Connected Health Trend Countdown: #3 Moving Beyond “Sick Care”

We’re winding down the countdown with one that is near and dear to my heart. One of my very first jobs, when I was just a wee lass of 14 years of age, was as a peer health educator for North County Health Services in California. That’s the foundation that still drives me in my career still today and makes this next trend very exciting:

Trend #3: Moving Beyond the “Sick Care” Model

Of all of the literature I’ve read recently on the topic, I believe Premier Healthcare Alliance summed it up best. In their Spring 2013 Economic Outlook they predicted a major shift in admissions from inpatient to outpatient settings.

Healthcare organizations must connect episodes of care through the development of integrated networks that include hospitals, health systems, ambulatory care centers, community clinics, long-term care facilities, home care agencies, and medical groups, that work together to coordinate care and share accountability for quality, cost, and outcomes.

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This is yet another perfect definition for the driving force that is Connected Health that has been found within this trend countdown. However, in order to make this work, care providers can’t simply be manufacturers of “sick care”, which has been the norm for far too long.

Transforming the Old Guard of Care

The old guard of care is an environment where all care takes place within the brick and mortar of an eight-minute doctor’s visit. Reimbursement took place under a fee-for-service model. There is a seismic, and stress inducing, cultural shift taking place that transforms our “sick care” model into a “wellness” model that impacts care outside of the clinical setting in a transformational way. The market has reached a place where the industry has both the incentives and information needed to move towards this new model of care. The business practice challenge will understandably take much more time to heal.

The shift towards the wellness model has important implications for the health insurance plan as well. For example, Humana has reported that technology will be key in the effort to engage their 20 million plus consumers in a wellness model. They are making investments in “information tools” that allow Humana to educate and motivate consumers, help them gain easier access to providers and more timely treatments, and work to improve their health in multiple ways. They see their role as transitioning into helping their members with their health needs as opposed to simply “financing access to sick care”. Their strategy “wraps around the integrated delivery model” so that they can:

1. help care delivery transform around reimbursement, quality, and cost and
2. engage with the consumer using both consumer analytics and technologies like social communities and mobile devices.