The two San Diego-based healthcare organizations have forged a three-year deal to develop an integrated care management plan for seniors, incorporating everything from primary care to inpatient services to home-based care.
Two San Diego-based healthcare organizations are joining forces to develop an integrated care management model for the nation's growing senior population.
Sharp Memorial Hospital and West Health have entered into a three-year deal to create a "model of excellence for older-adult care," which would bring together best practices for everything from primary care to inpatient services to home-based care.
“In collaboration with Sharp Memorial Hospital, we’re bringing together incredible advancements in geriatric care that have, until now, been largely siloed within medical specialties such as emergency medicine or surgery,” West Health Chair and CEO Shelley Lyford said in a press release. “By coordinating senior-friendly care across the entire health system, we’ll be amplifying those advancements and helping older patients achieve the best-possible healthcare experience.”
“Our population is rapidly shifting; by 2030, the number of older adults in San Diego will be 80 percent higher than the decade earlier,” added Tim Smith, Sharp Memorial's senior vice president and CEO. “These are valued members of our community who deserve the best-possible care. But the needs of older patients are quite different than those of the average adult, and that’s what’s driving our commitment to create new and better standards of care.”
The growing senior population is expected to strain the resources of the nation's healthcare industry, which is already struggling with staff and provider shortages amid a bad economy. In addition, many seniors are looking to remain in their homes for a longer time, rather than move in with family or into senior care facilities, putting pressure on healthcare to improve home-based monitoring and care management services.
Some health systems, like Dartmouth Health in New Hampshire, have developed specific geriatric care programs, and the American College of Surgeons offers certification for geriatric surgery. Sharp Memorial and West Health, a collection of non-profits focused on senior care services and successful aging, want to create a platform of care management that eliminates siloed services and gives healthcare organizations a master plan for treating seniors. It would include care coordination as well as senior-specific programs.
“West Health and Sharp Memorial are reimagining what successful system-wide care can look like for older-adult patients, and we’ll share the model with the world in the hopes others will make the same transformation,” Lyford said in the press release. “Already, hospital systems are seeing the positive impact of geriatric specialty care in emergency settings and operating rooms. Just think of the impact when that level of care extends throughout the entire system in an intentional and coordinated manner.”
“Injuries and illnesses in older patients can have immediate, permanent consequences on their independence and mobility,” added Diane Wintz, MD, a Sharp-affiliated critical care specialist and medical director of the Trauma Program at Sharp Memorial Hospital who helped forge the alliance with West Health. “We see the best results when there’s an exceptional level of teamwork across departments and specialties. We want to see emergency teams, surgeons, pharmacists, and primary care providers taking collaboration to a whole new level for our older patients.”
In the wake of the American Hospital Association's workforcereport released in November, HealthLeaders spoke with NAHQ Executive Director and CEO Stephanie Mercado, CPHQ, about how that quality component is the linchpin to building and keeping a strong workforce. This interview has been edited for brevity and clarity.
HealthLeaders: A takeaway that leapt out on the video summary of the report on your website was that hammers don't build houses, but people do.
Stephanie Mercado: That's right.
HL: Your report is all about the fact that we have all these marvelous information tools now, but we have a workforce that seems at times unable to use or optimize the use of those tools to really make the kind of difference we need to see in healthcare. That includes bending the cost curve, employee retention and all the things we write about over and over again. What was the origin of the report? How did you decide at this time that you needed to do this kind of survey or fact finding? And how did you go about gathering the evidence that you present?
Mercado: Let me rewind the tape a little bit further. I joined the organization about eight and a half years ago. And at that point in time, there were a handful of healthcare quality leaders. CQO [chief quality officer] roles were almost nonexistent. There were a few VPs you'd hear about, but most of the time it was directors and managers and coordinators of quality.
One of the things that occurred to me was how different the educational pathways are for people working in healthcare quality. I had previously come from the American Orthopedic Association and American Academy of Physical Medicine and Rehabilitation, where there are well-worn academic pathways for training – medical school, residency, fellowship, board certification, licensure, the whole thing. But the same is not true for people working in healthcare quality.
