Guest Column | August 8, 2016

10 Steps To Incorporating A PHM Strategy For Wearables Technology

Wearable PHM Strategy

By: Kevin Kenney, MBA, Chief Operating Officer, BioIQ, Inc.

As technology continues to play a greater role in U.S. healthcare policy and programs, there’s a central question vexing health plan leaders, employers, and payers who seek to maximize its value: How?

  • How do we select and integrate the technologies with the most promise?
  • How do we engage our employees and members?
  • How do we encourage physicians and providers to tap into the insights we know technology can bring?

These questions are particularly prevalent in the emerging wearables market, those promising digital healthcare tools that have grown into a near $30 billion a year industry. Wearables technology encompasses smart watches, fitness trackers, sport watches, and medical devices including glucometers. These high tech devices can be worn on the wrist, attached to your arm, worn around the neck or incorporated into clothing. The technology typically includes smart sensors and web connections that link them to smart phones.

The data provided can help an employer build better wellness programs by promoting healthy lifestyles and exercise, assist health plans in monitoring key health metrics for patients with chronic conditions from heart disease to diabetes, and enhance treatment plans.

The expansion of wearables into engagement and population health strategies is due in part to the rich data set they offer around clinical and wellness values. For instance, a person living with diabetes could be considered engaged when they actively participate and collaborate in their treatment plan, expend effort learning as much as they can about their condition, and practice routine self-management.

However, developing, integrating, and deploying technology to support population health can be an expensive and time-consuming process. With resources at a premium, organizations must carefully consider the expected use for these tools: who will be using them and whether they are adding complexity rather than convenience to the expected engagement behavior.

Steps To Take

It is possible to develop a strategic plan to create and implement strong and inclusive programs that produce the desired goals, and it is being done by many organizations today. Here are 10 important steps to consider.

  1. Know your population. People understand and use technology in different ways; program designers must consider these differences when deploying technology. For example, don’t assume older employees or seniors can’t benefit from wearables; they can. But do make the program simple, reliable, and easy to use, and provide easy-to-understand education and considerable user support.
  2. Enable interoperability. To gain maximum value from wearables, especially for population health initiatives, data must be shareable with healthcare providers who can then use it to develop better treatment plans and interventions. Data must also be disclosed, within the parameters agreed to by the user, within communities so they can share selected information with others to gain motivation, join in challenges, confirm participation, etc.
  3. Ensure data communicated to providers is meaningful, reliable, and relevant. Healthcare is changing. Providers today are rewarded for better outcomes within their populations. There is an incentive to provide healthy lifestyle interventions, self-management, condition care, clinical decision support, treatment plan transparency and collaboration, and useful educational tools. Providers want to take advantage of these new tools patients are using, but they insist on technologies that work within their systems, processes, and EHRs.
  4. Provide information in a timely manner. Often, valuable user data sits in a silo and may never get to the right department or individual. Gaps in communication of data to health plans and providers leads to inaccurate claims, poor coordination, and user frustration. Make sure data sent from wearables is timely, simple and seamless, and programs will secure support.
  5. Strive to ensure an optimal user experience. Today’s consumers have little patience for technology that falls short of its expected results, is confusing or generates frustration when interacting with it. Even the best intentioned and thought-out program will fail if devices are poorly designed, break down frequently or don’t meet user needs.
  6. Enable personalization. The best wearables programs allow users, providers, and coaches to personalize programs for the individual. For example, a physician may prescribe an exercise program for a cardiac patient, but the intensity is too high, or not high enough. Incorporating personal benchmarks through apps can help ensure optimal goals are set. Plus, it can also trigger notices to providers — for example, glucose monitoring for diabetics — so that prompt interventions can be made when needed.
  7. Make it cost effective. Tremendous value can be gained from wearables for Medicaid and Medicare populations, but this value won’t be achieved if a device is too costly to purchase and/or operate. Recognizing its value, some health plans are providing wearables to users at no cost. Yes, it’s a bold step. It’s also one that can pay off for organizations wanting to increase engagement and target specific populations.
  8. Keep health information secure. This, of course, is an absolute — no company wants to end up in the Wall Street Journal for a data breach. Choose technology vendors carefully and ask the right questions. For example, will data be kept natively on the devices, or in the cloud? Make sure to ask who will have access to the data and what their policies are for breach notification. Confirm they will not use patient-generated data for any purpose to which you have not agreed. Work with your compliance team to identify potential pitfalls and screen digital health providers accordingly.
  9. Reassure employees and members their data is private and secure. Provide frequent communications so users of wearable devices can understand their data will not be used in a manner that causes health insurance rates to increase or employers to gather personal information that could be used in a punitive manner. Take care of the fundamentals: be sure your member data is encrypted and find out where it is going to be stored — be sure to include descriptions of this data, how it will be used, and how it is protected in your member/employee terms and privacy statements.
  10. Find the right partners. One important step is to look for partners and vendors that have been certified by the Health Information Trust (HITRUST) Alliance. It shows an organization has met key healthcare regulations and requirements for protecting and securing sensitive private healthcare information.

And Steps Not To Take

There are also actions to avoid. A big mistake is taking a one size fits all approach. Simply offering wearables does not necessarily create an effective digital health platform. The successful method to wearables will incorporate a multidisciplinary model to program design encompassing consumer feedback, health behaviorists, user experience/interface designers, clinicians, marketing, and feedback from key business leaders to ensure the final product is effective.

It’s also critical to measure program results and make adjustments as needed. Wearable programs must measure both outcomes metrics and tools metrics. Tools metrics gauge the effectiveness of the tools themselves. For years, improving outcomes metrics, such as fitness levels, weight changes or cholesterol levels, were the cornerstone of many population health programs. While digital tools can influence these outcomes metrics, measuring engagement with the tool itself represents a newer approach to gaging the level of involvement and benefits.

Some metrics, such as page views or the number of sign-ins, have been considered standard reporting components since the advent of Web-based portals. Newer technology like wearables and mobile applications can provide even more information. Organizations should also look at metrics such as the average number of daily users, the average time since the last sign in, session intervals, the total number of active users, retention rates, launch and load times, and satisfaction rates.

Connect. Measure. Achieve.

Wearables mark an important step in the evolution of how healthcare is delivered. For the first time in history, individuals can shift from being passive recipients to active participants in their health. Instead of healthcare being something that happens to users, with wearables it’s something users can control.

More is on the horizon. Several companies are pushing hard to integrate this rich data to drive clinical decisions. To make that happen, the interoperability and transfer of data will be vital. Look for new innovations in this area. Equally promising is the move toward even more personalization of care and fitness based on the preferences, history, need and even genomic or personalized medicine.

However, none of these advancements will be meaningful or provide the results desired unless wearables are used to connect with target populations; unless results are measured and used for program improvements and unless organizations strive to use the insights provided by wearables to achieve their goals.

About The Author

Kevin Kenney is the COO for BioIQ, a healthcare technology company that enables provider organizations to better connect with their populations to achieve health improvement goals. He has more than 20 years of healthcare experience, including wellness, prevention and population health management. Prior to joining BioIQ, he held leadership positions at Accenture, Matria Healthcare (Alere), DaVita and US Preventive Medicine. For more information visit