Innovation in Care Management

Digital health innovations - from wearable sensors and portable diagnostic technologies to telemedicine tools and mobile health care apps – all have the potential to transform our country’s health care delivery system by empowering consumers to play an active role in their care and, more importantly, define what services are important to them.

These innovations may also help health care providers and insurers analyze a growing body of data about clinical experiences to identify unmet needs and measure treatment outcomes. The aim is that interventions could be tailored to a patient’s unique characteristics and situation. Since digital health tools can be used to engage consumers between office visits and in the course of their daily lives, these innovations may become a catalyst for individual behavior changes needed to improve health outcomes.

The need to constrain health care spending and the proliferation of payment models that hold health care providers accountable for the quality and costs of care have led to an increased interest in technology-enabled care tools. 

One major area that clinicians, developers, and entrepreneurs need to focus is the needs of patients with complex and life-limiting medical conditions. The majority of health spending is attributable to the patients with these complex conditions, and there is substantial room to improve their care and outcomes. The care support models in use today by most health plans are vintage designs created over 20 years ago when care management was more about controlling utilization than consumer engagement and empowerment.  These aging care management models create antagonistic relationships between payers and providers and do little to engage the patient in the process of decision-making.

I believe that if we focus our innovation efforts to redesign these vintage care management models (as I am doing with Narus Health) we can create new care models that will not only enhance the quality of life for these high-need patients; but will also have a spillover effect -benefiting healthier patients as well. I also believe that, if designed properly, these new care support models will help us move toward the creation of a new health care economy based on enhancing the efficiency of the health care workforce and providing consumers convenience and value, while empowering them to take charge of their own health.