Cracking the Digital Health Code

Rachel Hall, EY's US Consulting Digital Health and Smart Health Experience Leader, joins us for this episode as we peel back the layers of digital health.

Rachel will give her take on the landscape and how each player, patient, physician, and healthcare firm fit into the ecosystem.

We also talk about something that's been on everyone's minds lately - and that's artificial intelligence.

A Transcript of the Podcast

Omar: Well, hello and welcome to Let's Talk Medtech. Thanks for joining, Rachel. It's always a pleasure when we have someone from EY to stop by.

Rachel: Thank you so much for having sure, sure.

Omar: I know we're delving into digital health, but that's such a broad term. Can you kind of put that in perspective for us for the conversation we're going to have today?

Rachel: Absolutely. And I love that you acknowledge that it is a broad term because it absolutely means different things to different people.

Omar: Exactly.

Rachel: When I'm thinking about digital health, what I'm really talking about is, first and foremost, consumerism and how we enable that with different digital technologies. When we think about digital health, we're always thinking about ways to improve the quadruple aim, so things like outcomes and safety access, experience for patients and care team and certainly reduction of.

Omar:  I want to go back to that for a second. I almost feel like we have to look at digital health through two different lens, B.C. and after know, right. BC is before COVID That's like an inside joke here on let's talk med tech. I say BC a lot. But if this is true, how has it changed since the onset of the pandemic? How is digital health evolving?

Rachel: Yeah, and I would completely agree with you that COVID was almost this great accelerator, even though it was a tremendous challenge for all of us across the globe, but it was a great accelerator as we think about digital health. And in that regard, what was happening before COVID is that we had a lot of niche solutions for different aspects of virtual care, and we had pockets of what I would almost call pilots for different ways to enable consumerism in care. When COVID happened, people were no longer apt to go into physical care settings to provide their care. And so virtual care became something that had to scale immediately. And so what organizations had in terms of virtual care, which was really a white glove service for small populations, had to be scaled and oftentimes it was scaled with the technologies that were available, with the resources that were available because that is simply how it had to be. And so now we're in this place where we have virtual care and we have siloed offerings for a lot of different capabilities, but the experience that those enable is pretty poor. And so we have a lot of work to do to improve the overall experience related to digital health, related to virtual care, related to different technologies and care that we simply have to improve on and we have to leverage all the technologies available to us to be able to do that.

Omar: Let's take a moment and look into this idea of prioritizing the consumer. And first, before we do that, let's define who these consumers are. And this whole idea of a consumer in healthcare, I know it's been discussed, it's been talked about a lot, but we're seeing this shift, in my opinion, we're seeing this rapid shift from patients to consumers. And I think that in my opinion, that's because people are becoming more involved with their health and it's becoming more user friendly, so to speak. So the more knowledge, the more user friendly technologies, the more that patients are able to actually take ownership. I think we're seeing them slowly evolve into well, not slowly, but quickly evolve into consumers. What are your thoughts on that? And I know I just said a mouthful, right?

Rachel: Yeah, well, we would agree with what you said. Consumers expect out of healthcare what they're able to get out of every other industry. So first of all, let's talk about consumers because in this case we're talking about consumers being patients or there being family members. Like so if we're talking a pediatric patient, it's usually a family member who's helping them navigate that care. Or an aging individual, it's a family member helping them. But let's stay on that side as we think about consumerism. Consumers expect out of healthcare what they can get out of any other industry. So banking, for example, or consumer products, for example, you can access whatever you want to access via a mobile app, via your computer. It is insightful, it is transparent to the cost. It is real time. You can quickly get what you need. They expect that out of healthcare. And frankly, finally, we're at a place where regulations are changing and we are enabling consumers to have similar capabilities in healthcare. So, I don't think healthcare made that happen. I think consumers made that happen. And consumers will have and will continue to impact future care capabilities, and future roadmaps, because everyone's vying for how they attract and retain populations and continue to serve them.

