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By Julie Campbell, Director, Healthbox

Digital transformation is transitioning from a nice-to-have to a mission-critical element of any healthcare provider’s strategy. The HIMSS Digital Health Indicator (DHI) objectively measures a provider organization’s progress toward a digital health ecosystem that enables consumers to manage their health and wellness using digital tools—supported by connectivity with clinicians and provider teams—in a secure and private environment whenever and wherever care is needed. The DHI is the only comprehensive tool to assess and advise health system leaders on how to achieve outcomes using digital health, not just to use technologies or achieve other more specific measures. This blog series dives into each of the four dimensions of the DHI, all key to healthcare transformation : governance and workforce, interoperability, predictive analytics, and person-enabled health.

Person-enabled health is defined as focusing a health system on meeting and delivering on the consumer’s individual needs, values and personalized health goals. It recognizes the importance of connectivity between consumers and their care teams, creating a partnership based on consumer needs and choice. It leverages digital options—such as online tools, handheld devices for “care anywhere” approaches, and applications that enable on-demand health and wellness care—to empower self-management of personal health and wellness goals, shaped by the unique life circumstances, preferences, health needs, and choices of the consumer. All of this is key to achieving healthcare transformation.

This breaks down into three subdimensions:
Personalized care delivery ensures consumers are the primary decision-makers in managing their health and wellness with digital tools and technologies that fit into their unique life circumstances and approaches to healthcare.
Proactive risk management is guided by the proactive identification of individualized risks to health and wellness in a way that allows consumers and their care team partners to anticipate risk and intervene accordingly to strengthen progress toward health goals and overall wellness.
Predictive population health means a health system has a robust analytics infrastructure that mobilizes data to track population health outcomes, anticipate incidents and inform system-wide strategies to manage and reduce risks to identified population segments to enable better population health outcomes.

For further explanation, please see Digital Health: A Framework for Healthcare Transformation by Anne Snowdon, RN, PhD, FAAN, director of clinical research, HIMSS.

Why does it matter?

Healthcare costs are unsustainable. Over the last decade, there has been significant focus on transitioning care delivery programs and services in the healthcare community—all in an effort to contain the high costs of hospitalization for virtually all global health systems.

This has resulted in the consolidation and reduction of hospital beds per capita, but it has left the digital infrastructure and connectivity between health provider teams and consumers underdeveloped and underfinanced. The challenge we now face—due to an aging population, a pandemic and evolving consumer demands—is health systems’ ability to manage a surge of patients requiring acute care—and, more specifically, critical care. A key digital strategy of the future will require health systems to deliver care at home seamlessly, with tools and technology that consumers are familiar with and prefer.

Industry experts estimate 2,314 exabytes of healthcare data exist. People have never been more digitally connected in their personal lives, with the availability of smartphones, social network platforms, messaging apps and wearable devices. Over 95% of North Americans and Europeans are connected online, and nearly 60% of the global population has internet access. We have the information and technology required to understand patient behavior, predict personal and population risk, and deliver care when patients need it, no matter where they are. Despite this, greater than half of the global population lacks access to basic healthcare services.

Outcomes of a person-enabled approach include improved medication adherence and compliance of personalized care plans, and reductions in readmissions, adverse outcomes and total healthcare costs.

To continue driving healthcare transformation, it’s time that healthcare stakeholders—providers, payers, pharmaceutical producers, community organizations, government and policymakers, and scientific and research communities—collaborate to invest in the resources required to deliver quality, affordable care that fits patients’ needs.

What are best practices?

To achieve a person-enabled care model, there are a few key requirements that health organizations must pursue.

First, organizations must invest in IT experts, data scientists, data architects, human-centered designers and the right technology stack to build a digital infrastructure that functions within and across organizations—in homes and community care settings, virtually and remotely. They must invest in the ability to track, trace and measure individual and population health behaviors and outcomes. Health happens everywhere, and systems need to be able to understand patients holistically and connect with them in their preferred environment.

