Establishing the Pillars of Digital Health as a Service (DHaaS)

Digital Health as a Service (DHaaS) – A Single Integrated Platform

The phrase, “What gets measured, gets managed” is universally understood as truth. Collecting patient vitals is a good start, but these measurements alone are not enough to effectively manage the health of patients – especially as the industry shifts the point of care to outside the hospital. We need solutions to capture more actionable data that can meaningfully impact the health and care of specific individuals or patient populations, while remaining cost effective. Data should indicate trends in physiological, behavioral and environmental patterns, and include aggregation of different types of information, such as Digital Marketing, Social Media and User Engagement metrics – in order to produce better outcomes for the broadest population, relieve strain on healthcare systems and ultimately improve the bottom line for financially responsible stakeholders.

This has worked extremely well in the retail industry. For example, Amazon’s platform has catalyzed ecommerce and online retail shopping at scale by quantifying the offerings, integrating them to the Amazon cloud, aligning and engaging products with consumers on an extremely personal level. The Amazon platform facilitates the purchase, payment and distribution of goods, from both high volume mainstream products and the long tail, less mainstream products. This same exercise must happen with digital health, in order for the industry to scale.

For many years, the industry has provided line item catalogs of medical devices and solutions, which are highly static offerings and barely scratch the surface of providing the economics and ease of integration necessary to scale dynamically. These catalogs need to be “Digitally Integrated Catalogs” that allow solutions to be integrated and aligned to a specific patient population. A truly open platform allows solutions and services to be quickly contracted and integrated and will facilitate a consolidated data flow into the health systems backend system. New, more effectual solutions could be ready for health systems in a shorter time frame at a much-reduced integration cost, reducing the workload of the IT team and reducing the barrier to entry for many new solutions.

Many customers would prefer to utilize a service platform that includes hundreds of pre-screened and pre-integrated digital health solutions so they could distribute the most effective solutions for a population, or single individual, and receive the resulting data from any deployed solution into their backend system. The platform could recommend a solution set of apps, devices and services aimed at a specific individual being discharged or within a member population. The system would consolidate payment and billing as well into a single payment.

Recent articles have validated the need for the type of connected data that digital health solutions can provide, as well as emphasize the lack of interoperability between EMR / EHRs, Vendors, Providers, Payers, etc. – emphasizing the need for Server Based Health IT Middleware Framework to help fix the problem(s), in order to scale.

Launching the DHaaS Platform

With the need validated and the solution identified, how does one execute such an ambitious undertaking? Skeptics suggest the vision is just “too big”, fortunately, innovators are not deterred. The fact is, the pieces are already there – hardware, software, chips, sensors and SaaS – technologies that didn’t exist just a few short years ago. They’re ready to go, they just don’t “talk” to each other efficiently. Even the less rapidly moving parts, such as regulatory, quality measures, payment models and reimbursement are now in place with a focus on value based care – these factors also need to be integrated into the overall solution. It will take time to bring all of the Digital Health solutions together onto a common platform in order for the industry to scale, but healthcare systems will gain the benefit as the platform evolves and unifies. We are putting the pillars in place, to meet the pressing demand in the next 18-24 months.

Quantification

If you ask someone to list all of the digital health solutions available, they would be hard pressed to define what a digital health solution is, let alone name the ones available on the market today. It’s been stated that over 150,000 health apps exist on the Apple App Store and most get downloaded once and never used again. What factors determine the best digital health solutions? Is it a matter of the best efficacy, or simply the biggest marketing efforts by a vendor? Maybe the right saying is “What gets quantified, gets used”. In order to prescribe a digital health solution, you need to know it exists first, and that it can meet the needs of your individual or target population, in a cost effective manner. The solution must be identified and properly characterized; for example, a glucose monitoring service, using a smart phone app, with a cost $29/mth, very favorable usability ratings, and evidence that it decreases a specific population’s HbA1c by 15% over 12 months. This looks good so far, but it does not deliver a good experience or ROI outside of this user’s specific population characteristics. What solution may be effective and cost appropriate for one, may not be for another.

