‘Hybrid health’ opens up opportunities and reveals gaps in healthcare

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Adoption of digital health technologies has happened fast and furiously during the pandemic, but it is now up to insurers and patients to find the best recipe for a mix of remote and in-person care.

Very occasionally there are breakthroughs, but change is usually a slow one when it comes to health care, advancing or nibbling at the margins, entrenched interests and ways of doing that stand in its way.

But then there was March 2020, a health crisis like no other, and clumsy health care tiptoed up and pivoted. Parents who would previously have had an in-person medical visit for a mildly ill child have now replaced those visits with a telehealth consultation. Patients tested for COVID-19 are now checking electronic health record apps on their smartphones to get their results. And people worried they may have symptoms of COVID-19 have turned to their Apple Watches to check their blood oxygen levels.

“Companies like Amazon and Apple have taught consumers how to engage digitally,” says Amanda Baethke, MS, director of business development at Aeroflow Healthcare, a North Carolina-based manufacturer of durable medical equipment. “Second, the COVID-19 pandemic dramatically accelerated the adoption of digital healthcare, which transformed the patient experience and let patients consume healthcare digitally more than before.”

Even older patients, many of whom are better late adopters than ever, have begun to embrace technologies such as home monitoring devices to stay in touch with providers.

Baethke said the pandemic has brought the new paradigm of “hybrid healthcare” into focus. It’s not about digitally replacing in-person healthcare, but about layering tools and services that enable remote care and provide options for patients (and their families).

“A hybrid model enables both convenient and cost-effective healthcare through telehealth while providing face-to-face lifesaving care when needed,” Baethke says. “As patients become more familiar and health plans adopt more services, our tech-savvy consumers could receive timely care from the comfort of their homes.”

However, the pandemic has also highlighted how much work remains to be done to make hybrid healthcare an authentic and sustainable way to deliver healthcare. In some ways, the technology and its engineering are the easy part. What is more challenging and multidimensional is finding ways to integrate this technology into existing processes so that it can be used to improve people’s health.

Appreciate data points

For payers, the new health technology paradigm represents both an opportunity and a challenge. Patients who might normally see a doctor within 50 miles might suddenly want to see a doctor across the state — or the country — using a telehealth app while paying network rates. Consumers can also expect coverage for medical devices that may not be FDA approved. Take the Apple Watch, for example. Despite an intense marketing campaign positioning it as a health and fitness device, users who take a blood oxygen reading on their Apple Watch will see a warning that the reading is “not intended for medical use. “.

Baethke said some insurers were quick to align with changing consumer expectations, but she said there were too many exceptions. “Insurers seem to be slow to assess the different services that can be offered via telehealth,” she says. “There seems to be a disconnect between what consumers want and what insurers are willing to provide.”

The tension over which services insurers choose to cover is not new and will never go away. But remote care adds a new dimension. Baethke gives the example of a new mother who needs help breastfeeding. Although lactation counseling is traditionally done in person, it can also be offered online. However, for these services to be covered, insurers must be prepared to expand their networks to include new types of services and providers.

“In addition to providing prompt care, telehealth also creates more robust networks,” she says. “If the new mum was based in a rural area where access (to lactation consultants) was limited, the use of telehealth would provide support that she otherwise could not reach.”

“If telehealth offers the ability for a consumer to engage where they might not have otherwise,” adds Baethke, “health plans should appreciate the additional data point and capitalize on this behavior. to align with their patient journey goals.”

The wait-and-see

The early adopters among us (and the companies making the products they’ve adopted) may put some pressure on insurers to cover digital health services. But there is also a large part of the population who will probably need to see the services offered before wanting to take the step towards hybrid health. Baethke says this creates a communication challenge for insurers.

“We have arguably the most informed and engaged patient population we’ve ever had,” she observes. “As health care costs rise, patients want to know about its benefits and how it affects them.” For example, in competitive markets such as Medicaid managed care plans, the availability of hybrid health options is becoming increasingly important.

“We see consumers getting feedback from each other on which plans produce the most value for them, the consumer,” she comments. “It’s important that plans look at how consumers engage and why they join their plans and programs.”

In the market for employer-provided health care, insurers have an incentive to reduce costs not only for themselves, but also for their employer clients. Baethke says insurers can leverage intermediaries such as employers to help communicate their benefits.

“There may be an opportunity to look at historical services that have been provided and promote that they can be covered in another setting (like via telehealth),” she says. “Similarly, there may be campaigns that can be run with providers to promote that an in-office service that a patient received could also have been provided via telehealth.”

Such communication can take place at a macro level, but also at a micro level, targeting individual consumers to let them know about cheaper and more convenient options.

However, she says the opposite should also be available: Patients should have an easy way to communicate directly with their health plans about barriers to care. “Consumers will often have insightful ideas that should be listened to, which is why it’s important to create a space where their opinions can be heard and a dialogue can take place.”

Baethke says the world of hybrid health has greatly expanded the range of services available and made it much more convenient to receive those services. However, these services only have value if they are successfully integrated into the economic model of health.

“If we want to make sure patients are meeting their health care goals, we need to continually look at the reasons why they aren’t, such as access and availability, and make sure we’re making adjustments accordingly. result. »

Jared Kaltwasser is a freelance writer in Iowa.

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