Consumer tech, pandemic 'quick fixes' can't repair cracks in the healthcare system: Health Datapalooza 2022

ARLINGTON, Virginia—Healthcare has lagged other industries in consumer-centricity for years. But the pandemic-induced shift to virtual services forced healthcare’s hand, opening countless doors for digital innovation that touted personalized experiences for every patient.

If done right, bringing technology to healthcare “can really make magic happen,” said Omada Health co-founder and CEO Sean Duffy during a health tech panel at this year’s Health Datapalooza and National Health Policy Conference this week.

There are also plenty of opportunities for pitfalls. Here are three major blunders healthcare organizations make when diving into consumer tech, according to industry executives.

1.       Slotting tech on top of healthcare's structural weaknesses

From policy woes to labor dissatisfaction to inequities faced by patients and providers alike, healthcare has plenty of obstacles on its own. Consumer tech might offer Band-Aid solutions for those long-standing issues, but it can’t reach its full potential until the issues get addressed, panelists said.

Take telehealth billing policies, for example. Duffy said a senior hospital executive recently expressed to him that providers were struggling to balance their “day job,” meaning the in-person or virtual synchronous visits with patients, with their “night job,” or tackling the patient messages and tasks that have accumulated throughout the day, otherwise known as asynchronous care.

Asynchronous tools have gained popularity for their ability to offer consumers convenient and accessible options for their care. But providers don’t always get the same benefits, as they may be expected to perform those tasks free of charge.

There’s no national policy for reimbursing so-called store-and-forward care. Instead, the Centers for Medicare & Medicaid Services (CMS) allows coverage for asynchronous telehealth visits to be determined by individual states. State-to-state policies vary wildly, with some providing no coverage for asynchronous care, some only reimbursing the services for certain specialties and some offering wide reimbursement across uses.

Duffy identified the billing discrepancy as a core structural issue in conflict with the promise of consumer-centric care.

“The everyday person would love to just message their doctor, but the current billing structure can’t accommodate to bill for asynchronous time,” said Duffy.

Bottom line: Don’t ignore cracks in the system that consumer tech can’t repair, said Ashlee Wisdom, co-founder and CEO of Health In Her HUE.

“Overlooking those structural issues and thinking that consumer tech is going to solve some of these fundamental problems is one of the barriers we need to be thinking about,” she said.

2.        Designing solutions without the help of the target community

Plenty of health tech startups are creating digital offerings aimed at populations that healthcare has long overlooked, including women, people of color, indigenous communities and people with disabilities. But if companies xpect those communities to actually engage with the services, Wisdom said, the communities must have a hand in building them.

“It’s important to co-design and co-develop solutions so that they’re inclusive and actually will be utilized by the patient populations that have been traditionally underserved,” she said.

Involving the patients you plan to serve in evaluating a solution isn’t an innovative idea. Pilot programs are a mainstay of consumer tech.

But developers should be wary of taking those findings at face value, since “pilots are almost always successful,” said Xealth Senior Vice President of Product Richard Wang in a conference presentation with Babyscripts about personalized care. Pilot programs usually include a “small, highly motivated group,” so it’s easy for engagement metrics to fall when the business attempts to scale, he said.

Here, technology can help. Consumer tech solutions should leverage automation to anticipate that scale and maintain consistent infrastructure, Wang said. That way, the same level of quality is given to the tenth patient as to the ten thousandth patient, and changes to the base infrastructure are more easily achieved when patients aren’t satisfied.

Most importantly, though, developers must prioritize active collaboration with members of the population in question, whether those collaborators be providers, patients, patient advocates or community leaders, Wisdom said. They should be involved as directly as possible in developing and rolling out the solution, from the beginning and beyond the product’s launch, contributing feedback at every turn.

The effort is more than worth it, too, since a lack of deep understanding of the patients being served can lead to subpar engagement with a solution, spelling the product’s downfall.

“If patients don’t use it, might as well throw it in the trash,” said Babyscripts CEO and co-founder Juan Pablo Segura.

3.       Plowing forward with pandemic quick fixes

Just over two years ago, the pandemic crippled the U.S. healthcare system and forced providers and patients to adapt to virtual care in the span of a couple weeks. But now that in-person care is an option again, Omada Health’s Duffy said it’s time to reflect on what worked during the pandemic—and what didn’t.

At the start of the pandemic, “truth be told, a lot of (virtual care) was really hacky,” he said. "It was on the back of infrastructure and systems that weren’t suited for virtual-first care. The challenge right now, and it’s a good opportunity, is to take stock of what specifically should be done virtually versus in person, what specific tools to invest in for the right consumer experience for patients, and what tools support that experience for providers.”

At least with current technologies, the future of patient care can’t go all-in on telehealth. There are plenty of things providers simply can’t do as effectively, or can’t do at all, over a video visit.

Yet telemedicine clearly deserves a more significant place in healthcare than before the pandemic, said patient engagement consultant Stacy Hurt, for its ability to deliver accessible and affordable services.

“We have to keep telephonic care as an option, reimbursable, because sometimes that’s the only way a patient can access virtual care,” she said.

Healthcare needs to thoughtfully balance digital and in-person care, then, rather than attempting innovation for innovation’s sake. Echoing Duffy’s point, Maven Clinic’s chief medical officer Neel Shah, M.D., said these technologies provide a host of opportunities to not only augment healthcare as it existed before but also unlock forms of care that otherwise couldn’t exist.

But, he said, digital health certainly isn’t a cure-all.

“An app isn’t going to fix healthcare,” he said.