The real state of digital health – everywhere except Silicon Valley

MGMA CEO Halee Fischer-Wright offers a healthy dose of skepticism about patient access to data, digital and remote health services and wearables. And then she cautions about the two things the industry must not forget to do.
By Halee Fischer-Wright
02:57 PM
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state of digital health

Mary Meeker’s 2017 internet trends report is a remarkably data-rich and intriguing read for anyone interested in the topic of innovation or the art and science of trend-spotting.

Specific to Meeker’s insights on digital health, I couldn’t help but chuckle to myself a few times with a note of well-earned experiential skepticism. Through that lens, I thought it essential to document what I hear from the thousands of medical organizations that deliver nearly half of the care provided in the United States — in other words, the voices steeped in the reality from the frontline of U.S. care delivery. 

So here are some “facts from the frontline of practices” that are related to the actual state of some aspects of healthcare technology in the United States. Meeker’s trend report findings are in bold. 

Wearables adoption. A full 25 percent of Americans own a wearable with functionality like accelerometers to track speed, and heart rate monitoring, which are among the most common sensors included on the wrist. Sixty percent of consumers are willing to share their health data with tech brands like Google and Microsoft.

Right now, on my left wrist is a wearable. Does it make me healthier? Not necessarily. Here is where we need to talk about innovation being grounded in practical reality. The questions related to wearables that we need to ask are: Do patients who use wearables experience better health, and are the care providers who advocate for wearables seeing outcomes improve? In fact, if we want to get super granular, let’s ask what percentage of care providers are having a dialogue with patients about the data that consumers are collecting from personal wearables, such as heart rate and level of physical activity?

In reality, only a few practices are using data from patients’ wearable devices, but more plan to in the future. Our MGMA Stat poll found that just 6 percent of the 1,106 medical practice respondents indicated their practices were using this data, while 81 percent responded they were not doing so, and 14 percent were unsure. Sadly, the data on using wearables is disappointing — the effectiveness of using a wearable on measurable health outcomes is negligible.

My personal view is that any technology or data that drives engagement in the patient-care provider relationship is a good thing. In other words, we need to infuse a little more of the art of medicine, the relationship, if we want to make wearables adoption meaningful.

Patient access to their digital data. Meeker states that 95 percent of hospitals have enabled patients access to their digital data.

The reality is that giving patients access to their personal digital data and improving satisfaction, communication, and care are very different things. U.S. medical practices report that only a small percentage of patients use patient portals. Of those that do, the highest usage*, at a nascent 12% of patients, do so to access test results. Usage drops to 5% for functions like scheduling appointments, paying bills, and communicating with medical staff. What does this tell us? Are the portals too difficult to use? Do patients resist a perceived technology layer between themselves and care providers? For those looking to innovate in digital health, this appears to be an intriguing untapped area to delve into.

Digital and remote health services. Meeker reports that consumers (especially millennials) increasingly expect digital health services. For example, over a third of consumers have sought remote medical care or advice (the number jumps to 56% with baby boomers). 

When it comes to the reality of telehealth services in the US, it is fair to say that there is more consumer interest than there are services currently being offered by medical groups. MGMA’s Stat polling of 1,325 medical group respondents tells us that only 16.83 percent of those respondents currently offer telehealth in some form, 21.21 percent are planning to add those services and 36.23 percent offer no services and have no stated plans to do so. Telehealth is clearly an area with much work to be done.

I am a passionate advocate for digital health transformation and believe in the positive impact that scientific and technological innovations have had and will continue to have in the delivery of patient care, I’d also be remiss if I didn’t caution us to be careful not to drink so much Kool-Aid that we forget to do two important things.

  1. Keep innovation grounded in practical reality. That means being able to ask the right questions on what outcomes we want, and what we’re trying to actually achieve. Radical, no? It means that just because we have an app, doesn’t mean it actually identifies and provides an innovative approach to solve real-world problems in the delivery of care. We need the discipline to ask what problem we are solving and then partner with innovators to build frameworks for new products and services in the real-life circumstances and environments of practices.
  2. Balance the business and science of medicine with the art of patient care. The latter is anchored in the patient–physician relationship. Ask the patients. They’ll tell you they are game for anything that improves their quality of life and the affordability of care required. Just don’t get in the way of their care provider relationship.

While I’m not a Silicon Valley insider, as I’m sure you can surmise, I am a tremendous admirer and aspirer. What I hope to contribute to the conversation is the important vantage point from medical groups. Indeed, those on the frontlines have many of the insights and answers our broken care system needs to hear and act on.