million) in cash rewards, but has seen greatly reduced insurance claims from many of those who sign up for the program.¹
The healthcare industry is fertile ground for innovation, with smart sensors and devices, cloud applications and maturing analytics for providing living services. Healthcare providers may benefit significantly from being able to remotely monitor a patient’s health, for instance, identifying early signs of health degradation and preventing adverse events such as readmission to a hospital.
In the United States, 5% of patients account for almost half of healthcare costs through chronic conditions or unhealthy lifestyles.² Living services help prevent chronic diseases by encouraging people to live healthily and make the right lifestyle decisions.
Some digital offerings are already being aimed at specific therapeutic areas, including COPD, diabetes, hypertension, atrial fibrillation or heart failure. Across these areas, organizations are incorporating regulated devices (approved by the FDA or other regulatory authorities), nonclinical coaching and engaging content that promote self-service as the first layer of intervention.
Livongo Health, a California-based startup and an example of this movement, helps users with managing diabetes, a chronic condition. Members are given a two-way smart glucose meter that communicates their reading in real time to Livongo’s smart cloud. Livongo’s analytics provide personalized insights based on the glucose reading and the user’s personal history. Livongo diabetes ‘educators’ are alerted if a user’s glucose level is too high or too low, and will contact the user if necessary to offer advice.³ Livongo’s users do not pay for the service. Instead, the startup charges their employers or insurers a per-member-per-month fee, on the basis that they will benefit from having healthier employees or policyholders.
Around the world, a further 200 million people are expected to be diagnosed with diabetes by 2035,⁴ suggesting a substantial market exists for innovations that help people manage their condition.⁵ ⁶
Redesigning health systems to provide patient-centered care undoubtedly has its challenges, with primary care, specialist care and social care often funded by different payers and with different payment systems used. However, if Livongo, with just a couple hundred employees and $30 million of funding,⁷ succeeds in reinventing diabetes care, what will other digital disruptors be able to achieve in preventing those at risk for chronic conditions from developing them?
Empowered Care offers significant opportunities to improve healthcare outcomes – for instance by identifying people who are making poor lifestyle decisions and are ‘prediabetic’, so that interventions can be made to prevent the onset of diabetes. There is also potential for other chronic conditions to be managed in this way, with the use of apps to help people with asthma (around 300 million globally)⁸ or COPD.⁹
1. “How it works”, Discovery, 2015, https://www.discovery.co.za/portal/individual/vitality-how-it-works-overview.
2. Stanton, Mark, “The High Concentration of U.S. Health Care Expenditures”, Research in Action, issue no. 19, June 2006, at U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, http://archive.ahrq.gov/research/findings/factsheets/costs/expriach/index.html.
3. “Program Overview”, Livongo, 2015, http://www.livongo.com/program/program-overview.
4. “Diabetes: Facts and Figures”, International Diabetes Federation, 2014, https://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures.
5. Silow-Carroll, Sharon and Smith, Barbara, “Clinical Management Apps: Creating Partnerships Between Providers and Patients”, The Commonwealth Fund, November 2013, http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2013/nov/1713_silowcarroll_clinical_mgmt_apps_ib_v2.pdf.
6. Comstock, Jonah, “Prediction: 24 million will use diabetes apps by 2018”, MobiHealthNews, March 24, 2014, http://mobihealthnews.com/31313/prediction-24-million-will-use-diabetes-apps-by-2018/.
7. “Livongo Health”, CrunchBase, 2015, https://www.crunchbase.com/organization/livongo-health.
8. “Global Burden of Asthma”, Medical Research Institute of New Zealand et al, http://www.ginasthma.org/local/uploads/files/GINABurdenReport_1.pdf
9. Silow-Carroll, Sharon and Smith, Barbara, “Clinical Management Apps: Creating Partnerships Between Providers and Patients”, The Commonwealth Fund, November 2013, http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2013/nov/1713_silowcarroll_clinical_mgmt_apps_ib_v2.pdf
Healthcare is one of six industries (along with automotive, consumer, electricity, logistics and media) that have been the focus of the World Economic Forum’s Digital Transformation of Industries (DTI) 2016 project. An overview of the DTI program can be found here.
Our in-depth findings about the digital transformation of the healthcare industry are available in a white paper, which can be downloaded here.
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