Far too often, we see medical mixups and even deaths caused by interoperability obstacles in our healthcare system. In these situations, patients in critical conditions cannot speak to their past medical history in an emergency. Upon their recovery but through no fault of their healthcare providers, they are left footing a massive medical bill or facing other severe financial repercussions. Lack of access to data not only causes these terrible outcomes — it’s also part of the reason why our healthcare costs are nearly 18% of the GDP and growing.
Among the many reasons why healthcare data isn’t more digitally accessible is a very simple one: fear that it will be misused. Patients are scared their data will be used against them. This could happen in a number of ways, the most obvious being the threat that insurance companies will use health data to deny people coverage or that employers will use the data to exclude people when making hiring decisions. That’s why the rules and regulations surrounding health data privacy are so stringent.
So, how can investors advance (and capitalize on) tech development around this issue and help eradicate this fear?
Investors, take note
We know funding for companies in healthcare and digital health has not been a problem — but profitability has. Many of these companies are still struggling financially under a fee-for-service business as required by most insurance companies, Medicaid and Medicare. There are grave inefficiencies in the fee-for-service system: It creates the wrong alignment of interests; doesn’t favor the consumer; is complicated by CPT codes (the numerical codes used to identify medical services and procedures), high copayments and deductibles; and is riddled by waste and abuse.
If the investor community bets on companies that continue to embrace a model that many agree is broken, how can we expect outsized returns?
If the investor community bets on companies that continue to embrace a model that many agree is broken, how can we expect outsized returns? To truly lower costs and reduce inefficiencies, we have to abandon the existing structure and put the customer first.
The key here is to look at companies that are truly trying to solve not just one piece of this puzzle, but those that are attempting to create an end-to-end solution that connects the employer, member, hospital, specialists, pharmaceutical companies, primary care doctors and claims adjusters, powered by digital health data — all while making it more affordable for the consumer.
Keep an eye out for those that are moving away from the fee-for-service structure and focused on employer-driven systems. Employers are properly aligned with patients, as bad health outcomes and financial stress both negatively impact productivity. Employers are also focused on KPIs in their business; they’re used to measuring and tracking results, making them great candidates for data-focused healthcare companies.
Most importantly, in a labor market where companies are clamoring to attract employees, employers will have to work with healthcare technology companies that put a premium on data security because their current and potential employees will demand it.
Innovation over fear
The whole future of healthcare is going to focus on the ability to securely share data. To empower providers and patients to take control of their healthcare journey, we need to build a system of trust that allows the efficient flow of personal healthcare information from stakeholder to stakeholder.
Today, with the way HIPAA works and the requirement to keep data private, that trust has to be in the hands of a provider. Imagine if your primary care physician was the quarterback of your entire healthcare journey. Simply by handling your preventative care, they have a more complete picture.
Even better, preventative care is a major focus when it comes to reducing healthcare costs. If you put the data in the hands of a trusted entity and ensure that each person has access to their full medical history, people are much more likely to grant access at times of need.
The good news? There’s hope
The future is very bright because of technology. The challenge is being able to figure out meaningful ways to utilize and integrate it. Right now, we have a system of incumbency that is disincentivized to embrace new technologies.
Telehealth is a perfect example of how the system can meaningfully change. It took a global pandemic to really be able to break through to a point where telehealth was fully embraced (and covered by insurance). Now, health insurers such as Anthem are actively trying to improve care coordination and interoperability.
Three critical technologies not used in healthcare today could be instrumental in bringing about this change. Ideally, all three will align to usher in a new era of healthcare:
Healthcare telemetry 2.0: Collection of health data on cellular devices
Through our use of social apps and e-commerce platforms on our mobile devices, people have already accepted that our cell phones are constantly collecting data on us and willingly consent to this. Sometimes this function is quite helpful — just look at court cases where detailed location data have provided alibis to suspects.
Anybody with a cell phone is carrying a medical device that counts our steps, tracks our screen actions and is attuned to us as users. So why are we not leveraging this function for optimized care — or at the very least trying to get medical insights out of our device use data?
In the future, the number of times one checks their mobile calendar in a day could be an indicator of early-onset Alzheimer’s in people of a particular age group, as one example. Technologists must continue to push the boundaries of how the computing power in our pockets and purses is used to help us, especially with so much of the groundwork already laid.
Privacy 2.0: Application of blockchain to protect medical information
In just the past six months, we have seen bad actors capitalizing on digital risk to cripple entire industries through data breaches. The Colonial Pipeline hack effectively shuttered gas distribution to a massive portion of the U.S. in a matter of hours. With healthcare data, stewards of the system need to be even more careful. It will be tricky to regulate the privacy and protection of healthcare data, but blockchain technology has proven to be an effective measure in maintaining trust between consumers and data stewards.
Portability 2.0: Ability to securely share information with approved parties
For many people with life-threatening conditions, the simple act of wearing a medical bracelet can make a difference between life and death — but at this point, medical bracelets should be obsolete. Imagine the patient benefits that could come from a next-generation medical “bracelet” that carries a patient’s entire genome, tumor profiles, long-term heart rate trends and more, and can be uploaded instantly in an emergency situation.
Right now, the absence of health record portability creates redundancies that are both expensive and harmful to patients. Doctors spend time and resources rescanning patients, while patients suffer from repeated (and sometimes risky) diagnostics, like blood draws and radiation. Nobody has cracked the code on portability, but effective solutions must navigate tricky regulatory waters while solving for standardization across data sets.
We are already seeing these technologies used in other industries. Apple and Google have turned phones into remote monitoring devices that can easily collect all types of health telemetry data. Cryptocurrency represents billions of dollars in transactions with no breach of trust in various coin exchanges. Uber and Lyft have changed the way we hire, use and pay for transportation. Applying the core technologies used in each of these examples would provide a means for disrupting the current challenges in healthcare. It’s only a matter of time.
History has proven that with innovation, investment and technology, the world has become a dramatically better place. As long as rules and regulations stay out of the way, you can expect that technology will allow us to make enormous leaps forward in the next decade.
Making data secure and meaningful, along with personalized medicine, holds the promise to reduce long-term healthcare costs in the U.S. while improving healthcare outcomes.
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