Continuous Connected Care with Summer Knight of Deloitte Consulting
Episode 19816th March 2020 • This Week Health: Conference • This Week Health
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 Welcome to this week in health events where we amplify great thinking with interviews from the floor. Although we aren't getting as many steps in this week, uh, we're still gonna continue doing the interviews. Special thanks to our channel sponsors, Starbridge Advisors, he lyrics Galen Healthcare, VMware, and Pro talent advisors for choosing to invest in our show.

My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It. Set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. You know, a lot of healthcare happens between visits to care settings, and that is what we're gonna talk about today with Summer Night Managing director in Deloitte Consulting's life sciences and healthcare practice, where she leaves the, uh, virtual virtual health product portfolio as well as virtual health platform enablement practice.

As only a consulting firm can do, your titles are amazing. Good morning, summer, and welcome to the show. Good morning, bill. Thanks for having me. And I think you can get your steps in it. You know, you just have to be outside in nature a little bit more. Well give us, give us some background on your practice at Deloitte and, and we'll start there before we dive into virtual health.

Yeah, absolutely. So, um, have been just really enjoying all of the efforts that our team does at Deloitte. We, um, our, our virtual health, um, product platform, and what we do is that we have a comprehensive approach to virtual health and helping our clients be able to set up a virtual healthcare system.

What does that mean? That that means being able to bring technologies, both, um, converge Health Virtual Technologies, which is the Deloitte, um, technology, um, products, as well as our alliance partnerships to bring a. Comprehensive best in class solution to our clients to really help them to enable virtual health as part of their care delivery transformation to meet their business needs.

Well, back back in:

And a lot of health systems have expanded into retail, but the promise of digital has always been to be able to do that a again, to, uh, increase the number of touch points, uh, between visits and really the informed care team. Uh. To, uh, to do a lot of things right, to improve outcomes, to, uh, increase awareness to, uh, you know, just generally improve the quality of health in the community.

re talking about that back in:

Yeah. And, and, and you know, when framing, framing that, that question, um, oftentimes I might be in a mixture of, um, of. Folks who are clinicians like myself and, um, technology experts like yourself. So oftentimes I'll, I'll, I'll say we were joking about this before we even went online is, um, with a group of clinicians.

I am, I'm very tech savvy and with a group of technologists. I am a very clinical savvy. So one of the things to just kind of set the stage is to think about digital health. In three areas that we're hearing quite a bit in the health IT space. So we hear about, um, and, and then also to determine what is hype and what's actually happening.

So we hear quite a bit about, um, about. Integration and data. We're hearing about analytics and we're hearing about virtual health, and I, I, I think about that as the three main pillars, at least in my world, around digital health and, um, from a, from the perspective of what organizations are, have been focusing on.

I think y'all agree that it's. Been a lot around integration and how to manage and move data around. And then in that second, um, pillar, uh, and we've seen a lot of activity in that space and a lot of progress. Um, and then in the second, the second, um, leg of that stool, um, the analytics. So we're beginning to, now that we have better control over that data, um, beginning to, um, learn how do we.

Take that information and make it actionable through our analytics, AI and ml. Um, and then the, and, and that's an area that can really improve our, our, um, the, the information action, not just for clinicians like myself, but also for healthcare consumers. And help us to reach people, um, just in time or at a moment where they're making a decision or at a moment where they're ready to make change in their lives, um, which can be correlated to a major health impact unfortunately happening, um, um, to them.

And then third, we've heard a lot of hype, um, but not as much action in the virtual health. Space. I think we're right on that tipping point, um, from a predominantly bricks and mortar, um, situation. That's, um, also has been challenging from a reimbursement perspective to actually having this mixed, um, virtual and, and, and, and in-person, um, experience, uh, for, for the healthcare system.