Stephanie Mercado, CPHQ, executive director and chief executive officer of the National Association for Healthcare Quality. Photo courtesy NAHQ.
People working in healthcare quality generally are more like-minded than they are like type. And they're usually put into the role because they were really good at something else. I saw a chief quality officer position description the other day sent to me by a recruiter, and it said "MD required and quality experience preferred." And I thought, how could this even be right?
The whole reason why NAQH exists, and of course the impetus for the report, was to say we've got a lot of people and a lot of investments have been made over the years advancing quality, safety, and value. And yet, we do not have any standards for how we educate and train these individuals. That's the reason why we do all of our work.
We started by developing the Healthcare Quality Competency Framework, that has the eight dimensions, 29 competencies, and then, unpublished, 486 skills, stratified against foundational, proficient, and advanced levels. With the framework in hand, we know what work is supposed to be getting done out there in healthcare quality. Creating the standard and validating that standard twice in the market was the first step.
Once we had the standard validated, we were then able to start assessing both individual contributors and contributors within teams. That is really what you see in the workforce report. The first few data tables that you notice are from our aggregated national dataset. And the ones in the appendix are actually from healthcare organizations that we work with, to come in and help them understand how to leverage their workforce, through a solution we offer called Workforce Accelerator. At the end of the day, there's no technology implementation or consultant that will replace a coordinated competent workforce. And so that needs to be the focus of for sustainable systems.
HL: The report includes a data analytics data point, which was that 57% of respondents indicate analytics as part of the responsibility, but most work at lower levels of competency.
Mercado: Well, that is big. All of these competencies must be present in a high-performing organization. And I'm just pulling up health data analytics in particular. So 57% say that they work in that domain, and only 20% are performing at advanced ends of the competency spectrum.
HL: So why the gap here? They're not being trained properly?
Mercado: Oh, so many things. But yeah, there is not a well-worn academic pathway or even training solution that gets people ready to do this work. We have been saying what needs to change in healthcare for more than six decades – what needs to be measured, what we need to be doing, what technology needs implemented, all of these things, but we haven't said how. The whole how part of the equation has been left largely addressed.
The how gets back to hammers don't build houses, people do. A lot of times healthcare leaders, with very good intentions, will deploy technical solutions and then suffer from challenges with operator error because the people don't know how to use the tool. Safety event reporting software is the thing that helps identify risks and events in a hospital. It's a way to engage the workforce. And they will report things like, if there was actually an incident, like a slip and fall or anything like that, that goes into there.
And then there's also things like they put in near-misses or good catches, like, hey, there's water on the floor. And they enter it into the system to say it needs to be cleaned up, or we almost gave a patient the wrong medicine. They implement that into the event reporting. But guess what they don't do: Most organizations do not train their workforce on how to identify those risks and events. So now you have a whole software solution, which is very well-intended and necessary in healthcare, but the competencies required to identify those risks and events have not been part of the solution.
HL: One of the AHA report's recommendations is to foster professional development, expertise, and leadership skills by offering interdisciplinary training across organizations, departments, and sites of care. That would seem to intersect quite nicely with what you're urging.
Mercado: We are 100% on the same page with investing in continued professional development. We would expand upon that to say what we need in order to do that well is create some more of the standard operating procedures of how teams work together.
We have been working with a variety of healthcare organizations, first in pilot, most recently in beta, and are now moving past beta to actually go into healthcare organizations and implement this model.
For example, we are working with the Veterans Health Administration. The VHA implemented NAHQ's implementation model for this, which we call the Workforce Accelerator. VHA did that in beta with us with three of their VISNs [VHA regions]. They just expanded with us, and the VHA now has all 18 VISNs working on the workforce accelerator program with us. So the entire VHA infrastructure is now aligned to this effort. And it also represents the first time that the VHA has ever centralized quality.
