November 28, 2014

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Software-led Healthcare

Although the healthcare industry has been leveraging software's vast capabilities, it is time for software to take center stage.

A few years ago venture capitalist and iconic software engineer Marc Andreessen quipped, "Software is eating the world." While his comments might have been "tongue in cheek," they were prophetic. If you look around, it is easy to see every facet of our lives -- both personal and professional -- being impacted by software. Software is pivotal to the growth of most new and emerging industry segments and it has transformed mature industries such as agribusiness, mining, construction, industrial manufacturing, automotive and aerospace.

The healthcare industry is no exception. As an industry, it is responsible for saving and enhancing the lives of people, even if outcomes often are uncertain. Although the healthcare industry has been leveraging software's vast capabilities, it is time for software to take center stage to tackle the industry's growing complexities and reach the proverbial "Holy Grail" delivering effective care at the most optimum cost.

At 10.5 percent of the global GDP, healthcare spending is second only to social protection. Among all countries, the U.S. spends the highest percentage of its annual GDP -- 17.5 percent -- on healthcare. This figure is projected to exceed 20 percent over this decade, according to the U.S. government's own projections, and half of this cost will come from taxpayers' pockets! To deliver effective healthcare, it is imperative to curb this staggering cost spiral.

Approximately 75 percent of healthcare costs are attributed to seven chronic diseases: cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions and mental illness, according to the U.S. Centers for Disease Control and Prevention. Cost aside, chronic diseases account for 7 out of 10 deaths in the U.S. Software led care-adherence and self-help/managed care programs will play a vital role in saving lives and minimizing the costs associated with chronic diseases.

Software will also lead to the reduction of fraud, wastage and abuse in healthcare. Approximately $750 billion is lost annually in healthcare fraud and waste; a figure greater than the annual GDP of many countries. Software-led predictive fraud, waste and abuse systems are highly effective ways to significantly reduce this wastage.

The key in delivering effective care to patients is improved collaboration within the complex healthcare ecosystem of providers, labs, adjacency care providers, payers, pharmaceutical companies, biotech companies, medical device manufacturers and CROs. Integration of EMR/EHR to create a single episode of care with full accountability across the ecosystem or a single payment system with outcome based treatment, etc. are critical to delivering effective care while incorporating a holistic approach to healthcare and also reducing the per capita cost. Undoubtedly, software will lead the consumerization of healthcare through the ACA and outcome led payment to the providers.

Additionally, software-led predictive analytics will play a significant role in the future delivery of healthcare services. The cost of non-adherence to medication is estimated at $300 billion annually. Combine this with the high expenditure on chronic diseases, and we are presented with a massive opportunity to create a lasting impact on the healthcare ecosystem. By bridging the care-gap and enabling self-extended care, analytics and intervention models can boost current adherence levels; further reduce costs, and more importantly, improving patient care and wellness.

Unfortunately, healthcare delivery has remained largely unchanged during the past decade despite the evolution of members/patients' expectations, particularly in the developed countries. The proliferation of Internet and mobile technologies has ensured that people's knowledge related to wellness and health is significantly higher today than a decade ago. Yet, the traditional healthcare ecosystem of have been relatively slower to capitalize on this huge opportunity.

With the number of smartphone users projected to exceed 2 billion by 2015 and global internet penetration expected to significantly exceed the current level of 40 percent, the healthcare delivery model must take advantage of this colossal opportunity for care provision, medication adherence, patient self-help programs and concierge medicine, and provide 24×7 access to healthcare from the convenience of patients' homes. Software is the glue here, and all of these advantages can be achieved through digital healthcare systems.

Healthcare innovation, through the convergence of industries and technologies, is starting to take shape. Google has already taken a lead into healthcare by collaborating with Alcon to drive the "smart lens" technology. Smart lens, through its non-invasive sensors, will enable people to do away with their reading glasses, correct their vision, and also help diabetes patients track their glucose levels by measuring tear fluids. 3D printing is revolutionizing healthcare - scientists today have the ability to 3D print ears, and aim to print a fully functional heart by 2020! Digital care management frameworks collect 360 degree information about patients/members and process the data through an intelligence layer that is powered by predictive analytics, driving interaction with care providers whenever needed.

It is the shape of collaborative innovation, which sits at the intersection of industries and technologies that will sit at center stage of our industry in the future. Given the global scale of the healthcare industry, forward-looking and disruptive technology providers will play a huge role in driving next-generation innovation, which will benefit the world at large. If you think Facebook will continue being just a social network, think again!

The three tenets of healthcare are: to improve people's health, deliver better care and minimize its per capita cost. Among the most effective vehicles for achieving these goals is software and digital care management.

Software-led healthcare is the only way to work towards achieving sustainable healthcare.