Welcome to a new era in health care, where
digital health tools and approaches enable more connected experiences.
Kristi Henderson | May 21, 2021
As the COVID-19 pandemic increased consumers’
desire for health care access from the comfort and safety of their homes,
industry stakeholders scaled services to meet demand. While I’ve helped
organizations build and deploy these strategies for years, virtual care was
still used infrequently up until that point.
So it was incredible to see everyone — from
clinicians and industry executives to care provider and health plan
organizations — embrace the change together, removing barriers, reinventing our
care delivery model practically overnight, and supporting clinical teams and
consumers at an unprecedented pace.
And what many imagined would be a heavy lift
wasn’t as cumbersome as they had expected.
For example, supported in part by Optum
technology, UnitedHealthcare facilitated more than 33 million telehealth visits
in 2020,up from 1.2 million in 2019.¹ That’s
a 2,500% year-over-year growth.
And our Optum Care clinics had less than 1,000
telehealth visits in 2019, which grew closer to 1.5 million
visits in the last nine months of 2020. More generally, virtual
visits spanned all age groups nationally, with the average individual being
55–63 years of age.
2020 was a pivotal year that will forever change
health care because the long-held possibility of digital health quickly became
a reality. While a desire to meet demand in a crisis fueled our ability to
deliver on that demand, there’s more to the story.
For years, Optum has made and advocated for
investments in emerging technologies to drive digital health forward. But we
are building on the momentum from the past year to increase the pace of shaping
better care with digital health.
Growing a connected
digital health foundation
What enabled us to act quickly and initially
meet the digital health demand was a collection of in-house tools coupled with
our advanced data and analytics capabilities.
For example, Optum-provided internet-connected
health monitoring devices and wearables can feed information into the
UnitedHealth Group Nerve Center to monitor for early indicators and
intervene sooner to avoid preventable deterioration of chronic
conditions.
The real-time data that flows into the cloud
helps build a better picture of an individual’s health status. Contrast the
quality of those insights against the limited view that emerges from in-person
visits to a clinic (which happen less than three
times a year on average) and it’s easy to see the opportunities to
improve health that emerge.
If the remote monitoring data show signs of
someone needing immediate attention, care navigators can take quick
action.
In 2020, we created a Center for Digital Health, which will serve us in 2021 and
beyond as we harness our capabilities to offer the level of care and
convenience people have now come to expect. It's all about supporting a
continuous spectrum of care rather than only episodic and urgent telehealth
visits used in the past.
Our new and planned programs and technologies
will enhance routine health care, behavioral care, transitions from the
hospital and chronic disease management.
Improving care access
without sacrificing quality
At the onset of the COVID-19 pandemic,
UnitedHealthcare expanded telehealth access to 6.5 million Medicare
Advantage and dual-eligible Medicare/Medicaid members.
To put this into perspective, in 2019 just 0.1%
of their Medicare members had used telehealth. By the end of 2020, nearly 40% had completed a telehealth visit.
The level of virtual care visits has since
leveled off; we know telehealth can’t fully replace the doctor’s office.
However, if aligned the right way operationally, it can complement the standard
approach to care to create a hybrid system that expands consumers’ choice and
convenience while increasing engagement and access to care.
A pre-pandemic survey of patients showed that high numbers
of people found no difference in the quality of care between virtual visits and
office visits. Many preferred virtual visits for their convenience and reduced
travel time.
Putting this into practice, this spring we’ll
further expand telehealth access with the launch of the new Digital
Health @Home experience.
Digital Health @Home, which will roll out to 4 million individuals
with a UnitedHealthcare Medicare Advantage plan, harnesses the power of more
than 100 data streams from sources like the IHR and Nerve Center to help build
out an individual’s complete and personalized health dashboard.
Individuals with a qualifying health plan will
get one-stop access to virtual care options through Digital Health
@Home. Plus, using artificial
intelligence (AI) and other advanced technologies, the service
makes personalized “next best action” recommendations to help people manage
their health.
Digital Health @Home will also support our network of Optum
Care providers, giving them the data they need to engage individuals under
their care proactively.
Combining data and
digital tools to enhance behavioral health care
One in five U.S. adults has a mental health diagnosis. Despite
this high and growing number, many people still find it challenging to access
behavioral health services. COVID-19 only amplified these challenges.
To deliver mental health care to people when and
where they need it, we’ve partnered with AbleTo. Founded in 2008, AbleTo uses data analytics technology
to identify someone at risk for a behavioral health challenge, coordinates
clinician visits, and informs them of their care options, health insurance and
employer benefits.
