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dLife webinar looks at disruption in provider, patient roles

BY David Salazar

Last week, as part of its Prospectives Series of roundtables about hot healthcare topics, dLife Healthcare Solutions hosted the webinar “Disruption to Healthcare Providers: Trends Driving Demand for Digital Health.” The webinar was hosted by Canary Health president and CEO and featured Walmart’s senior director of product development, growth and payer innovation Alex Hurd; Optum/UnitedHealthcare’s senior product director of digital solutions Tia Simons; and Dr. Mandeep Brar, director of the diabetes care center and chief of Abrazo Health Systems’ endocrinology division.
 
Participants discussed the several ways that the health care landscape is changing — from an expanded provider team role to the impact that population has on that role and new locations of care, as well as the changing relationship between providers and patients. Two of the recurring elements connecting all these topics were the importance of primary care provider accessibility and the new, proactive role that patients are taking given that more of their money is at stake — what Simons referred to as consumerism. In particular with primary care, Brar discussed the move from a care team made up entirely of physicians to a more collaborative one that has grown to include retail clinics, urgent care, and specialists, as well as the patient and their family — with the primary care physician still at the cent. 
 
“The provider used to be the physician and the physician alone taking in a unidirectional manner to the patient,” Brar said. “[Now] we have more of a bidirectional conversation between the patients — who are  a huge part of their own care team — family members who may be supporting these patients at home and all the other providers that potentially could be touching these patients at any point in their disease process … or their health care in general. … So instead of having a single conversation in one direction, it's definitely back and forth and we need to incorporate everybody.”
 
Hurd spoke of how the changing provider role has impacted how his team at Walmart thinks about care delivery. He said that the company looked into health care costs in such other countries as the U.K. and noticed that the United States spends 18% to 19% of its gross domestic product on healthcare — a number that’s double several peer nations. He noticed that a common factor in other health systems was a well-established primary care network. 
 
“If you think about putting the primary car provider at the center, we're taking it a little further — we think and we would argue that the retail clinic … can, for many patients play the role of that primary care provider, especially folks that have historically not been able to access the system,” Hurd said. “At retail if you've got food and grocery, if you have other assets where you can build comprehensive solutions for the patient and really center those solutions around the patient, it just opens a phenomenal opportunity for innovation and hopefully bringing down that cost.”
 
As the care team and accessibility expand, patients are taking on a bigger role in that team, arriving informed to appointments, looking to get the best care possible — and Simons says this is having an impact on transparency. 
 
“As we all know, consumers have more dollars at risk and because of that, that's driving them to do more comparisons and actually make choices rather than assumptions around care,” Simons said. “And that comparison is driving more competitive pricing pressures as well as payment reform so that we're moving from a volume to a value model, which requires everybody to understand that total cost of care that drives outcomes. … I would say we’re really in the midst of a transformative time and the consumerism is driving transparency, which is driving this transformation.”
 
With the patient at the center, Brar said that it has changed how providers interact, but in a way that enhances the care, and noted that appropriate compensation for the new value of provider interactions will be the key to making it sustainable. 
 
“The way that I've taken it is that it's a step backwards, actually to good old-fashioned medicine,” she said. “Patients have an expectation that we'll be able to answer their questions, review with them what they have learned on the Internet and weed through all of that data and really provide them with appropriate quality. 
 
And alongside the transformations in transparency and quality of care, there has come a proliferation of digital health and telehealth offerings. But Hurd cautions that these are not so much the solution to longtime healthcare problems, but rather instruments to be used to arrive at a solution.
 
“They’re phenomenal tools but that’s what they are; It’s not a panacea,” Hurd said. “You’ve got to keep the customer and the patient at the center of everything you do. And some customers will love engaging with their phone, their digital app, but for others it’s not going to work and you have to find a solution that works for that consumers. … What it will come down to is ‘are you building the right ecosystem where it’s a combination of brick and mortar, it’s a combination of digital health and telehealth tools, specialist referrals. And … do we have the right ecosystem in place?’
 
Hurd mentioned that the place where digital health might play a big role is in continuing to grow patients’ role in the care team.
 
“The one place where I think digital health can be groundbreaking is: we need to figure out a way to really empower the patient — how do you make it easy for a patient to have access to their own data and freely move around with it and not have providers or pharmacies be gatekeepers of that information?” he said. “That’s where I think it’ll be critical.”
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