This is really big news, that the largest health system in the country is working with NAHQ to deploy this solution with success. Not only are they having organizational success, but individuals are feeling more engaged and more supported at their organization. They're creating succession plans for staffing and things like that. It's been a real success story at the Veterans Health Administration. And we have others -- Bon Secours Mercy Health, Valley Medical Center -- and many other organizations are working with us on this and it is working. We're really excited about that.
HL: How does this effort increase the likelihood that population health efforts are going to be successful at healthcare organizations?
Mercado: Let me tell you a story to answer that.
One of NAHQ's board members works at ChristianaCare. And for a long time, she led the department of quality. And she was so good at it and so effective as a leader, when they got involved in population health, many years ago, they asked Patty, who's my board member, Patty [Patricia] Resnik, to go lead the population health initiative. When she arrived in the population health department and was stitching together her team and getting everything situated and organized, what she realized was that the people who were there didn't have skills in quality and the skills that you need to have an effective population health program. You need to understand data, and you need to be able to do performance and process improvement. You need to be able to understand the different payment models and how you can support populations and measure those outcomes. How you can improve things like vaccination schedules and annual mammograms and all those things? Those are quality skills.
HL: To what degree are the analytics tools a part of the problem? Hammers are hammers. We all know how they work: they pound nails. In the case of technology deployed in the healthcare space, they're not simple. They're tough to evaluate and compare. We often hear this drumbeat of well, you're just using the wrong tool. If you just use this other tool, things are going to be better. And now it's gone beyond use this other tool – it's use this other AI with this other data set and you'll be successful. To what degree has the industry have allowed itself to be distracted by this endless discussion of what's the right tool? Are any of them good enough if you train people adequately on how to use them?
Mercado: They might be. Technology's job is to enable people to do their best work. Technology does not replace, in and of itself, people doing the work.
HL: It's critical thinking skills, too. It's not just their sheer competency with using the tool. It's how critically do they think – how they're able to make connections between things they might not otherwise connect.
Mercado: Absolutely. One of our competencies is in data, health data analytics, collecting data from disparate sources, being able to understand the relationship between it and then moving on to make that information useful and actionable. There's not a technology solution that does that without a human driving the thinking behind that.
HL: We're in an industry that's more and more hammered by spiraling costs, reduction in payments from Medicare and others. In such an environment, how do you persuade organizations to answer the call to action? Can you tell them with any certainty, based on your early work with VA and others, this is going to pay such dividends, that you'll wonder why you never did it earlier. Is it that straightforward? What's the cost involved? And what's the return on investment involved in making this workforce investment?
Mercado: We're researching right now the best way to quantify the value of activating these ideas. What we do know is people and organizations that are working with NAHQ to advance a coordinated, competent workforce, they are continuing to work and they're expanding their work. And they are not only seeing a difference in their quality infrastructure and having a more positive effect, but they are hearing from the workforce that the workforce feels supported, valued, recognized, to do their best work.
HL: You mentioned 486 skills, as yet unpublished. Are you going to publish those?
Mercado: We haven't published them for a couple of reasons.
Number one, we believe that the high degree of variability in healthcare delivery is very much related to the high degree of variability in healthcare quality competencies, so we're not going to solve for the end state problem without moving upstream and getting these competencies figured out. We have also observed that when we do push information into the market, because it is needed, it is needed very badly.
Since we released the report, a handful of weeks ago, I believe we're up to about 4,000 downloads of that report, and lots of sharing. No one person needs a list of 486 things to do. An organization needs it all, because they deploy that holistically. So we only get back to organizations that work directly with us.
HL: Academia has played a role in training the workforce. Should they be also playing a role in this? And how?
Mercado: From an academic, higher-ed perspective, in clinical disciplines we have done a good job at training our clinicians on clinical competencies for quality, how to clinically do their job well. But there is a high degree of variability in non-clinical competencies, in the training there. Even within nursing, they do it, [but] they're working on getting a more standardized way.
So it would not be fair to say they don't have it, but we have a long way to go in terms of standardizing the non-clinical competencies – performance and process improvement, health data analytics, population health, care transitions – the non-clinical competencies. NAHQ works with a handful of nursing programs right now to hardwire our non-clinical competency-based training into nursing curriculums.
