Digital health revolution: What we’ve learned so far

The effectiveness of digital health devices is being called into question by recent studies. Digital health devices provide personalized feedback to users, helping improve their health. Read this blog post to learn more.


The promise of the digital health revolution is tantalizing: a multitude of connected devices providing personalized feedback to help people improve their health. Yet, some recent studies have called into question the effectiveness of these resources.

While still evolving, many compelling use-cases are starting to emerge for digital health, including a set of best practices that can help guide the maturation of this emerging field. In the near future, many people may gain access to individual health records, a modern medical record that curates information from multiple sources, including electronic health records, pharmacies and medical claims, to help support physicians in care delivery through data sharing and evidence-based guidelines.

As these advances become a reality, here are several digital health strategies employers, employees and healthcare innovators should consider.

Micro-behavior change.

Part of the power of digital health is the ability to provide people with actionable information about their health status and behavior patterns. As part of that, some of the most successful digital health programs are demonstrating an ability to encourage daily “micro-behavior change” that, over time, may contribute to improved health outcomes and lower costs. For instance, wearable device walking programs can remind people to move consistently throughout the day, while offering objective metrics showcasing actual activity patterns and, ideally, reinforcing positive habits to support sustained change. Technology that encourages seemingly small healthy habits — each day — can eventually translate to meaningful improvements.

Clinical interventions.

Big data is a buzz word often associated with digital health, but the use of analytics and technology is only meaningful as part of a holistic approach to care. Through programs that incorporate clinical intervention and support by care providers, the true value of digital health can be unlocked to help make meaningful differences in people’s well-being. For instance, new programs are featuring connected asthma inhalers that use wirelessly enabled sensors to track adherence rates, including frequency and dosage, and relay that information to healthcare professionals. Armed with this tangible data, care providers can counsel patients more effectively on following recommended treatments. Rather than simply giving consumers the latest technologies and sending them along, these innovations can be most effective when integrated with a holistic care plan.

Real-time information.

One key advantage of digital resources, such as apps or websites, is the ability to provide real-time information, both to consumers and healthcare professionals. This can help improve how physicians treat people, enabling for more customized recommendations based on personal health histories and a patient’s specific health plan. For instance, new apps are enabling physicians to know which medications are covered by a person’s health plan and recommend lower-cost alternatives (if available) before the patient actually leaves the office. The ability to access real-time information — and act on it — can be crucial in the effort to use technology to empower healthcare providers and patients.

Financial incentives.

Nearly everyone wants to be healthy, but sometimes people need a nudge to take that first step toward wellness. To help drive that engagement, the use of financial incentives is becoming more widespread by employers and health plans, with targeted and structured rewards proving most effective. From using mobile apps and comparison shopping for healthcare services to encouraging expectant women to use a website to follow recommended prenatal and post-partum appointments, financial incentives can range from nominal amounts (such as gift cards) to hundreds of dollars per year. Coupling digital health resources with financial rewards can be an important step in getting — and keeping — people engaged.

The digital health market will continue to grow, with some studies estimating that the industry will exceed $379 billion by 2024. To make the most of these resources, healthcare innovators will be well served to take note of these initial concepts.

SOURCE: Madsen, R. (14 March 2019) "Digital health revolution: What we’ve learned so far" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/digital-health-revolution-what-weve-learned-so-far?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


New resource offers guidance on digital tools for diabetes management

Are you considering implementing digital diabetes tools or solutions in your employer-sponsored benefits? Read this blog post for the Northeast Business Group on Health’s updated guide on diabetes management tools.


The Northeast Business Group on Health has updated its “Digital Tools and Solutions for Diabetes: An Employer’s Guide,” to include both enhanced and new solutions—and promising future innovations—to help employers help their workers better manage their diabetes, lower costs and ultimately save more lives.

“Employers are well aware of the costs associated with diabetes in their employee and dependent populations—they continue to indicate this is a top concern and are increasingly aware of the links between diabetes and other chronic and debilitating health conditions, including cardiovascular disease,” says Candice Sherman, CEO of NEBGH.

The market for digital diabetes prevention and management solutions continues to mature since the group published its first guide in 2016, Sherman says. The updated guide provides a detailed checklist of the features and functionalities of the digital tools available now to manage diabetes, as well as information on several unique and innovative digital diabetes solutions that are being targeted to employers but were not part of NEBGH’s research, including Proteus Discover, BlueLoop and do-it-yourself programs.

“Proteus Discover is comprised of ingestible sensors, a small wearable sensor patch, an application on a mobile device and a provider portal,” the guide cites the provider. “Once activated, Proteus Discover unlocks never-before-seen insight into patient health patterns and medication treatment effectiveness, leading to more informed healthcare decisions for everyone involved.”

