Where We're Going We Don't Need Roads
Chair, Board of Directors, MedTech Association and Sr. Vice President
This line from the 1985 movie, Back to the Future, predicted that in 2015 flying cars would exist. Ronald Reagan, who loved the film, quoted the line in his 1986 State of the Union address. Thirty years later — while time travel or flying cars still do not exist, though auto-pilot cars may be available relatively soon — the advances in technology are in fact nothing short of astounding. The film correctly predicted tablets, smart wearables, video calling, fingerprint scanning, and the programmable home. Most people now carry a supercomputer more powerful than the state-of-the-art in the early 1990s. And there is at least one company with an actual Hoverboard, although it only works on a special skate park with a metallic surface.
In 2015, as Welch Allyn celebrates being a brand and business for 100 years, it is fitting to reflect on similar predictions of the application of technology in healthcare delivery. The industry, replete with wonderful advances in technologies for diagnosis and therapy, has been notably laggard in adopting information and communication technology, at least in the mainstream delivery of professional healthcare. Perhaps for the first time in history, the trends now suggest an imminent alignment of patients, providers, and payers with the incentives and behaviors needed to drive the application of technology to healthcare delivery, and the potential to realize its attendant benefits of increasing capacity (access), lowering utilization costs, and improving population health outcomes.
Trends now suggest an imminent alignment of patients, providers, and payers with the incentives and behaviors needed to drive the application of technology to healthcare delivery.
Clayton Christensen, the Harvard professor and author, teaches the concept of decentralization as the means to make something more affordable and more accessible. He uses the analogy of computing power going from the room-sized mainframe to the contemporary smartphone to suggest that healthcare delivery will (and must) decentralize from being delivered in high cost, specialized venues and move to the home, the ultimate low cost setting. In this sense, one could contend the movie prediction turns out to be correct in that roads will not be needed (or at least as frequent use of them) to obtain healthcare.
Wireless mobile technology, including smartphones, apps, devices, wearable sensors, and the cloud, have broken down any barriers to delivering decentralized healthcare that might have existed previously, at least in terms of the technology. However, technology is not the end, but rather the enabler or the means to the end. Despite these amazing advances, numerous other barriers to the adoption of “connected health” have persisted, including reimbursement schemes based on in-person encounters and volume, and consumers that were indifferent to cost and uninterested in engaging in their own healthcare.
Enter the age of high deductible health plans and health savings accounts, risk sharing (or bearing) providers, value-based payments, and consumers’ growing use of technology and economic decision-making in healthcare. The incentives are changing slowly but surely, and it would be perilous to argue this move toward consumerization and paying for value, quality and outcomes will not persist. There is even emerging new willingness on the part of payers, along with burgeoning legislation and Center for Medicare and Medicaid (CMS) policy, to reimburse fee-for-service telehealth in many manifestations.
Joe Kvedar, the Partners Healthcare physician and vice president of Connected Health, speaks from real world, contemporary experience in saying, “When we [the providers] take on risk payments centrally and are rewarded for keeping people healthy, the face-to-face barrier is removed. The cost-conscious consumer will likely prefer virtual care because it keeps care out of the high cost part of the system. High deductible plans and health savings accounts (HSAs) draw consumers into the conversation of healthcare costs. If we offer a virtual service for two-thirds the cost of a face-to-face service, you can bet consumers will flock, if they have a deductible to spend down or if it’s coming out of their HSA.”
Evidence points strongly to asymptomatic chronic diseases, those that are lifestyle-driven and the scourge of healthcare delivery.
So where in the grand scheme of things is the ideal combination or intersection of the biggest unmet need, the opportunity to make the greatest impact, and the distinctive advantages and strengths of Welch Allyn? The evidence points strongly to the asymptomatic chronic diseases (the “silent killers”), those that are lifestyle-driven, including hypertension, diabetes, and obesity, and the scourge of healthcare delivery. Chronic illnesses account for 70% of healthcare costs, but many only generate symptoms after progressing to a late stage, resulting in people not thinking about long-term implications or otherwise abdicating the worry and responsibility to their doctors. “We can’t get people to pay attention to diet, exercise and other preventative tasks because there is no symptom associated with unhealthy behavior – until it’s often too late. In fact, in many cases, it seems that the unhealthy behaviors are themselves psychologically rewarding, so we are really swimming upstream here,” claims Dr. Kvedar.
Dr. Kvedar stresses that the key ingredients for a successful telehealth program are “frictionless” patient experiences (sensors, devices, apps) with a dash of the sentinel effect (the tendency for human performance to improve when participants are aware their behavior is being evaluated [i.e., their doctor or nurse is watching]), seamless integration with provider workflow, and the economic incentives that align to make connected health an imperative in care delivery.
“Connected health can help us counteract these challenges. The vast array of sensors now available and their attendant feedback loops make it hard to ignore when we’re not on track with our health.
Even if we don’t feel symptoms, we can be reminded several times per day of how we’re doing with respect to a given health parameter. When these data are shared with a healthcare provider, it becomes more difficult for individuals to ‘abdicate responsibility,’ something we’ve called the sentinel effect. When patients know their objective health data is being shared with a provider, they naturally up their game to appear to be compliant and interested in their health. No one wants to look like a slacker in front of their doctor,” states Dr. Kvedar.
Welch Allyn is uniquely positioned to deliver the optimum combination of attributes in chronic illness connected health solutions that are patient-centered and physician/provider-driven. There are distinctive advantages Welch Allyn can bring to bear, including strengths and capabilities in accuracy, reliability, and user-friendly interface design to deliver sensors, devices, and apps with a superior patient experience. Welch Allyn can drive optimum patient engagement by leveraging leadership presence in the physician/clinic space to connect patients with their healthcare professionals. Welch Allyn’s extensive experience in streamlining workflow for nurses and doctors through capabilities and relationships in electronic medical record (EMR) integration will be a key enabler.
Overarching these advantages will be the trusted Welch Allyn brand. In entering the connected health space, Welch Allyn will leverage the halo effect of physicians’ trust. The future continues to be exciting indeed, even if it doesn’t include flying cars or time travel just yet.About the Author
Scott Gucciardi has 25 years of experience in the global medical technology business and has held a variety of executive leadership positions in his tenure at Welch Allyn. Scott is adjunct professor of entrepreneurship at Syracuse University’s Whitman School of Management and an instructor in the Boots2Business Program of the Institute for Veterans and Military Families. He is board chairman of MedTech Association, an advisor to the healthcare startup PurpleSun Inc., and is a director on the board of Liberty Resources, Inc. Scott has a bachelor’s in Mechanical Engineering from Clarkson University and an MBA from the Simon Business School at University of Rochester.
About Welch Allyn
Headquarters: Skaneateles Falls, NY
Since 1915, Welch Allyn has brought a unique perspective to developing diagnostic solutions by combining pragmatic knowledge with a visionary spirit of innovation and ongoing improvement. As a leading global manufacturer of physical examination instruments and accessories, as well as EMR-connected vital signs and cardiac monitoring solutions, the company has a steadfast commitment to delivering superlative medical products, services and solutions that help healthcare professionals provide better care for their patients.
NYS Employees: 1,300 (2,600 worldwide)