Alignment

Once quantified, the solution must be aligned with a given stratification and cohort of patients. The quantified solution list would be aligned with disease states and cohorts to allow the system or enterprise customers to select the best solutions for that specific patient stratification or cohort, based on the economics and returns they want to achieve. The example above might align with well-managed diabetics that have glucose meters, and strips, and a smart phone, match the patient type for 15% reduction in A1c and are within a price parameter to deliver an appropriate ROI.

Often, a customer implementing a diabetic program will likely select a diabetes management solution – based on ability to integrate, time and cost – then choose patients out of their population that fit the program. They have likely left behind a large group of individuals, outliers of the program, our customer wants to because integration is not practical. A different approach is to start with a target population or individuals. Life365 aligns the right solution providers with patient characterizations. As an example, our customer wants to target A1c reduction. Group A in the population is made up of well-managed diabetics who already have meters and strips. they own smart phones and are comfortable using technology. The Life365 platform may recommend a diabetes management app, like Glooko, for patients that are well managed, already have meters, strips and smart phone. But of course, “one solution doesn’t fit all”. Group B in the population is less comfortable with downloading apps, they have “flip” phones versus smart phones, and they need more “hands on” coaching. This group may be a candidate for a more comprehensive solution, perhaps a cellular enabled glucose meter, like Livingo, along with a diabetic educator. By having the solutions well characterized, the Health System or Payer can align the most appropriate solution with the right patient population based on well-qualified data. We can “Cherry Pick” the solution for the best ROI with a patient, instead of “Cherry Picking” the patient to get a good ROI for a solution.

Integration

Once the right solutions are contracted by the Healthcare Provider or Enterprise, a single API integration is performed from the Life365 DHaaS platform (Digital Health as a Service) to the enterprise, allowing for one integration and payment point. A multitude of quantified and characterized vendors that are already digitally integrated to the platform, can now be distributed much more easily to the right patient, with the patient’s data flowing into their backend system. A single integration to the digital health platform gives the Enterprise the ability to stratify and align patients to the right solutions, versus the other way around.

There is also great value to a vendor integrating to the DHaaS platform, as it allows their solution to be available to, and seen by, hundreds of Enterprise Healthcare systems with a single integration. The value for the Enterprise Healthcare system to use the DHaaS platform is to have access to hundreds of vendors whose solutions have already been integrated and aligned to enable maximum ROI for the Enterprise.

The strength of this platform is the ability to leverage other software platforms like Validic, Redox and others, in order to integrate to larger populations via a “Super Platform” without having to integrate to each platform one at a time.

Engagement

The addition of an engagement analytics AI to the mix, is like adding fuel to the fire. Personalized engagement is essential to drive optimal adherence across a patient population.

Life365 will offer Personalyze™, Engagement Analytics driven by AI that pinpoints the best solution to connect with a patient and their surrounding environment and lifestyle, which becomes smarter as it receives continuous feedback about how well a solution was implemented and achieved results. Personalyze implements 2 models called “I AM HUMAN”(TM) (comparing me to the population) and “I AM ME”(TM) (comparing me to me). Continuously fine-tuned with machine learning, these models will become more and more robust and individualized to maximize engagement.

In a real world example, the typical cohort for an 80 year old woman may respond well to a Silver Sneakers gym membership, but in looking at her as an individual, walking only 300 steps a day on a walker, a Netflix subscription over a gym membership, may be better motivation for her to stay adherent to her routine, stay out of the hospital and reduce healthcare costs. Although it might be considered counter intuitive to give a Netflix subscription, which might result in more sitting in front of a TV instead of exercising, the main goal for this particular woman might be to bring prescription medication adherence from 40% to 80%, and the motivation to adhere to that plan might come from Netflix combined with a medication management service. The goal is to keep her engaged, to motivate her to take her medication, to help her stay out of the hospital, and we do this by engaging her on her own terms to maximize adherence.

In the next installment, we will talk about the Life365 Digital Health as a Service Platform’s ability to give voice to solutions from all parts of the digital health spectrum: large and small solutions, hardware, software, devices, apps, services and more. There is so much innovation happening in the industry and behind the scenes at Life365, as we start to roll out the DHaaS solution to customers. We are fortunate to have other visionary partners with us as we build the next phase of Digital Health.

Until next time.

Other Articles in the Series:

Creating the Amazon of Healthcare – Part 1

Creating the Amazon of Healthcare – Part 3

Read original post on LinkedIn, here.