It's actually listed in this document which groups we're working with – George Washington, Georgetown, University of North Texas, Western Governors, etc. There are such things as quality and safety Master's Degree programs, but we are not graduating very many people through those programs. So we need a bigger commitment to Master's level training in the discipline of quality and safety as well.
Healthcare executives showed up to CES to talk about the unique value of digital health and look for diamonds in the rough.
Jason Swoboda came to CES 2023 eager to see the newest in consumer technologies. But while others were wowed by the color-changing cars, mega-screen TVs, and interactive games, the director of innovation at Tampa General Hospital had his sights set on digital health.
"I'm thinking about the patient room of the future," he said.
Swoboda was one of a growing number of healthcare executives to brave the crowds in Las Vegas and attend an event that healthcare had for many years kept at arm's length. Where health systems once regarded consumer-facing technology as a fashionable fad without clinical relevance, they're now taking a closer look at tools and platforms that could add value to the patient experience.
And CES has taken notice as well. What once was contained in a tiny corner of one conference hall now has its own dedicated digital health section, where Abbott was showing off the latest in testing tech, Withings had a collection of wearables on display, MedWand was demonstrating its home-based digital health tool, and Vivoo was offering up a smart toilet and home urine-testing platform. Other examples could be found at the nearby Venetian resort and conference center, where healthcare played an integral role in Parks Associates' Connections Summit.
Rene Quashie, vice president of digital health for the Consumer Technology Association, which produces the CES show, said the CTA's VIP tour for healthcare executives was a busy affair, and executives from healthcare organizations took part in several digital health panels, including a digital health keynote that focused on the evolution of hybrid care.
In short, healthcare organizations are interested in consumer-facing digital health as they maneuver the long, slow path from fee-for-service to value-based healthcare. They're interested in technologies that can engage the patient and develop a rapport that affects not only clinical care, but the patient's entire healthcare journey.
For Swoboda, this means finding the innovative new devices and platforms that can improve care at the bedside as he looks to redesign the inpatient experience. It also means checking out the fast-growing smart home technologies that could play a part in Tampa General's remote patient monitoring and hospital at home programs, both existing and in the future.
"Connecting to the home," he says, will be a key element of Tampa General's value-based care strategy, as more non-acute care shifts from the inpatient setting to virtual care platforms. That means finding the right technologies and channels to gather and analyze data from other settings, such as the home or office, and collaborate with patients on care management.
CES offers a glimpse of those technologies, including sensor arrays that integrate with beds, toilets, even refrigerators, and digital health platforms that can facilitate behavioral healthcare, test for viruses, scan blood or urine for certain chemicals, or even help men with their, ahem, sexual needs.
To be sure, CES is filled with technology that has nothing to be with healthcare, but it represents the latest in innovative ideas. Augmented and virtual reality first saw the light of day at this show, along with smart home products, drones, 3D printing, avatars, AI, and robots. Alongside the aforementioned smart toilets (for cats as well as humans), some relatively new ideas getting the spotlight this year included digital twin technology, light-based treatments, sensor-embedded jewelry and shoes, and smart strollers and car seats.
Most of these technologies won’t be found at the traditional healthcare conferences hosted by HIMSS, HLTH, ViVE, or the American Telemedicine Association, and that's fine with Swoboda. Just as healthcare has been pushed to "think outside the box" in terms of innovation, he says he's interested in ideas that haven't yet reached the mainstream but offer new approaches to old problems.
"We have a strategic imperative [that focuses on] consumerism," he says. And that means looking at the healthcare system from the consumer's perspective.
That sentiment extends to the vendors as well. It's what brought Teladoc Health, one of the biggest names in the telehealth field, to CES, where they announced the launch of a new digital health app aimed at "enabling personalized whole-person care to individuals." That includes access to primary care, mental health, and chronic care management services in both English and Spanish.