What, what, what, what keeps the reimbursement from, from really leading the way? What keeps the, because you know, if the funding's there. Virtual is going to explode. Is, is what I believe. I mean, is, is, is that, I agree. So what's, what's keeping that from happening? Um, well, uh, I, I think there's a lot of levers, so.

In the model that makes sense is when, um, when the providers, the clinical teams, and when I talk about clinical teams in virtual, there is a significant re-engineering of those teams, which we can hit on in just a few minutes. Yeah. Um, but they need to, um, they need to be able to work in an ecosystem where they have, um, where they have the capability of.

Choosing whether virtual health interaction versus an bricks and mortar interaction is the most appropriate to best serve that patient and best serve the situation at hand. Currently, our, the majority of our reimbursement model is such that, um, in order for that clinician or that clinical team to be paid for at an amount that.

It has to be in the bricks and mortar. There are some provisions that allow, um, allow care to occur virtually. Um, and there's been, uh, some wonderful, um, movement in that over the past couple of years. Um, we've seen rural virtual care reimbursed. On a national level, we've seen, um, indicators for, um, remote patient monitoring.

That's when a patient, um, will have a device that then that biometric information feeds into a system. Um, so we've seen, um, we've seen, we've seen some movement there and we've. Seen some movement definitely in situations where, um, where the clinical team is part of the risk of managing a patient's overall life.

And so that's often returned, referred to as risk-based, um, agreements. Um, and, and can be seen in, in bundles and in in other types of, um, uh, uh, a patient medical home. Um, uh. Opportunities. So, so summer, that's a, so the first, uh, roadblock we get to is, is financial. The second roadblock we get to is Mm-Hmm, , this re-engineering you're talking about there's a significant cultural change and, and, you know, what have you seen in terms of, uh, organizations that have been able to, to make that change and what have, what are they doing?

Yeah. You know, it, it, it is a huge cultural change. So one of the things that, uh, I think many people think about is the technology. You know, can the technology work and the technology has really been around for a while and think about, we've been having video conferences. For quite some time. We've been passing data over the internet for quite some time and so I, you know, I always like to say technology's there maybe, um, the analytics are still growing.

Um, the, you know, the new cutting edge, you know, technology's moving so fast that we are. We are going to be doing it better and better. Faster. Faster and, um, with, with, you know, better outcomes. Um, and, and so, but when we make these shifts into, um, integrating virtual health into care, um, there's so much more and culture is a huge piece of that.

Um, also there's workforce change. And so when I think about virtual health. I think about really a comprehensive, um, continuous therapeutic alliance that we're able to, um, to create between the health team and the home team. I think about the home team as the healthcare consumers to the patient and their natural support network of family, friends, and volunteers.

So that really extends the dec definition of who that healthcare consumer is. And then the health team is actually, um, in the past has been built on, built around a physician, so say for myself, and then an entire team wrapped around that with nurses, nutritionists, exercise physiologist. Um, case managers, et cetera, in this new world.

We're gonna be testing new BO models around that, around what that health team looks like, and really who, who is the, um, quarterback, I guess, for, uh, for better, better word of that team. Um, will that, will that quarter, you know, right now we think about that quarterback as being the physician. But as we move to, um, to caring for more and more people on a population based level, and we also struggle with the number of clinicians that we might have in ratio to patients, we have to start to think about using this technology to be able to move people to the top of their licenses and also rethink the team.

So in the future, it may be that the care coordinator and the care manager are really the, the, the, the, the middle of the team and. Physician and they pull in the nurses and the nutritionists as, as that patient, um, needs. And who knows, maybe based on as we help move the, uh, control of, um, the healthcare more and more towards the consumer, maybe that consumer will start to be able to take more an integrated integral role.

Um, really, uh, definitely in that health and wellness space where we're seeing people who are interested moving into that. Space. And then as we're able to meet people in their chronic conditions and really help to educate them and, and nudge them, um, they can even take a, a more active role and a leading role, um, in, in those situations as well.

