Home is where the health is, we know in the wake of the COVID-19 pandemic. To be sure, many of us who have been preaching that our ZIP codes are more impactful to our health than our genetic codes have known the evidence backing the social and behavioral determinants of health for a long time.
This week, Parks Associates convened the Connected Health Summit, focused on the theme of consumer engagement and innovation. I attended all three days’ worth of sessions in this well-planned and -executed virtual meeting. In this post, I’ll weave my favorite themes of consumer health engagement for self-care at home for ourselves and the people we love.
The first chart organizes Parks Associates’ introduction to the Summit, illustrating that health happens in every room of the house — from the kitchen to the loo, for young people and older, for our gyms for fitness and remote monitoring for our heart health.
To enable health care at home, across the continuum from health promotion, to disease prevention, chronic care management, safe and healthy aging-in-place, and palliative care at the end-of-life, it takes a village — in the form of a health/care services ecosystem.
Enter the second chart, which expands what we traditionally have called “home healthcare” into new areas for care at home. Typically, home healthcare has covered (definitionally and in terms of reimbursement) services addressing activities of daily living, durable medical equipment, and hospice.
Under “new partner services,” Parks Associates lists broadband, home security, retail health and tech (from Best Buy Health to CVS health and Walmart, among others), and the “tech giants” (namely Amazon, Apple, and Google), personal emergency response services (PERS), et al..
Hospitals, clinicians, long term care and other legacy health care system players must collaborate with the folks on the right side of the chart to provide continuity of care to people at home, if we are to realize the vision of connected health where people live.
The pandemic has made this vision more important and real as our homes have taken on more roles beyond pure shelter: for work, for education, for food service, for shopping, and indeed, for health care.
The third chart illustrates different parts of the home care experience all of which bolster self-care life-flows at home:
- Smart home functions of lighting and smart speakers, for example;
- Safety and independence for PERS and connected cars, shopping and GPS;
- Wellness, for fitness via wearable tech, exercise, and nutrition; and,
- Health, for the health”care” flows like remote monitoring for heart conditions, diabetes, respiratory, and other condition areas.
The drawing shows that increasingly complex medical care can happen at home through the use of sensors and services. These will require partnerships and collaborations across multiple providers and technologies, “unified” through good design centered on the person using the service at home.
Health care providers, plans, and payors will need to collaborate with those newer players who can add value and expertise to this vision. They may already be in peoples’ homes, trusted brands in kitchens and bathrooms and bedrooms. They will have expertise in on-boarding and up-skilling consumers with devices or services, and be design-thinking with knowledge of UX and understanding consumers’ lives and values.
Among various challenges to getting to the Holy Grail of connected health-for-all is how to reach at-risk populations. In particular, Parks Associates pointed out the fact that many patients are not currently being served, with at least 14 million U.S. households without broadband access and not reachable via app-based solutions. We’ve seen this play out poorly in the pandemic in households where people have been unable to work from home, access school classes from home, or reach a physician for a telehealth visit from home.
Health Populi’s Hot Points: Among the many excellent keynote sessions, two spoke most profoundly to me in the context of the home as the health hub.
This statement, that “Along with the pandemic, there is a humanitarian crisis in healthcare,” came from a talk given by Angie Kalousek Ebrahimi, Executive Director, Mind-Body Medicine at Blue Shield of California.
Angie described the health plan’s Wellvolution program which was launched in June 2019 — well-timed in advance of the COVID-19 pandemic. Wellvolution is a healthy living platform that supports peoples’ self-care at home, co-designed with plan members. Angie’s term learned three key lessons in developing this project:
- The importance of providing a personalized program that’s meaningful to the consumer
- Moving from being “transactional” to enabling experiences
- Breaking down siloes and expanding to a whole-person care paradigm.
Blue Shield of California was well-positioned to support plan members at-home in the pandemic with this platform in place, recognizing peoples’ own personal crises in care and disrupted lives as the coronavirus crisis emerged in early 2020.
Tori Ames, Manager of Cincy Kids Health Connect, the Center for Telehealth at Cincinnati Children’s Hospital, discussed how her organization met the pandemic’s challenge through the program’s many virtual care channels” diagnostics, specialty clinics, direct-to-consumer, remote patient monitoring, Project ECHO, and other touch points outside of the hospital.
Cincy Kids was able to onboard and create telehealth accounts for over 1,000 providers, expand existing programs, launch more than 25 new electronic health record builds in divisions that never used telehealth, and obtain thousands of temporary licenses for clinicians.
Impressively, the organization stood up virtual care using a variety of conferencing and software tech’s including Cisco Jabber, Epic/MyChart, Extended Care, Microsoft Teams, Teladoc, Tyto Care, and Zoom.
Tori had this image in her talk, which speaks to that humanitarian dimension to our pandemic journeys. We must keep the love and the person in mind at the center of the crisis in which we all find ourselves and each other.
Thanks to Parks Associates for bringing us together this week to share perspectives on the challenges and opportunities for connected health, essential in the era of COVID-19.