Mobile apps that guide people to the nearest emergency care clinic or specialist. Texting programs that remind those with chronic conditions to monitor their health. Bicycles that keep track of one’s vital signs. Teddy bears that can “send” hugs to family members.
This isn’t your parents’ health plan.
Faced with a dramatic paradigm shift in healthcare delivery, brought on by reform efforts and the newfound power of patients taking charge of their own healthcare, payers are taking a whole new look at their members. Workplace wellness, chronic care management programs, preventive measures and communications are all part of the plan now. And payers, often seen as reluctant to enter the technological mainstream, are now embracing mobile technology.
“If that’s where they’re going, that’s where we want to be,” said Yan Chow, director of innovation and advanced technology for Kaiser Permanente, the California-based payer/provider network. “Our goal is to be your healthcare provider rather than just a resource.”
Aside from wellness resources, Kaiser is focused on mobile applications, since more than 60 percent of its members now have Internet access. The company recently launched an iPhone app to help members find healthcare resources while on the go, and it plans on releasing a mobile version of its MyHealthManager personal health record later this year.
“This is just the tip of the iceberg,” said Christine Paige, Kaiser’s senior vice president of Internet services, who sees more than 700,000 hits a month on the company’s website. “We know that there’s a demand for” mobile access, she said.
The problem, says Chow, is that there are more than 9,000 healthcare-related apps on the market these days. Many of them are downloaded, used once or twice, then forgotten.
“There is a difference between a mobile phone and a website,” he said. “All of those apps are fine, but most are just patient portals to the Internet. We want to add to that experience.”
Paige said Kaiser’s corporate partners are becoming more interested in mobile healthcare applications as well – in particular, employers who want to reduce employee healthcare costs by improving lifestyles or offering quicker access to non-emergency healthcare.
“With them, information is not so much the issue as motivation,” said Paige. “We know that people who interact with Kaiser online are more satisfied and healthier. But how do you get them motivated?”
At Aetna, the Hartford, Conn.-based insurer is working with Dallas-based Teladoc to provide online access to doctors for non-urgent care over the phone. The consultations, which cost $38 or less, cover a wide range of conditions, including sinus problems, common colds and allergies, and are being piloted to fully insured medical plans in Florida and Texas.
“When a member’s primary care doctor is not available, a telephone consultation from Teladoc’s local physicians may be a good option for some members with minor illnesses,” said Robert Kropp, MD, Aetna’s regional medical director. “Members not only have access to quality care from the comfort of their home or office, but they can also avoid the time and expense of emergency rooms.”
Aetna is also expanding its relationship with NaviNet to offer Florida physicians access, via smartphone or tablet, to medical literature and patient information contained in the insurer’s claims database. The NaviNet Mobile Network will also give doctors access to mobile Care Considerations, powered by ActiveHealth Management’s CareEngine System, enabling them to push evidence-based healthcare guidelines directly to their patients.
At Humana, the move to mobile health is twofold. First of all, a significant portion of healthcare waste is tied to administrative costs, which in turn is tied to insurers’ denials based on missing or incorrect data. Meanwhile, Raja Rajamannar, the Louisville, Ky.-based insurer’s senior vice president and chief innovation and marketing officer, says it takes six seconds for someone to buy a bag of potato chips with a credit card in a convenience store.
Beyond improving the payment process, Rajamannar said, Humana’s embrace of mobile health is tied to “making healthy things fun and fun things healthy.”
“We’re trying to have a whole ecosystem for our health well-being,” he said.
The ecosystem includes a bike-sharing program with Trek Cycle. Launched in 2008 in Denver, the B-Cycle program is now in place in 11 cities and is a finalist in New York City. The bikes are equipped with sensors that track miles ridden, calories burned, pollution avoided and carbon emissions saved, among other data.
Other initiatives launched through its newest division, Humana Games for Health, include the “Hydration Station” app, which offers information on how much water one should drink in a day; HumanaVitality, a site that combines health information with fitness and nutrition programs and ties that into a rewards program; and Grand2Grand, a new program that connects seniors with grandchildren and other family members through a Teddy bear that lights up and gets warm when it’s hugged.
Earlier this, year, in response to studies that indicate one-third of all seniors regard a visit to the doctor as a social visit, Humana launched Humanaville.com, an online community designed to create a “virtual neighborhood” that connects seniors to health and wellness resources. The site was developed by LifeSynch, Humana’s behavioral health and behavior change subsidiary.
Kaiser Permanente’s Chow says health plans are embracing mobile health applications much quicker than the larger, more expensive telehealth projects, which haven’t yet shown an ROI and face a difficult and uncertain path to reimbursement. While programs such as videoconferencing, store-and-forward system and remote patient monitoring solutions hold great promise, he said, “there needs to be more rigorous studies of outcomes” to prove their value.
Paige pointed out that physicians need to be convinced that quality healthcare can be delivered through telemedicine devices and self-reporting, rather than through the office visit. If the data coming in from the patient’s home isn’t improving outcomes, she said, then it’s not an effective use of anyone’s time or money.