“BlueLoop is the one and only tool that allows kids and their caregivers to log and share diabetes information—both online and with the app—in real time, via instant e-mail and text message, giving peace of mind to parents,more class time for students and fewer phone calls and paper logs for school nurses,” the provider tells NEBGH. “Online, parents can share real-time BG logs with their clinicians, who can see logs (in the format they prefer), current dosages and reports, all in one place.”

The guide also hints at promising future innovations:

“Technology is constantly evolving: by connecting sensors, wearables and apps, it is increasingly possible to pool and leverage data in innovative ways to provide timely interventions so that people with diabetes can be truly independent and effectively self-manage their care,” the authors write.

The guide lists a hypothetical scenario: A person with diabetes enters a restaurant where a GPS sensor identifies the location, reviews the menu and proposes the best choices based on caloric and carbohydrate content. The technology also proposes and delivers a rapidly acting insulin bolus dose based on the person’s exercise level that day and prior experiences when eating similar meals.

Also included are key questions for employers considering implementing digital diabetes tools or solutions, including:

  •  What does the company want to achieve with a digital tool?
  • How much is the company willing to pay?
  • How will success be measured?
  • How will digital solutions and tools be marketed to employees and their families?
  • What privacy issues need to be addressed when tools or solutions are implemented?

“Digital health tools hold the promise of improved health outcomes and reduced health care expenses through improved engagement, better collaboration and sustained behavior change,” says Mark Cunningham-Hill, NEBGH’s medical director. “However, digital diabetes solutions are not a panacea. Employers will need to address several obstacles such as the difficulty of recruitment and enrollment, lack of sustained employee engagement and the cost of deployment of digital solutions. This can be accomplished through careful planning and learning from other employers that have successfully implemented these tools.”

SOURCE: Kuehner-Hebert, K. (4 December 2018) "New resource offers guidance on digital tools for diabetes management" (Web Blog Post). Retrieved from https://www.benefitspro.com/2018/12/04/new-resource-digital-tools-for-diabetes-management/


Bettering Health Plan Management Through Modern Healthcare Technology

Taking advantage of modern technology is part of the reason why Hierl excels in providing the best results for our clients. In this installment of CenterStage, we asked our Executive Vice President, Scott Smeaton, to give an in-depth overview of how we use our technological resources to create customized, high-quality, low-cost health plans for our clients.

Technology and Data

There are three steps to developing plans for our clients, when using technology and data. The first step is to identify the client’s cost drivers within their health program(s). For example, we may look at a client’s claims data and find their highest dollar claims are musculoskeletal – such as hip and knee replacements – identifying whether health plan members are going to the higher cost, lower quality provider. These are becoming much more prevalent and are among most plans top cost drivers. With the technology at Hierl, we can import our client’s data – medical and prescription claims and health screening results from wellness – and aggregate it into one technology platform. Doing so, will help keep our clients’ members updated on physician requests and advice.

Competitive Advantage

The second step beyond identifying our client’s cost drivers is to implement management programs and plan designs to address their health plan issues. This kind of technology is newer to the healthcare industry. It can be a great resource and tool that larger employers can use to their advantage. Think about Netflix. They analyze their viewer’s behaviors and apply predictive modeling in a way that they know what their viewers like to watch and when they want to watch it, incorporating those preferences into the ads their customers see. That kind of technology is coming to healthcare, allowing us to look at all claims and behaviors and predict where the next large claim will come from. This helps plan administrators fully understand what’s driving their health plan costs and do something about it through plan design changes, provider relations and contracting, member incentives, and member education and engagement.

Employee Betterment

After identifying areas that can be improved upon and creating a plan to address these cost drivers as discussed above, our third and final step is to create a communication program that will engage and educate employees. Our goal is to help employees understand that, within a healthcare system, there are some providers who perform better than others and cost less. When we give employees the tools and resources they need to be better healthcare consumers, everyone wins. Employer sponsored health plans have lower overall costs. This means their employees and their families lower their out-of-pocket costs, save healthcare dollars for the future, and have better outcomes. Not to mention that a happier, healthier employee is also a more productive employee at work and in the community. Hierl accomplishes this with our “Why Matters” program, which is a custom designed, year-round member education and communication program using a variety of mediums to reach our clients’ members. Through Why Matters, Hierl builds a custom (intranet) and mobile app for our clients to access basic information about their benefits 24/7. Think of it as a homepage to one of your favorite websites that you bookmark in your browser. This is where your members go to research, make decisions, educate themselves on your benefit offerings and how to be a better healthcare consumer. Based on the cost drivers identified through the process above we build out a 12-month calendar of communication materials specifically addressing the areas we’ve identified as a concern and can be delivered via paper, email, mobile app, etc.

Hierl strives to bring our clients the best possible solutions that result in high-quality, low-cost benefits. If you think your company needs to take this step toward improvement, please contact Scott Smeaton at 920.921.5921 or send him an email at ssmeaton@hierl.com.