The service mixes the right blend of human and
digital support by aligning each person’s unique needs with a personalized
behavioral health program. Individual care may be delivered via a digital
solution that offers a coach’s virtual support or a multi-week program via
telehealth sessions.
Using the AbleTo digital tool and clinical
services — proven to reduce
depression and improve chronic disease management and medication adherence —
we’ll be able to expand access to 235,000 providers with Optum Behavioral
Health services.
Strengthening virtual
care delivery
Medications and ongoing monitoring are critical
to chronic disease management. During the height of COVID-19, virtual solutions
were necessary to ensure access to the routine care required by those with
chronic diseases.
Remote patient
monitoring (RPM) offers a continuous health care experience,
keeping people connected to their care team and empowering them to manage their
health from the convenience of their homes. Many people realized it was
possible to do more through telehealth quite easily with access to RPM tools at
the pandemic’s height.
The Vivify Health platform gives providers the ability to
monitor patients remotely and intervene in their care as needed. Adoption of
these tools grew exponentially during the pandemic: as my colleague and CEO of
Vivify Eric Rock estimates, we likely leaped three years ahead on the RPM adoption curve.
RPM programs like Vivify Health can help keep
patients out of the emergency room or hospital and reduce the overall cost of
care. They are already used by some of the most respected health care
organizations in the U.S.
Less than a week after the World Health
Organization (WHO) declared COVID-19 to be a global pandemic, Vivify released
its first set of screening and monitoring tools. They were quickly adopted
by over 60 health systems and organizations.
Vivify made most of these COVID-19 screening
tools available to all providers free of charge for support early on. The
Vivify Pathways platform was then offered at a discount to extend that
support.
RPM is also a part of the solution to rising
costs related to chronic disease management, as are pharmaceutical advancements
and digital therapeutics.
Digital therapeutics have the potential to
impact chronic disease care, specifically diabetes care, positively. For some,
digital therapeutics could help eliminate the need for medications.
Digital therapeutics can empower people to
manage their health while also creating an ongoing, direct connection with
their care team, creating more continuity in care.
Backed by data from UnitedHealth Group® researchers, we’ve developed
a digital therapeutic solution to help people with Type 2 diabetes to reduce spikes
in blood sugar levels and even achieve remission.
Level2 is
an example of the integration of human support with data-informed services and
digital health technologies to encourage healthier lifestyle choices.
Level2 combines continuous glucose monitors
(CGM), activity trackers, app-based alerts and one-on-one clinical coaching. It
can help participants better recognize the connection between lifestyle
choices, such as nutrition, exercise and sleep, and blood sugar levels.
Level2 uses an AI algorithm to alert care
providers and enrollees to potential disease changes or complications.
The AI-derived insights can drive care
recommendations at the micro level. For example, Level2 may prompt someone to
take their medication at a different time of day based on specific blood
glucose reading trends.
Through Level2, certain participants
achieved a clinically meaningful reduction in their A1c within 90
days. People with the most significantly elevated A1c (above 8.0%) experienced
the greatest reduction (more than 1.6 percentage point decrease on
average).
A “continuous care”
future
As an industry, our goal is to improve health.
The possibilities unleashed by digital technologies are new ways of thinking,
simplifying and improving experiences, and new inventions that increase
mobility and convenience.
We need digital care, we need in-person care and
we need connected devices to achieve this goal. It’s all about bringing this
triangle together to achieve continuous care through connected health.
We’re talking about redesigning how, where and
when care is delivered — and now we can achieve that in ways that meet newfound
consumer experience expectations without sacrificing the delivery of
high-quality value-based care.
Access at your fingertips through phones,
tablets and other internet-connected devices, which have come about in the last
decade, will continue to open opportunities to do things better.
However, this will require a multi-prong
approach to garner permanent and full adoption among the health plans,
government payers, clinicians and the consumer, while also requiring
organizational infrastructure investments.
Stay connected to how we’re accelerating digital
health and other innovations in health care by joining our
email list or visiting our
blog.
Kristi Henderson, DNP,
NP-C, FAAN, FAEN
Senior Vice President, Center for Digital Health
and Innovation, Optum
Henderson is a health care change agent and
clinician with more than 25 years of experience. She has designed, implemented
and optimized the health care delivery system using digital health tools and
technology throughout her career.
In her current role, Henderson focuses on
modernizing the Optum care delivery organization using digital health tools and
telehealth.
A few of her other leadership roles include
service as an executive board member for the American Telemedicine Association;
AAMC Telehealth Committee member; ANA co-chair for Committee on Connected
Health; and member of the NQF Telehealth Committee. She is a Fellow in the
American Academy of Nursing and the Emergency Nurses Association.
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