3 ways traditional primary care plus consumer technologies can revolutionize health care

A stitch in time saves nine is an adage that holds true in health care. Early identification or the proactive management of a disease condition can achieve better health outcomes faster and reduce the cost of care. Primary care is set up for precisely that purpose.

Traditional primary care capabilities, when enhanced with existing consumer technologies, can enable a need-based intervention paradigm. The result can be increased outcomes across the quadruple aim of care—reducing the cost of care, enhancing the experience of care, improving health outcomes, and addressing health equities.

Exhibit 1: Primary care can extend its reach and enhance outcomes with existing technologies: ©HFS Research

The following are three ways that combining traditional primary care with consumer technologies can revolutionize health care:

Need-based-intervention triggers the care team based on real-time analytics of health data

The prevalent care delivery paradigm is a demand-based one. It is one where health consumers (patients, beneficiaries, customers) generally decide how they feel and when and who they want to see to address their health issues (outside emergencies). A non-emergency doctor visit is typically triggered because one feels sick or needs an annual wellness visit. The ensuing diagnosis and treatment are driven by symptoms shared by the patient and a set of “if-then” driven medical protocols to treat. It is not based on real-time health data.

Consider a paradigm where real-time health data is captured through ambient technologies, wearables, medical IoT, and mobile devices. This data is then intersected with the individual’s social determinants of health and biometrics to create a personalized health baseline that reflects the average state of health. Various factors make a tolerance threshold within which the person’s health is acceptable. That tolerance threshold could incorporate time of day, day of the month, and amount of time outside tolerance, e.g., glucose levels post-lunch.

Once set up, a person’s health could be continuously monitored. Any health data attributes above or below the tolerance threshold could trigger a primary care intervention. The type of intervention would depend upon specific data attributes such as spikes in blood pressure or glucose levels, which could have a family nurse practitioner call the patient, for instance. More serious vitals might necessitate a telehealth or an in-person visit with the primary care physician.

This data-driven approach ensures that intervention, diagnosis, and care are determined by personalized health data when and where required. It is a far cry from the process of a patient setting an appointment and expressing, “Doctor, I am not feeling well,” followed by questioning him/her on a long list of symptoms that may or may not provide the right information to lead to the correct diagnosis and treatment.

The need-based intervention paradigm can positively impact attributes of the quadruple aim of care

A key measure of our health care system is its performance against the quadruple aim of care. The need-based intervention paradigm has critical characteristics that can have a materially positive impact.

• Cost: The average daily price for acute care is between $3,000 and $3,500, depending upon location. The average length of stay in an acute care setting is 4.5 days. An average acute care visit can typically cost between $13,500 and $16,000. The need-based intervention is intrinsically designed to identify and address health conditions early, potentially preventing the need for acute care. Despite the minor investment in consumer technologies and training for primary care, avoiding a single acute care admission could yield significant savings both at an individual and a community level.
• Experience: Continuous monitoring and proactive intervention can be ideal for driving organic engagement between the care team and health consumers. This construct can reduce episodic interactions and enhance trust driven by holistic and proactive engagement. It can be more than appointments, co-pays, and prescriptions; instead, it can be about proactive identification, early intervention, and managing conditions.
• Health outcomes: While heredity and DNA play a huge part in one’s health, lifestyle choices (activity, food), early identification, and treatments play an equally significant part. Need-based intervention is intrinsically built to improve health outcomes and to be done consistently. Imagine a diabetes educator or a nutritionist proactively engaging a patient with diabetes based on the results of their continuous glucose monitor in real-time to identify triggers for spikes in blood glucose to avoid or manage them better.
• Health equities: Using technologies at a consumer level can help to identify and clarify health disparities in a community that needs attention. While the barriers for underserved health consumers to adopt technologies remain high, optimizing primary care team utilization can create the time space to care for the underserved and reverse some of the inequities .

The need-based-intervention paradigm has the characteristics to make health care effective and fit for purpose in the 21st century

A need-based intervention can optimize the patient-caregiver connection. This data-driven approach can eliminate the need to guess and experiment while accelerating the selection of the right caregiver for the issue at hand. It forces both parties to address broader issues beyond the contemporary episodic transaction.

1. Costs: By aligning primary care to address the health of the consumer population based on health needs, primary care can effectively improve clinical utilization. Consequently, they can increase the patient population that they can care for, reducing the total unit cost of care. Technology can further ensure severity is measured and addressed accurately, improving the cost equation.
2. Experience: A key challenge is the episodic construct adopted by consumers and clinicians in the current demand-based paradigm, which forces symptom addressed rather than causal cure of the disease condition. This can negatively impact the experience of care. However, with the need-based intervention, an engagement can be organically developed that fundamentally improves the care experience, resulting in relevant changes in behaviors, lifestyles, and better adherence to treatments.
3. Health outcomes: Optimized clinical utilization by the primary care team and sustainable engagement between consumers and their care team obtained through the greater efficiencies from the above model can lead to improved health outcomes. The ability to leverage data to accelerate the identification of disease conditions and to address those rapidly can have a direct impact on improving health outcomes.
4. Health equity: Creating the financial and care space to target disparities at a community level by those closest to patients who need it most, i.e., primary care clinicians interacting with patients, can provide opportunities to go beyond the narrative to reduce health equities.

The Bottom Line: Embracing a new tech-enabled care delivery paradigm can improve the quadruple aim of care.

Empowering health consumers and primary caregivers with existing technologies can accelerate the identification of disease conditions; quickly diagnose, treat, leverage the opportunity to create an engagement path, and help manage health on a consistent basis. This can offer many advances as the healthcare industry continues to move forward.

Rohan Kulkarni is Executive Research Leader, Healthcare & Life Sciences at HFS Research, a global research and analysis firm specialized in the disruptive power of emerging technologies. He draws on two decades in health care, including as head of health care strategy at multiple Fortune 500 companies and product management executive and CIO at two health plans. He can be reached at rohan.kulkarni@hfsresearch.com.