A independent report on the UK care technology market was released earlier this month which has both UK and international implications. Commissioned by Essex County Council and produced by Socitm Advisory, it is must reading for those engaged in the procurement and development of local care technology. In a wider sense, the study is part of a larger international trend around community-based health and wellbeing, data utilization and digital tools to promote self-care, mitigate acute illness, and better management of chronic conditions, including social determinants of health (SDH). Digital tools are integrated into care and measured on enabling outcomes, versus being ends in themselves as they tend to be today.
The envisioned emerging care technology solutions framework looks like this: Adrian Scaife of Alcuris Ltd was kind enough to send a link and review copy of this study to this Editor, the link which we are pleased to provide to our Readers. (Download it from Socitm’s website.) He has written a blog post in HousingLIN, Is it time for the next generation of telecare?, which provides a more detailed analysis of the 52-page study and its implications.
Crap Game (Don Rickles): Ya make a DEAL!
Big Joe (Telly Savalas): What kind of a deal?
Crap Game: A DEAL DEAL.
—Kelly’s Heroes (1970), on getting the German Tiger tank and commander to help them in their bank heist
A $37 bn deal, that is. Announced on the Friday before the US Independence Day holiday (a day which may define media ‘black hole’), Aetna and Humana announced either their merger or the acquisition by the former of the latter, depending on what account you read. If approved by the Feds, the combination of #3 and #4 insurers (by revenue) respectively will exceed 33 million insured, making the combined entity #3 in insured individuals (after UHG and Anthem) and #2 in revenue. The announcement also stated that Louisville, Kentucky, Humana’s current headquarters, will continue to manage the Medicare, Medicaid and military Tricare businesses. Both are in Medicare Advantage, which is problematic due to market share and anti-trust considerations in at least four states, according to Reuters. (Humana has about 20 percent of national Medicare Advantage private policies.) We’ve previously noted the unfavorable comparison to the end stages of airline deregulation–consolidation reducing competition and consumer-favorable pricing. No word on the future of the Humana brand and marketing, which has always been executed well.
As to the outlook for digital health support–the prognosis by this Editor of this combination is, in the Magic 8 Ball’s answer, ‘reply hazy, ask later’.
- Humana was known in the industry for being fairly open to opportunities and backed them with funding (Healthsense, Vitality, what remained of Healthrageous) under business such as Humana Cares. Humana at Home also owns a home care management company, SeniorBridge. Will this be of interest to Aetna in population health management, or an early ‘For Sale’?
- Aetna, by contrast, has pivoted several times. CarePass consumer apps was a patient engagement experiment that proved the point that policyholders don’t want apps from insurers. Healthagen (an acquisition) was first positioned as an ’emerging businesses’ skunkworks of sorts umbrella-ing over iTriage (now integrated into the parent), ActiveHealth, Medicity and other digital health/analytics related businesses, then scaled back in early 2014 [TTA 28 Feb 14]. Repositioned as ‘population health management, the ACO business dominates.
Various reports: Daily Mail, Forbes (which likes it not at all and sees none of the touted ‘economies of scale’) and the WSJ.
Reader and independent UK consultant Guy Dewsbury writes about an approach to health and social care delivery that gives staff more control, as well as accountability, and integrates mobile into not just tablets, but keeping care plans updated in real time.
Effectively it inverts the current care pathway, but potentially achieves a better quality of care, as frontline staff are not required to spend time updating records in an office because they are updated on the go.
Having a smartphone-based programme, in real time, allows the managers to be kept up-to-date on all their staff. The software could also help with reports and handovers ensuring the most up-to-date information on each person being cared for is available to the frontline staff coming on shift.
Empowering frontline staff with technology can mean more appropriate, timely care and a more resilient workforce who are happier as their worth is valued.
He’s been kind enough to give TTA readers access to his freshly published article in Care Management Matters.
Guy’s website here. Previously in TTA on the Dependability Assessment Tool for telecare.
Healthcare payer Cigna’s Healthspring Medicare plan unit has been piloting a congestive heart failure (CHF) care management program with Intel-GE Care Innovations in Tennessee to reduce same-cause hospital readmissions. The initial year-long 50-patient program is being expanded to 250 patients who have had a CHF diagnosis plus a previous ER visit or hospital admission. Patients are supplied at no cost a blood pressure cuff, a scale and the Care Innovations Guide on a tablet platform. Daily biometrics are sent to Cigna-HealthSpring nurse practitioners, and also complete an educational program to help them manage their CHF at home. After a 90-day minimum, once certain goals (e.g. weight loss, blood pressure and heart rate) are met, the patients stay in the program, the tablet is withdrawn but they continue to monitor and log their vitals with a case manager. What is curious about this seemingly anodyne (more…)
Prof. Michael Georgeff is the aforementioned rocket scientist (actually the Program Director for the Space Shuttle’s control software) who is now CEO of Precedence Health Care. The company has developed what they claim is the first-ever chronic disease management network, cdmNet, accessible via broadband and mobile. Instead of controlling the shuttle, cdmNet controls the workflow end-to-end from care plans to follow up including all documentation. It is part of the Collaborative Care Cluster Australia initiative and is also the core technology infrastructure for Australia’s Diabetes Care Project. Post-discharge and chronic disease management integration into hospital/practice workflows is of course a huge issue elsewhere in the world, and perhaps the solution is found Down Under. eHealthSpace.org