Omar: Interesting. I just wonder when we just talk about these patients, consumers, I'm wondering how physicians kind of see that right now. Are they embracing that idea? And I'll tell just a quick story whenever I go to the doctor now I go to see my physician for a physical. I'm looking up all of my stats. I'm googling to see what my lab results mean, to put it into perspective for me so I have a better knowledge. And I can say, okay, wait a minute, this is only 0.5 off. What does this really mean in the larger scheme of things? So I'm taking that ownership, right? I'm taking that responsibility where in the past, probably in my parents day, they would have just taken the numbers and seen it and just been like, okay, and listened to the physician's recommendation. But now there's the ability to have a conversation or to go back and forth with the physician. And I'm just wondering, how are they dealing with this new age of education and digital health, since digital health provides a lot of that knowledge.

Rachel: That right. And we often say what's happened with the physician's role is they used to be the authority, and now they're more of a guide because patients do come in so much more informed, and they've done research. Whether that research is correct or incorrect is sort of not the point. They come in with information, and then the physician, the clinician, has to respond to that and guide them because they also patients and caregivers. They want access to that information in and around their home, through their community, and through other aspects of their lives. So there's a lot to navigate. Your question was about what do clinicians think of that? And my sense is, from working with some of the medical schools and from working with clinicians, I think that sometimes that can be challenging for them. But I think for the most part, they expect that they understand the population. They too receive care. They too have family members. They understand that what they're trying to do is make sure that the information at the hands of the patients is fact based information. And it's real, and it's difficult when you're dealing with the Internet. It's difficult to help them sort through what's correct and what's incorrect, given what the data is showing them.

Omar: Now, data integration is something that you're big on when discussing digital health. Let's talk about that a bit. Let's delve into that now.

Rachel: Yeah, data is so interesting. So we talk about data in a couple of different ways. First of all, starting from that point of consumerism, which we were just on, only 20% of what keeps an individual well is actually 20% of the data that keeps an individual healthy is contained in a clinical record. That's really important. So when we think about what does it take to know and understand everything that we would need to in order to provide the right care to an individual, 80% of that data is not in a clinical record. That means that health behaviors are they exercising, not exercising what's going on as it relates to their behaviors, social and economic factors, access to care, the physical environment that they live in. Is air healthy? Is the air not healthy? All those different types of factors are important to understand when we start to think about how do we keep someone well, they're also important to understand when we think about how do we help them change behaviors so that they are empowered to keep themselves well. Our data today in health is contained in so many different systems. It grew by acquisition lots of legacy technologies. Our data is siloed and it's very difficult to access. And we even say that we expect there will be 27 billion connected devices by 2025. They're connected, but the data associated with them is not connected. And what clinicians need is a longitudinal patient record in order to really understand what's right for this individual and how do I make sure that I'm providing the right care and incenting them in the right ways to influence their care.

Omar: And that brings that brings back memories of electronic health records and when they were first coming into play. And I remember being at a conference in Atlanta and hearing just the concern over data integration or how do we get these things to talk to each other and how do we get this to work? And it was just such an amazing discussion back then. I can't remember maybe 2011, or 2012, I might be off with my years, but just back then, it was just such an incredible discussion. And now seeing where we are with data integration on a much even larger scale, it's just amazing.

Rachel: It is. And even if we think about that just in terms of primary care, for example, primary care, now we have primary care teams that are multidisciplinary care teams that are accessing data from a smart home. And so that data is coming into these digital command centers. And the command centers are highlighting just the data that needs to be seen by these care teams so that they can predictively intervene on behalf of patients. It's so many different data sets. It's not just data associated with organ systems, but it's wearables and smart devices in the home. So everything about care and the future care ecosystem, it's shifting. And it's shifting in a way that improves our overall outcomes and improves our experiences just as we sort of started talking about. But to make that work, data has to be accessible and it has to be insightful.

Omar: Agreed? Agreed. Rachel, I'm pausing a little bit. I'm hesitant a little bit now because we're going to get into a real heavy topic and it's been discussed a lot lately. And I almost want to take a deep breath before I say this, but let's delve into it. Let's talk about the role of artificial intelligence in healthcare and digital health. It's a heavy term that's constantly evolving. In fact, I think the last six months, there's just been so much activity right now surrounding AI that it's incredible. What are we seeing that's really catching your eye right now in AI and healthcare?

Rachel: Yeah, there's so much going on with AI.

Omar: I know you're taking that deep breath, too. You're preparing. Yeah, I get it.