Second, organizations need to provide and/or integrate with the digital tools patients use in their daily life (e.g., wearables, apps, online portals, secure messaging) to empower patients to self-manage chronic conditions and overall health and wellness. Organizations need to establish seamless interconnectedness with patients via open platforms and APIs, and by providing patients with insights (not just data) on platforms they know and in languages they understand.

Lastly, organizations must be able to capture and analyze data proactively and in real time—and use that information to alert patients and care teams appropriately to prevent harm and manage population and individual health risks. The power of data can only be harnessed if it is understood and if it can inspire evidence-based action.

A few organizations focused on healthcare transformation have worked on this diligently. For example, UnitedHealth Group conducted a pilot with the Children’s Hospital of Minnesota to use digital health tools to control glucose levels. The organization equipped 117 teenagers with type 1 diabetes with Fitbits, disease education and weekly emails from physicians to help them better control their blood glucose levels. Participants who received this intensive remote therapy (IRT) as part of the study successfully reduced their HbA1c levels by 0.34, compared to 0.05 in the control group. The IRT cohort additionally reported higher quality of life about their diabetes care, despite having to do more work to manage their care during the study.

Additionally, Providence has partnered with Xealth and Twistle to reach out to at-risk patients automatically via secure text messaging and smartphone apps to gather up-to-date information about symptoms and send alerts to their care team if their symptoms require attention. They are also leveraging a self-assessment tool that identifies at-risk patients and sends them digitally enabled pulse oximeters and thermometers to monitor conditions at home.

Final Thoughts

The COVID-19 pandemic has shed light on the health disparities many healthcare organizations are working actively to address: social determinants of health (SDOH), or the “root causes of health.” Predictive analytics provide visibility into some of the main SDOH factors impacting health outcomes, such as race, physical environment, education, gender and more. As the use of connected health devices, telehealth services and digital patient communication increases, health systems must actively work to lessen the gaps in both precision population health data and population-specific access to technology and connectivity.

Partnerships with community health organizations, universities, big tech companies and retailers will be critical for organizations addressing these gaps. They must support the treatment of the mental, physical, emotional and social aspects of care and establish trust with the populations they serve.

Further, partnerships will allow organizations to engage with patients beyond the clinical setting to deliver culturally competent care at scale. For example, consider Chicago’s West Side United coalition of community and hospital partnerships, or Intermountain Healthcare’s partnership with Omada Health and the American Medical Association to reduce type 2 diabetes.

Providing person-enabled care does not reduce the importance or replace the need for standardization of care treatment pathways, plans and operations that allow organizations to operate efficiently and safely. Instead, standardized care models and personalized care delivery will coexist. Person-enabled health encourages healthcare organizations to invest in secure, predictive, efficient digital infrastructure, social determinants of health resources and predictive analytics solutions to better understand the unique needs of patient segments and influence policy, patient behavior, and clinical decision-making based on the information available.

In all, delivering person-enabled care is the solution for health organizations striving to meet these patient demands:

  1. Understand and manage one’s own health and wellness
  2. Connect socially in a digitally enabled way
  3. Grant more autonomy through shared health and wellness decision-making

The Journey to Healthcare Transformation Starts Here

Healthbox, a HIMSS Solution and healthcare advisory firm, drives innovation from the inside and out, helping organizations build internal innovation programs, assess the potential of employee-led projects, and look to the market to find solutions to implement or invest in.

Identify your organization’s strengths and opportunities to inform a comprehensive digital health strategy with the complimentary HIMSS Digital Health Indicator (DHI) Virtual Assessment.

Learn how to build connected communities of care: read about the newly released playbook from our partners at PCCI and explore the step-by-step guide.

Learn more about predictive, proactive and preventative care by reading about and watching this presentation from HIMSS Europe.

Person-Enabled Health’s Role in Healthcare Transformation

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