Shayan Vyas, MD, MBA, Teladoc Health's senior vice president and chief medical officer, said health systems are certainly interested in the consumer health space, but they want one single point of entry, rather than a collection of disparate apps, tools, or platforms. Many are looking for help managing that connected health approach.
"The hospital itself is not the most efficient place right now," he said, watching attendees surge into the CES events at the Venetian on a Thursday morning. "They're focusing on maximizing the investment in their EMRs and they need help" creating a unified platform that incorporates digital health, one that can be scaled outwards.
Indeed, health systems are plagued by plunging operating margins and growing staff and provider shortages, and they need all the help they can get. At the same time, they're not going to spend a lot of money on new or unproven technologies. They're looking for solutions that not only ease their pain but are sustainable either through ROI or growth.
"It's all about maximizing investments," Vyas reiterated.
And that's what Swoboda is looking for as well. Amid all the booths offering nice-to-have solutions or conveniences, he's looking for technology that will make a difference in the patient experience and push Tampa General closer to value-based care.
Healthcare executives speaking at CES 2023 this week in Las Vegas say the industry has to evolve to keep up with the times. How it deals with collecting, analyzing and using data may be the key to that evolution.
Healthcare organizations may have a hard time figuring out what to do with consumer technology, especially in this time of tight profit margins, but there's no denying that the data coming from these tools and platforms will have a significant impact on the future of healthcare.
And at CES 2023 this week in Las Vegas, that's what the experts were talking about.
"Using data to really leverage the journey of healthcare is very important," said Susan Turney, MD, MS, FACP, FACPME, CEO of Wisconsin's Marshfield Clinic Health System.
"When you start getting that data together with making it easier and seamless, that's [the goal] we have to get to," added Stephen Klasko, MD, MBA, former president and CEO of Thomas Jefferson University and Jefferson Health and now an executive in residence at General Catalyst.
Turney and Klasko took part in a high-profile panel on the first day of the sprawling consumer electronics show. Titled "The Future of Care in America: A New Hybrid Model," it included Carlos Nunez, MD, chief medical officer for ResMed, Anne Docimo, MD, UnitedHealthcare's chief medical officer, and Vidya Raman-Tangella, MD, chief medical officer of Teladoc Health.
The panel's topic offered ample evidence of the impact that digital health is having on healthcare, and was underscored by the size and breadth of digital health and healthcare companies and products at CES 2023. And underneath all those tools and technologies, from smart toilets to mobile health apps to companion robots to digital twins to AI and VR and AR, is data. It's what everything collects, analyzes and uses.
Healthcare has been slow to catch on to the value of digital health and data, and the panel was on hand to emphasize that this is how the industry must evolve to take in value-based care. Health systems and hospitals that fail to evolve in this manner risk losing their patients to Amazon, Walgreen's, CVS, and the health plans and health systems that de embrace digital health data.
Nunez referenced a recent Intel report that estimated healthcare data makes up one third of all the data collected around the globe, yet roughly 95% of that data isn't being used. It's sitting out there in many different forms and locations, offering insights into how health and wellness can be measured and improved for every individual.
And yet healthcare hasn't yet caught on.
"The fact that we define hospitals as where we fail to keep people healthy is wrong," Klasko said.
So healthcare needs to evolve to collect and use that data. Klasko pointed out that this evolution is being defined by new partnerships that embrace digital health, with parties that might not have had a presence in healthcare before. Hospitals are joining forces with AI companies, food distribution and nutrition companies, and others to identify and address gaps in care and improve not only clinical outcomes but health and wellness.
"How do we redefine ourselves in a radically collaborative way?" he asked.
Docimo pointed out that a key to harnessing and using data will be finding the right platform, a challenge right now with so many EHRs out there unable to work with each other.
"What we have to get to is a common platform so we can unify that data," she said.
And that's where healthcare should and will be headed.
The Weekly Wrap, HealthLeaders' new video series, brings you a quick look at what we're covering around the healthcare industry.
Looking for a quick review of what’s hot in the healthcare industry?