So it'd be really interesting to see how this whole Health team home team integrates as we leverage all these technologies. So. Big cultural changes, um, in the future, um, that, that will be interesting to see how they unravel and how they evolve and how roles such as mine as a physician, um, will be part of, of their lives.

But hopefully we'll continue to create this therapeutic alliance, which is built on a continuous longitudinal connectivity, built on trust and optimizing healthfulness even when somebody is impacted by a chronic condition. Health team and home team. I'm gonna take that. That's, I'm gonna steal that. I'll give you credit every now and then.

It's yours, . Um, but that's, that, that integration's interesting, but, uh, I, I wanna get to the last roadblock and it's me, right? So it's the, it's the consumer of health is the last roadblock. And, and, and I wanna give you permission to talk a little bit about some of the tools that you guys have. You, you need to engage me, you need to keep me from eating at McDonald's.

You need to get me up and moving. You need to get me. You know, uh, when I'm potentially sick, instead of going into work interacting with my care team virtually. So what are we, what are we gonna do to engage me the consumer of health? Yeah. So, you know, right now the majority of folks will run to, um, to, you know, with the cliche is Dr.

Google. Don't be offended. Google fans, I love Google. Um, but will run and get information and that info or talk with, um, neighbors and friends. Um, and that information, um, can be fraught. Misinformation. Um, and so what we really want is for the healthcare consumer to have the best, most accurate information that really works to, for their situation and their constellation of, um, disease situations, genetics, um, past history, family history, et cetera.

So really more of a. Uh, precision medicine perspective. And to do that, we, we really need to create, um, and this is where I was talking about that therapeutic alliance, and that's why I think technology can be so powerful and all of the learnings that we have from consumerism and consumer marketing and, and app, um, apps and how people interact with their phones.

And, and so, um, what, what we, what what we've created is really this. Um, new perspective on a virtual healthcare system where, um, what would it look like if we, um, didn't have the bricks and mortar except in very specific, um, times such as specific types of surgeries. And, um, in, in, um. Areas of care that required, you know, um, bricks and mortar centers of excellence.

And then if we did that and we built that system around the healthcare consumer, um, as we previously defined in creating a continuous, long longitudinal relationship, that would mean that at, at all times that we are actually moving through that individual's life. Because remember. It, it right now in the current transactional healthcare, um, space, we get to see a patient if they're healthy, um, maybe a few minutes of their entire year, if we're lucky.

Um, if they have a chronic condition, maybe four times a year. Um, so that's, it's very hard to impact them. But if we are with them all the time with technology, such as, um, solutions that we've built, um, called myPath for Connected Care, which is, um, a solution that's built on a hub that, um, is integrated with the patient's, um, uh, uh, smartphone.

It's integrated, um, with. Their records, it's integrated with other systems that, um, that they might want to, uh, connect with, um, such as Amazon. And then being able to, um, being able to move, you know, move, move through that. Uh, with that connection as they have needs, they can communicate with their health team and then we can also, um, communicate them with them nudges and therefore when chronic condition.

Turn to that, um, that connection through their application, um, through other omnichannel capabilities and being able to, um, to, to to, to turn to their health system, let's say brand, um, on a regular basis and get their needs met. Which is very different than what they're able to do at this point when they have to call, um, wait for, uh, uh, wait for somebody to call back, make an appointment, um, uh, sit in a waiting room, et cetera.

Absolutely. And I, you know, it's, as you're talking about, I, I, I sort of wanna go into a big brainstorming session on what we should do here, but the, it's because it's interesting to me with the, with the final rule coming through, I think you're gonna start seeing patient centric, consumer health centric, uh, data stores.

Those data stores are gonna have more access to data, right? So I'm able to bring in all my Amazon purchases, all my Google search history, all my, you know, fill in the blank, my, uh, swipe card at Ralph's grocery store, whatever. So I'm able to bring all that data in. And when you talk about a virtual health system, I'm almost thinking.

