At times, it can feel like we’re mired in this particular health care moment: no longer stuck in the dark ages of analog records and one-size-fits-all approaches, but not yet at some idealized future of AI-enabled personalized care plans, drones delivering prescriptions, and data exchange that’s as streamlined as it is secure and transparent.
Yet when you get health care leaders together for a few days of candid conversation and sharing, as we did for Rally’s most recent Innovation Summit in Napa, California, something surprising and inspiring happens: People begin pointing to today’s bright spots — those early glimmers that something in their hospital system, health plan, or benefits is going right.
Those are the moments, contends Duke University professor Dan Heath, that need to be celebrated, studied and duplicated. Because while a myopic focus on current problems or far-off fantasies can leave you feeling stuck, those bright spots can spark real momentum toward lasting change. (And that’s why we asked Heath to speak at our first Innovation Summit.)
There were many such moments at the Napa gathering, both presented formally and shared casually between industry peers, as a select group of payers, providers, and employers sat shoulder to shoulder during the three-day gathering. Here are four bright spots that, even days later, I can’t stop thinking about (and cheering):
1. Data Moats Are Going the Way of the Flip Phone
When the U.S. Department of Health and Human Services first published rules, back in 2010, around the minimum data any EHR should collect, industry insiders “thought that would be a floor, not a ceiling,” says Aneesh Chopra, then the White House chief technical officer and now president of Care Journey. But the vast majority of EHRs aimed for data compliance, not excellence, and “the percentage of data that’s mapped in an open model has not been a lick more than what the government regulated,” he says.
But that bare minimum is poised to change, as the government in February announced new rules that would require health care providers and insurance companies to implement open-data sharing technologies, making it easier for patients to access and move their data.
“Information won’t realize its full potential if it’s locked away,” says Neal Batra, principal, Deloitte Life Sciences & Health Care Strategy. “Regardless of regulatory dynamics, consumers, based on experience in other industries, are demanding that you set the data free.”
2. Collaboration Is Conquering Cancer
Darshak Sanghavi, MD, volunteered at a summer camp for teens battling or in remission from cancer for nearly 15 years. And during that time he noticed a bright spot emerge.
“Every year, we seemed to have more and more kids in the picture,” as survival rates increased, he says. So, being a doctor, he dug into the data and found that, between the early 1970s and the late 1990s, the long-term survival rate of children with leukemia jumped from less than 20 percent to around 80 percent.
“Was it some new incredible therapy, some bone marrow transplant? No. Not a single new drug was invented during this entire time,” says Sanghavi, now the chief medical officer at OptumLabs.
Instead, that astronomical increase was a result of collaboration. Oncologists at different health care systems worked together on clinical trials — using the same arsenal of available therapies but varying the doses and administration route — and then shared those insights. Little by little, it led to dramatic change.
The health care landscape is dotted with similar stats, says Sanghavi. Age-adjusted rates of dementia have dropped by roughly 25 percent since 2000. Mortality for cardiovascular disease has been slashed by more than half since the 1960s, thanks to everything from lower smoking rates to public health campaigns around exercise and blood pressure control.
“While we still cleave to this dream of a medical hero — the lone right person making the right discovery — the truth is we’re living in the golden age of collaboration,” he says. “And that’s reason to celebrate.”
3. Encouraging Efficient Choices Is Sometimes Super Simple
Multitiered networks offer a tantalizing possibility for payers, employers, and patients alike: Involve people in the financial implications of their health care decisions, and control costs without compromising quality of care. That’s a promise with nearly universal popularity. In a January 2019 poll by the Harvard School of Public Health, a whopping 92 percent of respondents listed lowering prescription drug costs as a top priority. And more than half of plans in the large group market now have four or more tiers, according to the Robert Wood Johnson Foundation.
So if patients, employers, and payers share the same cost-controlling motivation, what drives people to select providers who cost more? For some, it’s the complexity involved in finding, verifying, and contacting a tier-one provider, says Karl Ulfers, Rally Health’s chief product officer. And when digital tools are able to make that easier, the impact can be pretty dramatic. At one large health care systems in the Southwest, for instance, Rally recently piloted a new feature that allows users to find an in-network provider and schedule an appointment without leaving the app.
“With that schedule integration in place, people see the best results for them, and they follow through,” says Ulfers. And because the platform delivers tier-one providers at the top of search results, that follow-through is also cost effective. In the health system pilot, the utilization of tier-one providers was 17 percent higher than other plans after the scheduling integration rolled out. And that bright spot could fuel more innovations in the future. As Ulfers says, “You can’t design in theory nearly as well as you can design and improve in practice.”
4. Domino’s as a Case Study for Health Care
Pizza and health care may seem like odd bedfellows, but there’s plenty the industry can learn from a turnaround brand like Domino’s, says Deloitte’s Batra. That’s because the pizza chain didn’t change customer opinion by only obsessing over getting pies out the door sooner. Instead, it focused on the entire pizza delivery experience. This led them to experiment with everything from a pizza-tracker app and geofencing that allows delivery in public spaces to fixing potholes on community roads.
This focus on experience over product helped the 45-year-old company become one of Fast Company’s most innovative companies for 2019. The question for health care executives, says Batra, is “What has you excited and feels provocative? What role can you play?”
Indeed, Innovation Summit attendees opened up about plenty of current projects, including a new tool at BlueCross BlueShield South Carolina that will allow consumers to track — much like the pizza tracker — the status of their request in the preauthorization and appeals process.
“Preauthorization and appeals is not a pretty process,” says Sarah Martin, the company’s VP of product and consumer innovation. But, she says, they are working to pull back the curtain and give customers more transparency and a clearer sense of their timing.
Why? Because the bar has risen on customer expectations, Martin points out, and that extends across the entire health care ecosystem. “We’re dealing with expectations set by Amazon, Apple, Google, etc.,” she says. “We can’t offer a subpar experience.”
And while that kind of intense pressure can be stressful, it can also encourage collaboration, experimentation, and cross-pollination, with inspiration coming from all kinds of places, (yes, even legacy pizza companies).
It’s easy to focus on the challenges crowding the current health care landscape. And easier still to get frustrated by the false starts and friction that threaten to block or bog down new ideas.
“You see a lot of resources, time, and money invested in things — and you know there’s a better way,” says Matt Shaffer, senior vice president BlueCross BlueShield South Carolina. But there are also bright spots to learn from and replicate. And when employers, health plans, health systems, and government agencies work together, he says, “We have the ability to come together and think differently, to be at the forefront of this monumental change. There’s no nobler cause than being at work with that end in mind.”
Brian Dolan is chief strategy and partner integration officer at Rally Health.
Rally® is the only truly integrated health care platform that unites benefits, wellness, medical care, and rewards in a single, intuitive experience. It is the proven choice implemented by more than 200,000 employers, including 47 percent of the Fortune 500. If you’d like to learn more about how to simplify heath care, contact firstname.lastname@example.org.