Are Virtual Doctor Visits Really Cost-Effective? Not So Much, Study Says

As the virtual world expands, it raises a question: at what point does it take away from the user experience? In this article from Kaiser Health News, we take a look at a study presenting facts on how virtual healthcare may be an issue rather than a convenience. Read further for more information.


Consultations with doctors by phone or video conference appear to be catching on, with well over a million virtual visits reported in 2015. The convenience of “telehealth” appeals to patients, and the notion that it costs less than an in-office visit would make it attractive to employers and health plans. But a new study suggests that while telehealth services may boost access to a physician, they don’t necessarily reduce health care spending, contrary to assertions by telehealth companies. The study, published Monday in the journal Health Affairs, shows that telehealth prompts patients to seek care for minor illnesses that otherwise would not have induced them to visit a doctor’s office. Telehealth has been around for more than a decade, but its growth has been fueled more recently by the ubiquity of smartphones and laptops, said Lori Uscher-Pines, one of the study’s authors who is a policy researcher at the Rand Corp., a nonprofit think tank based in Santa Monica, Calif.

These virtual consultations are designed to replace more expensive visits to a doctor’s office or emergency room. On average, a telehealth visit costs about $79, compared with about $146 for an office visit, according to the study. But it found that virtual visits generate additional medical use. “What we found is contrary to what [telehealth] companies often say,” Uscher-Pines told California Healthline. “We found an increase in spending for the payer.” The researchers found that only 12 percent of telemedicine visits replaced an in-person provider visit, while 88 percent represented new demand. The researchers examined 2011-13 utilization data of 300,000 people enrolled in the Blue Shield of California Health Maintenance Organization plan offered by the California Public Employees Retirement System, which covers current and former state employees and their families. CalPERS’ Blue Shield HMO started offering telehealth services, available 24/7 to its beneficiaries, in April 2012.

The researchers focused on virtual visits for respiratory illnesses, which include sinusitis, bronchitis, pneumonia and tonsillitis, among others. While a single telehealth visit for a respiratory illness costs less than an in-person visit, it often results in more follow-up appointments, lab tests and prescriptions, which increases spending in the long run. Liability concerns may prompt telehealth physicians to recommend that a patient go in for a face-to-face appointment with a doctor, the study notes. Researchers estimated that annual spending for respiratory illnesses increased about $45 per telehealth user, compared with patients who did not take advantage of such virtual consultations. Jason Gorevic, the CEO at Teladoc, the operator that provides telehealth services for CalPERS Blue Shield members, said the new study doesn’t square with Teladoc data showing the cost savings of telemedicine.

According to 2016 data, Gorevic said, only 13 percent of Teladoc visits represent new medical use. He noted that the Rand study uses older data, and that many things have changed since then — including the technology, the rate at which these services are being adopted and patient engagement. “In fact, other more comprehensive studies — using six times the amount of claims data including the same population as the [Rand] study — have found tremendous value of telehealth, with consistently repeatable results,” Gorevic said. These other studies have shown that telehealth decreases overall health care spending, he said. But Uscher-Pines said the Rand findings were not surprising.

When Rand researchers studied retail clinics last year, they found that making access to health care more convenient triggers new use and additional costs. That study found 58 percent of visits to in-store clinics represented new use of medical services rather than a substitute for doctor office visits. Yet the fact that telehealth services are more affordable per visit than a trip to a physician’s office shows that there is still a pathway to cost savings, Uscher-Pines said. To achieve cost savings, telehealth services would have to replace costlier visits, the researcher said. Insurers could increase telehealth visit costs for patients to deter unnecessary use.

Another way to increase the health system value of virtual doctor visits is to target specific groups of patients — such as those who often use emergency rooms for less severe illnesses. An emergency room visit costs an estimated $1,734. “You could take these people in the emergency department and offer them this cheaper option. That would be a direct replacement,” Uscher-Pines said. Gorevic said that a challenge for telehealth is engaging consumers, so the comparatively low fees provide a financial incentive. “Because a telehealth visit is much cheaper than an in-person visit, the cost sharing should be reflective of that,” he said.

Marcus Thygeson, senior vice president and chief health officer at Blue Shield, which also provides virtual doctor visits through Teladoc, in a statement said that “increased convenience can increase utilization, so overall healthcare costs may increase or stay the same. Blue Shield supports the use of telemedicine to improve access for both primary and specialty healthcare, especially in rural communities.” The researchers noted several limitations to the Rand study.

For example, researchers examined only one telehealth company and studied only visits for respiratory illnesses. In addition, the patients whose data were scrutinized had commercial insurance, and it is possible the use of telehealth would differ among people with government insurance, high-deductible plans or no insurance at all, the study said.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Written by: Ana B. Ibarra