Our Weekly Wrap video recaps the latest news and analysis that HealthLeaders covers each week and features health system, hospital, pharma, and payer executives.
New episodes will be released each Friday.
Subscribe now to HealthLeaders YouTube channel to catch all the episodes. Don’t miss out!
Check out our featured story, podcast, and event for the week:
HealthLeaders editor Jay Asser sits down with Colleen Vetere, principal at Vizient, to talk about current trends and challenges for managing capacity. Vetere, who has over 35 years of experience in...
The pandemic has turned the spotlight on inaccessible, unusable, patient data. It's time to accept the reality that this is a comorbidity.
Editor's Note: Paul Markovich is president and CEO of Blue Shield of California.
Nearly three years into the pandemic, the Centers for Disease Control and Prevention (CDC) reports more than 1 million lives lost due to COVID-19 in the United States, with the World Health Organization reporting more than 6.6 million deaths globally. Many analysts put the actual number of deaths caused by COVID significantly higher than these numbers and neither estimate captures the potential long-term health effects of COVID.
One of the biggest challenges to preventing and managing illness, including COVID-19 infections, hospitalizations, and deaths, is inaccessible, unusable patient data. Despite Californians reporting increases in care quality this year compared to last, the United States’ lack of comprehensive, timely, usable, and secure digital information is perhaps the greatest barrier to improving health and improving our ability to address a pandemic at the local, state, and national level.
It’s time to accept the reality that a lack of readily available and usable patient data is a comorbidity – and it’s beyond time to fix it.
Poor information sharing as a US comorbidity
Clearly, our country was not ready for a pandemic, and many experts have correctly pointed out how broken our data exchange system was at the outset. One study found that the most common barrier to effective surveillance was the inability of public health agencies to receive electronic data from providers.
More than 40% of hospitals reported being unable to share patient data with public health agencies, which impacted how COVID-19 was tracked, reported, and treated, with patients paying the ultimate price. This shouldn’t be a shocking discovery to anyone. Name another major industry in the 2022 version of the United States that relies substantially on CD-ROM discs and fax machines to capture and share information.
After leading California’s COVID-19 Testing Task Force and serving as the third-party administrator for the state’s vaccine operations, Blue Shield of California saw first-hand the challenges created by a lack of timely access to actionable data. The inability to easily exchange, integrate, store, and use patient electronic health records surely heightened the impact of the pandemic.
These essential records are often maintained in many different proprietary databases designed to support private companies’ business models (that of physicians, hospitals, electronic medical record vendors, health plans, and others) rather than public health interests.
While legislation is underway that aims to improve data sharing at the national level (i.e., implementation of the Office of the National Coordinator for Health IT’s final rule on information blocking), it will not ultimately fix this problem.
Addressing this issue won’t just help us respond far more effectively and quickly to a pandemic but will also help us diagnose, treat, and support those with other illnesses, particularly those with chronic conditions. An estimated 7 million people in California have multiple chronic conditions, and taking care of them accounts for nearly 60% of the state’s healthcare spend, but the state of California, like most of the rest of the country, lacks the digital infrastructure to address it.
The health information exchange must go national to be effective
This issue can be solved if the health care system aligns interests and takes proper action. Specifically, we will need to do two things across all industry stakeholders to produce these records and thereby bring health care fully into the digital world:
Formally establish required standards for creating, maintaining, and sharing these records.
Create the infrastructure and capabilities needed to gather, integrate, store, and use the records.
California has taken a big step on the first of these issues by mandating digital information sharing among industry players. As part of this effort, the state convened an advisory group that included stakeholders across the industry – from health systems and health plans to academic leaders and public health agencies – to design and implement an information exchange framework, which the California Health and Human Services published in July 2022.
This is a good start, but the mandate to share data needs to be expanded beyond California, and even in California we must do more to make this data timely, usable, and secure – not just shared. A physician cannot improve their treatment of a patient and the state cannot improve its COVID response by getting a patient data dump in the form of a 70-page PDF file of an electronic medical record – a common occurrence in today’s world.
