Going "Beyond the Pill" in Healthcare IoT

Tumultuous changes in health care have placed consumers in a crisis, and providers are going beyond simple diagnosis and treatment to provide more comprehensive services that are enabled by digital technology. A new use cycle is taking patient management systems, coordination with devices and even VR applications to a transformative level.The healthcare industry in the United States is undergoing a very public crisis. Delivery of health care has become socially, financially and politically charged, with every participant in the industry left reeling: insurers, healthcare networks, individual practitioners, big pharma companies and, of course, patients. With the potential for another restructuring of the entire healthcare system, the system’s complexity has reached unmanageable levels. Errors and confusion are pervasive, and the spirit of cooperation that once existed between patients and providers is now freighted with distrust as consumers struggle to pay medical bills they have no control over and may not even understand. To combat rising internal costs and compete for the loyalty of stressed consumers, healthcare companies are shifting their focus and looking "beyond the pill."

What Is "Beyond the Pill?"

This phrase, which emerged in the public lexicon a few of years ago, initially referred to patient care that doesn't directly involve medication, surgery or lab testing. Healthcare providers have started looking to digital to transform the way they interact with consumers. Effective use of technology offers them the potential to cut costs and drive revenue, while simultaneously improving patient outcomes. These new strategies are not limited to flashy technology like VR or AR – though these are certainly valuable – but instead include pragmatic cross-channel functionality, comprehensive data analysis and integration of IoT devices.

Integrating Patient Care and Patient Management

One result of introducing digital capabilities into health care is that the increased data flow serves many purposes beyond revolutionizing direct patient care. While patients benefit from closer electronic monitoring and virtual doctor visits, the data resulting from such interactions also streamlines office record keeping and finances. Tech companies like Virtual Health offer all-in-one platforms for a broad spectrum of patient management. Their flexible web- and app-based platforms – for providers, patients, caregivers and insurers – collect and distribute data.These systems gather a range of information from across a patient's life -- electronic medical records, caretaker notes, insurance information, prescriptions and even transmissions from devices connected to the internet of things (IoT) -- and then deliver that information when and where it is needed. The Virtual Health website explains that its platform "overcomes the complex challenges of enabling data to flow seamlessly among the various healthcare silos and providing specialized yet collaborative tools to the entire care continuum."Some examples of data flowing between those silos can be seen in the following examples:

• If a patient checks into a new hospital, Virtual Health will integrate with a hospital's system to deliver up-to-date medical history and billing information.
• If an IoT "wearable" monitor detects abnormally high blood pressure, the app can automatically send an alert to a caregiver.
• Virtual Health can help patients track and follow their medication regimes by reminding them with push notifications or email alerts.
• Virtual Health coordinates the participation of all members of a care team, including outside specialists, so there is no duplication of effort or dangerous medication mixing.

Big Pharma Turns to Digital

Recognizing the increasing role of IoT platforms in medical treatment, drug companies are seizing the initiative by purchasing or partnering with tech companies. By this action, they hope to head off potential competition and leverage the potential of this technology to achieve their own business goals. In 2015, Teva Pharmaceuticals purchased Gecko Health Innovations to procure Gecko's product CareTRx. This platform combined a monitor attached to a patient's inhaler with an advanced analytic function so that health providers can be informed if a respiratory crisis occurs.Similarly, French pharmaceutical company Sanofi combined forces with Verily Life Sciences to develop devices and solutions for people with diabetes. In many cases, the basis of drug companies' interest in these devices is simply to streamline and standardize the patient's prescription regimen. For example, Novartis, which makes the cardiac drug called Entresto, is collaborating with an insurer to provide monitoring and coaching to an experimental group of patients with advanced cardiac disease. While the drug on its own is proven to reduce hospitalization and mortality in its users by 20 percent, Novartis is looking to increase the drug benefits by combining them with the extra digital attention.

