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The digital transformation in healthcare

Digital tools and capabilities are having a transformational effect on our lives and the same is true for the health insurance and health care industries.

The digital transformation in healthcare

According to PwC, global health care spending will increase at an annual rate of 4.1% in 2017-2021, up from 1.3% in 2012-2016. This trend is driven by a number of factors, including the rising incidence of chronic diseases due to urbanisation, lifestyles and diet. China and India have the largest number of diabetes cases in the world, at around 114 million and 69 million, respectively and globally the number of is expected to rise from 415 million today to 642 million by 2040. Likewise, the incidence of care-intensive diseases is projected to increase: according to the British Journal of Cancer, incidence rates for thyroid, liver, oral and kidney cancer are accelerating, and this creates a heightened sense of urgency around the need for effective treatment.

Against such a background, it’s unsurprising that health insurers and medical providers are continually looking to introduce efficiencies and controls around how care is accessed and utilised.

In this context of different local realities, each with its distinct challenges and peculiarities, and ever-growing population of globally mobile individuals pose specific healthcare delivery challenges for insurers looking to move from claims payers to wellness providers.
More frequent migratory patterns and the increasing need to access world-class healthcare with no geographical restriction are driving the demand for wellness strategies and the need to remove barriers to high quality care.
However, providing easy access to care, minimising the burden of administration, delivering healthcare that matches the patient’s needs and enabling secure access to medical records can all be problematic. Many of these challenges can be solved through digital technology: from a mere commercial buzzword to a set of actionable initiatives that enhance members’ satisfaction and create a frictionless customer experience.

Providing easy access to care

Lack of time and remote living are challenges many globally mobile individuals face. The development of telemedicine as a mainstream healthcare delivery channel, however, is changing that.

Telemedicine provides access to primary care through the internet, allowing a patient to talk to a doctor on their smart device or via computers. Whilst physical consultations will be necessary in certain circumstances, there are many instances where telemedicine provides a more cost effective and accessible alternative.

“Digital Doctors” have access to the patient’s medical records and images of symptoms, where appropriate. And importantly, consultants will be specially trained telemedicine practitioners, enabling them to ask specific questions and manage the patient in an appropriate way.

As the technology develops, so too does the scope of telemedicine, which is now being referred to in some quarters as virtual health. Virtual health solutions are more holistic in nature and offer greater connection between the various stages of patient care: initial consultations, through to out or in-patient care and onwards to rehabilitation.

The take-up trend in telemedicine is unlikely to diminish. Undoubtedly technological developments will improve the patient experience further over the coming years and employers are beginning to realise the advantages too.

Telemedicine means less time away from the office for staff members, with trips to the doctor being replaced by an on-screen consultation in the office. Employees may also be more likely to talk to their digital doctor earlier than they would have done, thus catching illnesses earlier than they may have otherwise and potentially preventing the condition becoming so bad they cannot function. The potential also exists to save on insurance premiums, with insurers better able to pass on cost savings through more efficient management of the patient care pathway.   

For example, early observations in the US are showing that telemedicine is being rapidly adopted by employers, and this trend is likely to spread around the world. A recent survey found that, where this is allowed, 96% of employers in the US will make telemedicine services available to their staff in 2018.

Secure transfer of information

Key to services like telemedicine is the ability to digitally transfer confidential medical records so that each doctor in the treatment chain has full knowledge of a patient’s condition. Security poses a major risk in this process, of course, and duplicating records can result in errors and cost significant time and money.

The threat from hacking and cyber-crime is significant but recent developments in block-chain technology means this challenge might be less of an issue in the future. Blockchain technology allows data – this could be contracts, agreements, information on transactions, and even medical records - to be securely recorded and transferred across many computers around the world, through a distributed digital ledger that self-validates at each step of the chain. This principle effectively prevents hackers from having unauthorized access, and they would have to get hold of each piece of information, or set of data, held on the various computers around the world at precisely the same time.

This is why the application of Blockchain technology to the transferring of medical records and other data is very interesting to the healthcare community.

It’s fair to say that the healthcare sector is only just beginning to grapple with the possibilities offered by Blockchain technology, but interest is rapidly growing. The Healthcare Rallies for Blockchain study, for example, found that 56% of surveyed healthcare executives had solid plans to implement a commercial Blockchain solution by 2020.

Reducing the administrative burden

Gone are the days of customers having to complete a claims form by hand, and posting or faxing it to their insurer. These days the forms are available through websites and apps, as user-friendly, quick data-capture tools that encourage customers to interact with insurers, by allowing them to take pictures of their receipts and other information and send them electronically. Developments like these ease the burden of administration when seeking healthcare for the time-strapped globally mobile individual and their dependants.

With claims information delivered directly into insurers’ databases, electronic form submission effectively streamlines a potentially error-prone and time consuming process.

Of course, technology has also enabled direct billing to be firmly established, meaning that insured members no longer have to complete a claim form at all, as long as they use an in-network medical facility. Simply showing the membership card is good enough to access care, and the administration and cost element of care will be done by the insurer and medical provider.

Improving patient treatment

Data collection, analysis, information sharing and artificial intelligence are improving healthcare delivery. Structured and unstructured data collected through multiple sources including social media, wearable fitness devices and electronic health records have created very large and complex databases, and as the algorithms designed to interpret this data evolves, so the potential to improve patient outcomes increases.

Increased database sophistication and the ability to securely distribute information electronically also facilitate the opportunity for doctors to share best treatment practices with their colleagues around the world, paving the way for more effective and targeted healthcare.

Take, for example, a medication or treatment for a specific disease. This might work for some people but not for others. Looking at each case in detail would not be possible but by collating and analysing large datasets, doctors are more able to identify trends, correlations and inconsistencies. For more complex or larger data sets, AI techniques might be applied and if medical teams can share the data and findings securely with colleagues around the world, increasing numbers of people can benefit.

What’s more, the principle of personalised healthcare, as the sharing of the best treatment for a particular individual, rather than just for a particular condition, is now increasingly available to patients themselves. For example, a simple mouth swab test can tell patients diagnosed with cancer what the best treatment plan is for their genetic profile.

As insurers look to move from claims payers to proactive wellness providers, the emphasis of their activities will focus more on encouraging members to stay fit and well, and reducing their need to claim. This not only means a focus on providing the tools for members to live healthier lives, but also provision of quality care – both minimising barriers to access and improving the care itself.