Digital health is the buzzword when it comes to the present and the future of care. Technologies, such as telemedicine, remote patient monitoring and patient engagement via smartphones, are designed to enable providers and patients to manage health and wellness more effectively and cost-efficiently.
The migration to digital is driven largely by healthcare reform, which requires providers and insurers to give good care at a lower cost.
Executives at Providence St. Joseph Health, MemorialCare Health System, Children’s Hospital Orange County and Kaiser Permanente told the Business Journal that digital health is still evolving and that there are many technologies to choose from. There is no one-size-fits-all digital health solution, said CHOC Vice President and Chief Information Officer John Henderson. He said advancement will come from understanding “what other systems are doing and how they are approaching [digital health],” as well as pushing the boundaries of what’s possible.
Owning Outcomes
Chronic diseases and conditions create the most healthcare costs—86% of the U.S.’ $2.7 trillion annual healthcare spending is for people with chronic and mental health conditions, according to the Centers for Disease Control and Prevention—and elderly people in particular are likely to have at least one chronic disease.
Executive Director of Kaiser Orange County Mark Costa said the region has a fast-growing elderly population and that Kaiser is “focused on making sure individuals get the right care at the right location [and helping them] stay healthy so they don’t find themselves in those emergency-room health crises.”
Top chronic diseases include congestive heart disease, diabetes and dementia.
Area Chief Information Officer James Brady said Kaiser is working to enhance remote monitoring capability. It currently monitors diabetic patients, tracking their glucose levels through a mobile app.
Kaiser also introduces patients with chronic conditions to community organizations and groups for health education and interaction about how they are doing.
“We found that if our patient members are able to take ownership of their health outcome, they do much better,” Brady said. “We must engage patients.”
Kaiser is focused on making its online portal at kp.org—which got a facelift last year—easy to use. Costa said the portal drew more than 300 million visits last year, an 18% year-over-year increase. More than 65% of the visits happened through mobile devices.
“We want to provide access to our patients, whether that’s in our hospitals, ambulatory [centers] or digital,” he said.
Comprehensive Experience
CHOC’s Henderson said, “There’s a whole patient experience side when it comes to digital.”
For example, CHOC’s new mobile app “will let you know if you need to leave 45 minutes early instead of 20 minutes early because of traffic, and where to park,” Henderson said. The app is in development.
He joined CHOC in June, having previously served as assistant vice president at Texas Children’s Hospital, where he was responsible for information technology operations.
Henderson said CHOC’s digital strategy covers patient monitoring and secured communication among providers.
For the former, CHOC acquired Allston, Mass.-based Etiometry Inc.’s patient monitoring technology, comprised of a Food and Drug Administration-cleared software application that collects, visualizes and stores intensive-care unit data in near real time. The technology automatically synthesizes data from multiple sources, including the patient’s medical record.
Henderson said CHOC will first launch the tool for its cardiovascular intensive care unit. “That’s our unit with the most ill children, and we want to start this technology with our 12-bed unit before we move on to our much larger units [with] 30 to 50 beds,” he said.
CHOC will soon start monitoring asthma patients with a wearable developed by Canadian company Ideal Life Inc. Its software is designed to simplify how patients, doctors and caregivers track and manage health conditions. CHOC plans to expand remote monitoring in June to include diabetic patients.
Digital Ventures
MemorialCare Executive Vice President and Chief Operating Officer Tammie Brailsford said patient care remains the same when it comes to digital health—“compassionate and personalized”—just delivered via apps and other tools.
Offerings include patient portals, real-time blood monitoring, a text-based app that simplifies communications between patients and doctors, and remote stroke patient monitoring—neurologists can exam and treat stroke patients using round-the-clock video conferencing.
“We focus on technology for communication among patients, their physicians and other caregivers and support staff,” Brailsford said. She said the system is interested in “digital front door” opportunities, such as scheduling, provider searches, and patient-referral management software.
The Fountain Valley-based health network invests in digital health companies through its innovation fund and Summation Health Ventures—a partnership with Cedars-Sinai Health System.
“Patient-reported outcomes are a big area of opportunity,” Brailsford said. For example, HealthLoop, a technology platform in the Summation portfolio, engages patients before admission and after discharge by sending them daily check-in messages and personalized information about their conditions and needed follow-up, plus tasks to perform. When complications are identified, the patient’s healthcare team is notified to follow up before those become more severe and expensive to treat.
Other areas of interest that it’s pursuing are analytics and artificial intelligence and telehealth, Brailsford said.
Three-Pronged Approach
Digital for Renton, Wash.-based Providence St. Joseph is comprised of three areas: Express Care, Xealth Inc. and Circle, said Executive Vice President and Chief Digital Officer Aaron Martin. He also oversees Providence Venture, the health system’s $150 million venture fund that invests in early-stage technology and medical device investment opportunities.
Martin said the first part of the strategy is to make sure patients have more access to care on-demand.
Express Care consists of walk-in clinics, online visits via a phone, tablet or laptop, and same-day house calls.
“Maybe your whole family’s down with the flu, and instead of coming to us, we’ll come to you,” said Martin, noting that the function got more utilization as a result of the recent flu outbreak (see related story, 26).
Seattle-based Xealth was founded in 2016 as a digital platform that allows doctors to prescribe digital content, apps and videos. Martin said patients can easily access “digital prescriptions” and that doctors can monitor patient compliance.
Providence St. Joseph spun out Xealth in June.
Circle is a tool for expectant and new mothers, providing clinically approved answers to frequently asked questions about pregnancy and newborns, customized to-do lists, and access to local and online resources. Martin said the health system plans to expand Circle to include pediatric care next year and will soon span the spectrum of women’s health.
“The female of a household controls 90% of healthcare spending. She is our customer—there’s not anyone a close second to her. She controls it, not only for herself, but for her partner, kids, parents and in-laws,” Martin said. “She is the chief medical officer of the household.”
The three initiatives are currently implemented in the 50-hospital health system’s Seattle and Portland markets.
Martin said Providence St. Joseph plans to offer the programs in Southern California this year. The region, headed by Erik Wexler, spans Orange, Los Angeles and San Bernardino counties.
