Opinion

The Next Big Thing in Health Care Is …

Health care can learn from the retail industry. 

The most successful online retailers use advanced technology to understand our behaviors and our buying habits and then recommend products tailored to our interests. You buy a softball glove for your daughter, for example, and soon see ads for cleats, bats and softballs.

The health care industry is beginning to employ the same approaches, albeit with a much more stringent attention to privacy concerns related to the very personal nature of consumer data. We believe we can improve health if we learn more about the behaviors and needs of the people we serve.

Based on our interactions with members, we have learned that patients want the most advanced, personalized care delivered where it is most convenient: their homes. That’s because health “happens” in the home, between visits to the doctor.

Seniors living with multiple chronic conditions who require complex care and are on fixed incomes want to receive care in their homes, not in institutional settings. For prevention and management of chronic conditions, the home is the place to provide a high degree of personalization.

There is a caveat: The technology we use in the home and the data we accumulate have to make it easier for people to improve their health, and do so affordably. This often means recommending to reduce the use of low-value care in addition to promoting care that is likely to have the greatest health impact. This is important because 77 percent of older U.S. adults have two or more chronic diseases, which account for 75 percent of our annual $3.5 trillion heath care spend.

Given these challenges, how can health care — which needs to spend more wisely — leverage the principles of a retail concept designed to get people to spend more? 

Make improving health outcomes the ultimate goal. In retail, it’s about getting customers to engage and purchase in a physical or virtual storefront. In health care, it’s about better health and reducing unnecessary costs. We do this by mirroring patient wishes and tailoring to their individual goals. By leveraging retail principles to improve our understanding of behavior, we can tailor offerings to people’s needs and goals.

Use data analytics to create a more holistic approach to care. Addressing social determinants of health are critical, when food insecure seniors are 65 percent more likely to have diabetes. Personalized health care is about data. Data captured in the home, such as identifying a patient who is forgoing prescription medications for managing diabetes, offers a deeper understanding of the relationship between social context and healthy behaviors. 

Leverage telemedicine so the care team and patient can have an immediate connection with their physician. In many cases, these real-time interactions can help patients avoid emergency department visits and hospital stays. When it comes to holistic care, care teams can see if there are loose scatter rugs, needed grab bars in the shower or other ways to avoid falls in the home.

Pay for better health outcomes, not just procedures. For decades, care has been reactive rather than preventive — focused on advanced procedures, services and diagnostics that help people only after they get sick. Medicare Advantage plans, driven by value-based payment models, are key to leveraging home health. These models align physicians and health plans around health outcomes and enable doctors to spend time with patients most in need.

Online consumer retail technology has ushered in a new era of consumer behavior, transforming countless industries and enabling companies to build an unprecedented customer understanding. We have a similar opportunity in health care, expanding our view of our patients’ health and bringing clinical care to the place they need and want it the most: the home.

 

William Shrank, M.D., is chief medical and corporate affairs officer at Humana.

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