Following a surge in telehealth and digital care use under the pandemic, the healthcare industry is now grappling with finding the balance between in-person and virtual services.
At CVS Kidney Care, the healthcare giant's kidney care arm, that means starting with meeting the patient where they are, said CVS Kidney Care President Lisa Rometty in an interview with Fierce Healthcare at the ViVE conference. She said it's important to not boil the conversation down to an either-or paradigm.
"I think technology is going to allow companies like ours to be able to personalize healthcare for the consumer," Rometty said.
CVS Kidney Care aims to provide an end-to-end experience to manage kidney care in the long term before it reaches chronic kidney disease or end-stage renal disease. It takes a home-first approach to its care model and is currently co-developing a hemodialysis device that is built specifically with home care in mind.
The device is co-developed by Deka Research & Development and is currently in clinical trials. Rometty said CVS expects to complete the trial by the end of this year, with anticipated approval and launch sometime in 2023.
CVS chose to get involved in developing the tool, she said, because the company saw an unmet need in the market for a device that's built from the ground up for in-home dialysis rather than adapted to it. Existing tools are not designed to be easy for a senior patient to understand, for example, Rometty said.
"We did it because we really felt strongly at the time that there wasn't at the time a device that would meet the unique experience and ease of use and also the safety and clinical aspects," Rometty said.
Kidney care has been an active space of late, with a significant push for more value-based care as well as a slew of startups entering the market to shake up the traditional approaches. The Center for Medicare and Medicaid Innovation has launched the Comprehensive Kidney Care Choices model, for example, in which CVS Kidney Care is a participant.
Rometty said the drive toward value is a key focus for her team.
She said the team views value-based care models like bundles as natural enablers of new technology, driving uptake of wearables and other tech that can be useful in managing chronic illnesses like kidney disease.
"Most payment models are still fee-for-service," she said. "That I don't believe is the friend of innovation."
Pushing for value requires finding the right partners, which CVS has the scale to achieve, Rometty said. The company's size and reach is a huge boon in expanding its work with patients as well, as CVS' community presence accelerates the process of building trust with them.
That trust is especially important in advancing home care, making patients more willing to welcome providers and services into their homes.
"If you're going to care for someone in their home, you have to build that trust," Rometty said.
For example, CVS unveiled a partnership with Uber Health in three cities as part of its Health Zones initiative earlier this year. Rometty said this program will benefit its kidney care patients, as transportation represents a critical barrier to accessing services they may need.
More than 12% of patients miss in-center dialysis appointments, she said. Digging deeper reveals they may struggle with finding transportation to the appointments, or the appointments do not align with their work schedules, so they skip critical visits.
Uber rides tackle the first challenge, she said, and CVS' dialysis centers offer flexible scheduling to address the latter. Identifying these hurdles and addressing them is key ensuring access to care is equitable.
"Healthcare is personal," she said. "Healthcare of the past was very one-size-fits-all, and that is not at all what optimal health should look like."