Rachel: But go ahead and you read the news and you're excited, and yet you're a little scared because you hear all of the fear factor. In health, though, AI can offer so many insights. So here are a couple of examples we could be thinking about in health. Things like ways to address patient safety and reducing adverse effects, adverse errors. Because we have insights. If we're illuminating patient history, we have better insights to them, to populations like them, and we're able to tailor care correctly for them. We could have insights about whether or not conducting additional tests for a particular individual would give us enough information to make the test meaningful for us. We have things like a metaverse, and I think about what a metaverse might mean for an autistic population. For example, to help an individual with autism better anticipate what might going through a particular procedure feel like for them before, during, and after, and what can they expect? So just preparing people for what the future can be, even if the future is immediate. But just using AI to set expectations, to better inform and to alleviate some of the anxiety that's associated with healthcare. So AI has so many different potential places to inform us and to improve our care experiences and the results associated with our care.

Omar: Yeah, it's such a dense topic, and it's all over the news right now. And my good friend Dave Saunders and I had a discussion on an earlier episode of let's Talk Medtech, and Dave is with Galen Robotics. But we had this discussion about do we see AI in healthcare or is it just machine learning? And I won't have you get into that whole debate, but he and I went back and forth on that. And if you get a chance, please, audience, check out that episode of let's Talk Med Tech with Dave Saunders. But I say that to say this. The conversations that we're having now about artificial intelligence, I'm willing to bet five months from now we won't be having those same conversations, because it's rapidly evolving, it is constantly changing. And that's the exciting but of course, it's also the scary part of it, too, I think.

Rachel: That's right. And there are so many different aspects digital therapeutics and future workforce, and there are just so many things to think about, even in terms of clinical documentation. And what does that look like? I look at it as a huge opportunity for us. As with any new technology, you can think about it in terms of the negative, or you could think about it in terms of the positive. And I think in this case, there's so much positive that can be applied. And we need to look at things with our eyes open, but really inform improved decision making and insights for clinicians. And as consumers of health, and we're all consumers of health, we need things that are going to be simpler for us, more personalized toward us, understand our lifestyles. I look at AI as an opportunity to get us to that.

Omar: Yes, agreed. Same here. While we're talking about looks into the future, five years from now, where do you see digital health? What kinds of discussions will there be in the space? Will the conversation be different or much the same? Will we still be calling it digital health? That's another huge debate. I've had a couple of guests that have come on and say it's not digital health anymore, it's health. We're just using digital applications because it's becoming so normalized now.

Rachel: Yeah, absolutely. And I would agree with that. It is all health. And we talk about sometimes digital health transformation, and really that's just digital business. It's this evolution we're going through, and we're always going through an evolution like that, but five years from now. So one of the things we haven't talked about is health equity. And everyone's focused on it, but we certainly aren't making enough impact. And I think five years from now, we're going to see some significant impacts as it relates to health equity. We have to it's not just the right thing to do. It's good for business, too. We've got to make care more accessible to different populations. And I think that will be a tremendous, like, five years down the road. I think we will have made some great strides in that regard, I think, as well. Access just overall for all and virtual care will look much different in the future. I also think if you thought about the health ecosystem that we're in today, today we talk about hospitals, we talk about payers, we talk about outpatient surgery centers, things like that. The ecosystem is going to be different five years from today. It will no longer be just your traditional health players. You're going to have financial services much more closely tied. There's a direct tie between health and wealth. Banking is going to be right in there. Consumer products will be right in there. We're going to have networks as a huge part of the health ecosystem. And so I think that there is a tremendous convergence that's happening as we think about what does it really take to understand the consumer and how do we really make that happen in health?

Omar: Yeah, I just think this is going to be an amazing journey, and can't wait to see how things unfold.

Rachel: I agree. And I feel very fortunate to be in this place, to be able to not just be an observer in it, but to be able to influence it. So it's really a particularly exciting time, I think, to be in this.

Omar: Yes, yes, an exciting time. Well, Rachel, thank you for being on this episode. Of. Let's talk med tech. We appreciate it whenever anyone from EY comes out, but this was a great conversation, just an awesome conversation.

Rachel: Thank you so much. It was such a pleasure to be with you and I look forward to potential opportunities to work with you again in the future.