Making data timely, usable, and secure: We need to want it
Opponents to data sharing routinely cite the millions of data exchanges made daily, which belies their lack of utility and integration with patients’ medical histories. Often this information ‘sharing’ will come in the form of PDFs or reams of faxed admission and discharge records. This is exactly what I experienced recently with my weekend warrior sports injury where I was given a CD-ROM and paper records from my providers.
While digital records may be plentiful, there is a deep lack of usability and integration that makes that data useful to improve the entire health care system and make it more effective.
Technology must be deployed and funded to make data sharing and usability possible for the entire health care delivery system. To do this, we must be able to create a unique patient profile; process and share clinical information in real time; and make available to each patient their own complete health information regardless of where they received care.
Technology is available. What’s required is the will to align on a common vision of our data ecosystem. Together, with collaboration among all participants of the healthcare system – including the public and private sectors – we need to create a patient-centered system that benefits everyone for the care we all need and be better prepared for the next public health crisis.
Care to share your view? HealthLeaders accepts original thought leadership articles from healthcare industry leaders in active executive roles at payer and provider organizations. These may include case studies, research, and guest editorials. We neither accept payment nor offer compensation for contributed content. Send questions and submissions to Erika Randall, content manager, erandall@healthleadersmedia.com.
HealthLeaders editor Melanie Blackman is joined by Sara Criger, the senior vice president of Allina Health operations and acute care services. During the conversation, Criger, who was promoted to her...
Once considered the health plan for privileged people, concierge medicine is enjoying a rebirth, using technology and data to create 'personalized, proactive, and preventive' care for anyone who needs it.
The evolution of personalized healthcare is giving new meaning to concierge services. What once was a platform for the rich and famous now offers precision healthcare, including chronic care management and health and wellness services, for anyone.
"We're optimizing health for everyone," says Rakesh Suri, MD, D.Phil., president and chief medical officer of Fountain Life, a Florida-based provider of "predictive, preventative, and personalized" care services that aims to create an international chain of healthcare centers. "We're focusing on the healthy years of life."
Concierge medicine encompasses a variety of terms, like boutique medicine, retainer-based medicine, platinum practice, and direct primary care. Generally, the organization contracts with a consumer or group, such as a company or health plan, for a fee to provide healthcare services.
Some health systems are launching their own concierge medicine programs. Tampa General Hospital recently opened TGH Concierge Health to offer residents of Florida's Palm Beach County and Treasure Coast personalized access to primary care services.
“If someone isn’t feeling well, they don’t want to wait for the next available appointment,” Laurie P. Rothman, MD, the first doctor to join the new program, said in a press release. “In addition to more time, my patients will also have increased access. If there is an emergency or they are sick, and it’s 9 o’clock at night, they can call me or text me and we’ll be able to talk it through and make a plan.”
But while some see this popular trend as paying for access to healthcare, others see the opportunity to create programs for personalized care that go beyond what a doctor or hospital can do.
Suri, who spent 12 years at The Mayo Clinic and seven years at The Cleveland Clinic, most recently as chief executive officer of its Abu Dhabi site, before joining Fountain Life in October 2022, says the concept of concierge care has undergone a make-over, so much so that he doesn't like that term. What Fountain Life and other sin this space are doing, he says, is developing "personalized, proactive, and preventive care."
Rakesh Suri, MD, D.Phil, president and chief medical officer at Fountain Life. Photo courtesy Fountain Life.
"We're taking concierge care and advancing it upstream," he says. Traditional health systems "focus more on care of the unwell. We start with the healthy person and use advanced diagnostics to focus on preventive health … [and] prevent catastrophic events."
Organizations like Fountain Life may very well fit into the health system of the future, where hospitals would evolve to focus on the most critical cases and medical practices, retail healthcare sites would take care of episodic, not-acute needs, and medical practices, specialists, and other clinics would focus more on ongoing health management.
Suri says Fountain Life fits into that ecosystem, and would form partnerships with health systems and other organizations to optimize a patient's healthcare journey. New technology, like digital health and AI, are being used not only to help people deal with ongoing health concerns, but identify and manage future issues.