Multi-Functional Information Systems

These patient platforms aren't just originating in the medical industry, however. Large enterprise CRMs like Salesforce have started to add healthcare-related functionality to their existing ecosystems.Salesforce provides a full app ecosystem that many developers have leveraged for handling health information, and this function is now featured prominently on the Salesforce website. The page on which Salesforce highlights its CRM healthcare solution shows a typically iconic image of today's health care snarl: a stressed-out looking patient/consumer in the midst of a web of connecting threads that lead to caregiver, insurer, pharmaceutical manufacturer, primary care physician, nurse, pharmacist and medical devices.Salesforce notes that its solution exists to break down the complexity and existing barriers, making the patient journey an easy one. It further captures the spirit of today's digital innovation by observing that the competition among providers for patient allegiance is formidable and that offering patients an easy, pleasant experience is the best way to win that competition.

Individual Patient Experiences Are Enhanced by Digital Systems

Beyond-the-pill systems don't all consist of big sweeping integrations. They can be equally innovative when they focus on individual digital experiences: chatbots, AI and gamification apps that help patients adhere to proper treatment regimes or medication cycles. These reminders improve patient outcomes, saving them and their insurer's huge sums of money by reducing rehospitalizations. Furthermore, telehealth platforms are being developed to connect patients directly with physicians for virtual office consultations.MDLive is one example of this evolving care paradigm, providing a leap over the standard impediments of appointment making and insurance coverage for office visits. Through MDLive, patients simply pay a fixed fee for a virtual non-emergency visit with a doctor or therapist. These visits can take place right away, and payment is direct by credit card -- thus removing obstacles for patients who simply need advice or a basic prescription. The size and success of MDLive have led some companies to pay for their employees to use its telehealth service to maintain healthy lifestyles and address non-acute health issues.

Information Is the Most Valuable Commodity

While the mainstream conversation about health care focuses on clinical procedures or payment flow, the real core of current health care lies in information. The collection and proliferation of medical information have always been a gauntlet of ethical, moral, and regulatory challenges. In the past, the sea of unregulated and undiluted data often did more harm to patients and doctors than good. Now, new digital technologies are now able to parse and organize this soup of data so that it is useful and actionable.Patients need qualified and useful information to inform their health choices, answer whether their symptoms require an office visit, and provide accurate prescriptions and payments. Meanwhile, providers need accurate and relevant information on patient history, scheduling, and insurance coverage, as well as updates on how a particular patient is faring at any given moment. The proliferation of IoT devices and modern AI systems allow useful information to be the foundation for every health care interaction.One example of a digital solution for this information hunger is Microsoft's HealthBot. This platform incorporates artificial intelligence (AI) and natural language processing to provide health-related information on demand. MDLive uses HealthBot to streamline its online services even further: patients answer triage questions generated by HealthBot and are then connected with a live practitioner on video. Premera Blue Cross provides answers to coverage questions using HealthBot. Partners can customize HealthBot as needed for their particular user base, connecting it with HealthVault personal medical records or Cortana's search engine for patients to learn more about their particular conditions.

Jumpstarting Beyond-the-Pill Digital Integration

The complexity of today's healthcare environment and its attendant regulations poses a challenge to any company looking to integrate a digital transformation. It's helpful to view the process as consisting of several separate steps:

1. Self-Assessment: A company must benchmark its digital and non-digital properties to understand where the gaps are and where it is leading or lagging.
2. User Journey Mapping: The key to beyond-the-pill integration is understanding how patients interact with their health care, what they currently receive from their healthcare providers, what they want and what they need. By aligning these four items, a company can set out to create a better patient experience.
3. Investment in Leadership: If a healthcare company seeking to enter the new digital ecosystem doesn't have a Chief Digital Officer, as distinct from an Information Officer or Technology Officer, it should get one. Only a strong centralized leader with a clear view across all silos can properly institute a viable digital transformation.
4. Agile Approach: Although VR and AR are bleeding edge technology now, it won't be long before they become expected components across the industry. It is not enough to simply add a Salesforce CRM to a health organization and wait. Healthcare institutions must continually add and integrate new systems and technology, so a company culture of agile adaptability is essential.

As patients become more informed and more aware of the gaps in their health, healthcare companies across the spectrum must embrace new strategies. Digital methodologies can demonstrably improve the health of patients, but they are also the key to transforming the industry as a whole. Companies must recognize the primacy of quality information in providing for the health of the population. In the quarters to come, they need to embrace high-level digital transformations that integrate and analyze data, as well as targeted customer experiences that improve the lives of patients outside the hospital and beyond the pill.