You know, there's now this, this potential for either existing health systems to play this role or new entrants to play this role where I give them all my data. They, they are able to go through all that and say, look, we're gonna, we're gonna help you with the behavioral change that you need. That's what I need.

I need behavioral change. I need to walk more, I need to exercise more. I need to eat less. I need to, you know, hike more, whatever I need to do a, a whole host of things. Yeah. And I think that data tells 85 to 90%. Yeah. 85 to 90% of your health has to do with the choices that you're making. That's correct.

So how are you gonna integrate? And this is my last question by the way, 'cause we're already three minutes over . I apologize, . But my last question is, how are we gonna, because there's really powerful stuff around behavioral change and are we gonna start integrating that stuff into these digital tools where it's, it's actually looking at our persona, a deep look into our persona and recognizing what causes me to change versus what causes you to change.

Yes, we are. And that's actually, um, a lot of people ask me why I'm so proud to be part of the Deloitte team. And part of it is because as a convener, we, um, we know that we don't have all the answers. Um, believe it or not, , there's, there's a, a lot of, so many amazing people, um, and experts in the firm. Um, but also what we have.

Created an amazing network of alliance partners and that gives us the capability using our virtual healthcare system hub to be able to work with some of these best, um, best in class alliance partners. And they can be anywhere from big tech all the way through brand new startups that are just starting to leverage, um, cutting edge technology in order to bring some of those best in class.

Um. Solutioning. Um, and you gave a great example. There's some really amazing, um, behavioral health, precision health solutions leveraging ai. Um, that can really change that, um, conversation that we're having in healthcare by pulling in that data, uh, um, and then advising and, and those systems get smarter and smarter.

And so being able to integrate that into our. Um, and to our solution in order to offer our clients a comprehensive offering that really benefits that healthcare consumer and helps that healthcare consumer become part of the, the solution and therefore decreasing their risks around health. Um, and improving proving their outcomes, um, really is the winning structure.

So I, I think if, as you said, we're, we're, we're rounding up our conversation, I. That anyone at Deloitte would say that it's, um, that we are part of a solution with an ecosystem of partners, with our clients, with our, um, with, with our alliance partners to really help solve this problem together. Um, and so, uh, and, and, and, and to make the lives of healthcare consumers and healthcare clinicians, um, just so much better, um, as we evolve to this future of.

Really excited to be part of that and excited to be, um, talking to you as well, bill, about all that's possible in New World. Yeah, this is, this is, this is exciting stuff. Uh, thanks Summer for coming on the show. Is there any way people could get more information on this stuff you're, you're talking about here?

I. Yeah, absolutely. So, um, so on our Deloitte, uh, website, uh, we have Converge Health, which is a really great way, um, to look up information. We also have some, um, blogs that, um, I've been putting out. Um, and you'll, we're gonna see a big increase in that, um, from a virtual health perspective, um, uh, rolling out as well.

So. Connect on LinkedIn and I'm, I'm also gonna do a shameless plug, is that, um, we're publishing a book called Humanizing Healthcare. Um, of what, what I worked on is my own experience, um, in the healthcare system with one of my dear family members and how we navigated that and how it really. Impacted my life in a way, um, that shifted, um, all of my activities.

Um, and, uh, and, and actually landed me here around trying to, um, do care delivery transformation. So that's called, um, humanizing healthcare. So look for that coming out as well. Um, and so it, it, hopefully this experience was good for you. 'cause I, I'd love to interview you after the book comes out and just talk through the book.

That would be great. That would be great. It would, it would be such an honor. Thank you so much. Don't forget to check back multiple times. This week. We're dropping a bunch of hymns episodes. We're not walking the floor, but we are interviewing, uh, a bunch of people. So please check back. This show's production of this week in Health It.

For more great content, check out the website this week, health.com or the YouTube channel. Thanks for listening. That's all for now.

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