"It's not the newest, brightest shiny object alone," he says, but an integrated and scalable platform that, much like the design of a value-based care system, focuses on overall health rather than periodic issues. In doing so, they're focusing on "the pre-symptomatic population."
"We are and will continue to be on the cutting edge of innovation," he says. "And it's all about the data. All of this is poured into a very sophisticated version of a data lake."
The company's business plan sounds very much like a concierge medicine organization, with high-tech, attractive centers now located in Naples, Florida; White Plains, New York; and Dallas. The company's website lists future centers in Lake Nona, Florida; Santa Monica, California; Toronto; Dubai; and New Delhi, India.
Suri says the company's plan is to create a network of clinics that collaborate with local health systems and providers.
"Mainstream health right now is reactive, and perhaps unsustainable," he says. "The escalating cost of healthcare is straining [traditional] health systems, who are operating on razor-thin margins. On top of that, insurance companies are asking providers to take on more risk, and corporate entities are seeing their employees ask to provide healthcare services for them."
The massive consumer electronics show returns to Las Vegas in January with a renewed focus on consumer-facing technology that personalizes and improves the healthcare journey.
CES 2023 kicks off next week in Las Vegas, shining a spotlight on the consumer electronic industry and bringing renewed attention to the growing influence of digital health.
What once was a small corner of one exhibit hall at the Las Vegas Convention Center exhibiting early smartwatches and fitness trackers will now be found throughout the massive conference. Digital health has been integrated into smart home devices that track daily activities alongside room temperature, lights and visitors at the front door; as well as in electronic games and home entertainment platforms. It's in TVs that can connect to the internet and enable connections with family, friends and caregivers, and new cars that can monitor a driver's health.
Virtual and augmented reality (VR and AR) will be featured prominently in Vegas this year, as will AI and robotics. And expect remote monitoring tools and platforms to make their presence known in wearables that track a wide range of vital signs and activities and the aforementioned smart home technology. In short, while healthcare was once a side benefit or add-on to consumer electronics, it's now part of the form and functionality.
The event, one of the largest in the world, is becoming increasingly popular to healthcare organizations as well.
Consumer-facing technology was once kept at a distance from healthcare providers who felt that the technology wasn't reliable or accurate enough to be used in clinical situations. But as forward-thinking organizations began using smartwatches and other wearables to track activity and trends, and as the technology becomes more sophisticated, with some achieving clinical-grade status, the landscape is now crowded with health systems and providers looking for new opportunities to connect with and manage care for patients outsider the hospital, clinic, or doctor's office.
Expect that trend to continue, as the healthcare industry looks to become more consumer-centric and providers of all sorts look to establish new connected health experiences.
Among the special events scheduled at CES 2023 is "The Future of Care in America: A New Hybrid Model," featuring Carlos Nunez, MD, chief medical officer for ResMed as the moderator and panelists Anne Docimo, MD, UnitedHealthcare's chief medical officer, Susan Turney, MD, MS, FACP, FACPME, CEO of Wisconsin's Marshfield Clinic Health System, Vidya Raman-Tangella, MD, chief medical officer of Teladoc Health, and Stephen Klasko, MD, MBA, former president and CEO of Thomas Jefferson University and Jefferson Health and now an executive in residence at General Catalyst.
Other panels of note will address virtual care and independent living, healthcare technology for seniors, sports technology, AI and digital health, self-tracking, hybrid care, bridging gaps in care, the future of at-home testing and diagnosis, and smart cities in health.
Also of note: HealthLeaders Senior Editor of Innovation and Technology Eric Wicklund will moderate a panel on "Data in the Age of Public Health Emergencies," featuring Alexander Garza, MD, chief community health officer at the St. Louis-based SSM Health System, Deven McGraw, former deputy director of health information policy for the HHS Office of Civil Rights and co-founder and chief regulatory officer for consumer health tech company Ciitizen, and Lee Schwamm, MD, vice president of patient experience at Mass General Brigham.
