By: Bipin Thomas

Consumer empowerment, a fixture in such industries as retail products, travel and banking, is taking shape in health care at last. But only because consumers finally have to get involved in their own care to head off things like higher insurance premiums and workplace penalties for poor health. Health care providers are headed into the community to track down consumers and help keep them well. Incentives embedded in Medicare programs to share savings from more efficient and effective care have spawned all manner of inventiveness to promote health and intervene early when a chronically sick person is in danger of getting much sicker.

This intersection of like motivations for consumers and caregivers is creating a remarkable opportunity for entrepreneurs to market digital products that people can stand on, strap on or wear to yield information valuable to their ongoing health. That same information is valuable to new health management cooperatives such as accountable care organizations, which will earn their income by keeping a defined population, say, members of a local health plan, as healthy as possible.

Health consumerism has been anticipated ever since the Internet first stepped in front of the white coat — the longstanding embodiment of health care knowledge — to create alternatives to getting that information. But the forecast rise of consumerism failed to gain momentum until several forces came together. People with insurance became more involved with determining health care decisions once their decisions had an increased impact on their finances. High deductibles and other cost sharing increased consumer “skin in the game” and provided motivation to seek out advice on self-care.

Hospitals and physicians now have to be concerned about Medicare patient satisfaction surveys, publicized on a government web site and figuring into formulas for reimbursing them for their services. Incentives from value-measuring programs of Medicare and private insurers can be boiled down to this: keep people healthy or intervene early in failing health, get a bonus check. With the growing importance of consumer welfare and its tie to reimbursement, emerging collectives of health care providers need every advantage possible to track and monitor the health status of consumers more effectively and efficiently.

Presentations on wearable technology over the years usually started with the lead-in, “Imagine if …” Not anymore. Ralph Lauren is developing a stylish polo shirt that can measure calories burned, heart data, distance traveled and other health-related details. Other products such as the Apple Watch are providing personalized ways to collect data, get feedback and take action. The odds of consumers achieving good health — or at least better health than they would otherwise — increase with the use of such products as smart patches worn on the skin to gather vital signs continuously, with little or no need to train consumers to record and report data. Further lifting these technologies out of the realm of mere curiosities are advances in the analysis of large amounts of data for trends, warnings and suggestions regarding personal health.

For providers of health care products and services, engaging consumers throughout the health management process is the first step to monetize the emerging health care economy. One large health care provider and payer jointly reduced costs by using a common care management software platform to track a specific patient population suffering from chronic conditions.

It started with the grouping of people with similar chronic illnesses — heart failure, diabetes and so on — and specifying types of medical interventions and patient self-care that a certain illness called for. Then, the progress in making sure these steps were followed through extensive care management notes enabled by the software. The upshot: the organization identified what health care interventions — wellness programs, member education, thorough attention by a care team in a doctor’s office — tended to work for which condition, and for which consumer profile. The true success in reducing costs was in engaging patients, mapping their daily routines and honing interventions before patients experienced serious complications, while identifying and discouraging costly procedures.

The new incentives governing approaches to care are not so much around cutting expenditures, but rather counseling the consumer to achieve his or her best outcome, and to get there on a path that is both proven and what they prefer. Health care payers and providers must look at wellness, and its financial implications, through the eyes of the consumer. Consumer-centric shifts are making an impact on the major components of health care:

Payers: The long-time dependence on taking medical information from insurance claims is being replaced by continuous feeds of health status data required for timely management of chronic conditions and other ills. Consumer-oriented digital innovations are playing an important role.

Medical devices: They can no longer stand alone, performing their functions and keeping valuable clinical data to themselves. They have to seamlessly connect with the mainstream of data flowing to electronic health records.

Retail health: This creature of consumerism, offering simple health screenings and creating personal health records, is emerging as a competitor to traditional health care.

About the author: Bipin Thomas is a renowned global thought-leader on consumer-centric health care transformation. Thomas is a board member of HCBN and chairman of ICURO, a digital business outcomes management organization.