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Evolving in the Digital Age: How Health Care Apps Are Improving Care and Costs

pat keranIn a recent podcast, Pat Keran, vice president of UnitedHealthcare, highlighted the major benefits of using an application as a health care resource, explained how apps improve patient care and lower costs, and also reviewed the challenges associated with app usage. The following is an edited excerpt of that podcast.

Please tell us a little bit about yourself.

My name is Pat Keran, vice president of UnitedHealthcare. I’ve been with the company now for close to 15 years, with the vast majority of my 25 year career being in technology; anywhere from e commerce, to data security, to innovation, where I had been the last seven years, before coming into my product role where I’ve been for the last seven months.

Can you highlight the major benefits of using an app as a health care resource?

First of all, we are in the digital age. The use of applications is astounding. You look at your personal lives and how we use applications for a variety of things, whether it’s retail or banking, or if it’s health care, the benefits of it increase in regards to what we can do.

If we were talking five years ago, it might be as simple as looking up certain information, but now, you can actually do things like conduct telemedicine visits. As we look at health care today, first and foremost, there’s over 300,000 health care applications in the top digital stores out there.

What we need to do is we need to break down a more a practical way of how we’re using these applications for our health.

Now, as people are on their mobile app, they’re able to look at what does the cost of a health care service going to be for themselves. If I have twisted my knee, and I think after talking to my doctor, I might need knee surgery, what is that going to cost? I can start using this application in the way I need so I can act from an intelligence standpoint and help with decision making.

I mentioned telemedicine and it is hopping on as more of a secure methodology. Using it like FaceTime, you’re meeting with a doctor in regards to the care that you need in more of an on demand type of service.

Another benefit is getting information about how much I have within my health savings account today. I can use that and actually pay my bills through the app. You’re finding that the intelligence and the applicability of mobile apps, such as our UnitedHealthcare app, becomes a lot more prevalent in decision making and actually facilitating health care.

How can applications, like the UnitedHealthcare app, improve care for patients and also access to care?

Again, we’re in that digital age today. How we now utilize these applications—that have now become a lot more sophisticated—in how we’re engaging individuals in care today.

Right off the bat, first thing that most people do within their apps today from a health care standpoint, is they look for a doctor. They look for someone that’s available to them within their area that they could meet with.

Symptom checking is another way that most individuals start using the app. From a health care standpoint, how do I take symptoms that I have and utilize this to drive some kind of next best action?

Using that as a way to meet with a doctor and have a visit that’s going to last somewhere around 10 minutes, if that, for things like low acuity type of care—flu, colds, pink eye, fevers, rashes, something that may be important for me to get looked at right now, but maybe I can’t get into my primary care doctor for a week or tw0—I can very simply do an urgent care appointment through a video visit via the app.

The impact of these digital applications, these digital assets, become vital in how we engage members with ongoing care. That’s going to continue to grow as we start evolving to areas such as chronic care, complex care, and using tools like remote patient monitoring and similar devices.

We are going to continue how we improve the type of care we’re offering to our members, not only through what we call in office visits or brick and mortar visits, but how we use the digital assets, like the UnitedHealthcare app, to provide that type of care from a remote, virtual standpoint.

 

How does the use of phone applications and/or telemedicine services lower the cost of care? Can you give a comparison of the cost of care in a hospital or an office setting, compared to that of someone using telemedicine services?

As we look at one of the barriers of care today, it is cost. There’s a lot of realization out there by members and individuals there of what a cost of a particular service is.

Doing that comparison, if we were to go to lower cost of care up to expensive cost of care, like a virtual visit. We’re looking at under $50 for that visit. Again, within 10 minutes, on demand service, 7/24, 365.

If you look at the other cost of care, and of course there’s going to be variability, depending on people’s individual insurance plans, and of course, the markets that they’re in as well, your office visit, typical office visit could be somewhere around $120.

If you look at urgent care, it’s probably going to be a little bit more, maybe $150, $170 a visit. Then as you go all the way up into emergency care, that could be $740, $1,000 a visit for that type of care.

This is really an interesting statistic. We did a model looking at all of the types of care that individuals go into the emergency room for. Twenty-five percent of those visits could have gone through virtual care. Now, you’re taking something, on average, let’s say an emergency room visit of $740, and you could have gotten it done for around less than $50.

There are pretty significant savings when it comes to using virtual visits or telemedicine as another care path. Of course, the caveat is that an emergency service is an emergency service. Meaning that if I have a broken arm, telehealth is not going to be my path. You’re going to go to emergency care. It’s the low acuity type of care that is going to be best fit for a virtual visit.

What are the challenges of using applications as health resources?

One of the things I had mentioned early on, when you have over 300,000 health care apps at the various digital stores, its completely overwhelming. Of course, as I look at my personal situation, I have three or four health care apps I use on a regular basis. There are many other individuals, similar in nature, that are using multiple different apps.

If I use several health care apps, unfortunately, there is not a digital hub or connector for all of the applications. If I’m using a weight loss app, a nutrition app, a telemedicine app, and any other health-related apps, they don’t talk to one another.

That becomes then a hindrance in regards to looking at the individual holistically when it comes to their health. What we want to do with these challenges is start structuring apps like more of a hub model, create a dashboard where we have these connections into these various applications, using remote patient monitoring devices like an Apple watch, a Fitbit, Garmin, etc.

How do we bring this information together to now get a better holistic picture of the individual? Interoperability is a huge challenge in trying to do all of this as well here, too. Those are some of the major challenges, other than people just simply not knowing that health care services are available, like a telehealth visit, or the price of care and the differentiation between do I need to go in to see my doctor, vs can I do it via a virtual visit, or do I need to go to an emergency room?

There are multiple different challenges, even outside the applications, that individuals need to be aware of. We can now progress through digital, through creating these hubs, through communications, through awareness that all of these tools and services are available.

Do you find that older adults have more challenges understanding these applications and this use of technology?

As you look at the older population, new technology that is easier to use is actually emerging for them.

As I look at certain iPad applications that are developed more for an older population, I see caregiving as an opportunity. Caregivers are engaging with their loved ones through digital tools like applications.

The adoptability is becoming better. I think there is a long way to go in how we do it and how we make it easier for that population. It is definitely an emerging area that I think you are going to find a lot of growth in.

Not just applications, but as you look at things like remote patient monitoring, the way that you’re using artificial intelligence, like these voice assistants, the Google Homes, the Amazon Echoes, etc, in how we can now engage in yet another way with that population for their health care needs. It’s definitely emerging, and definitely an area that has a lot of growth and opportunity.

 

Can you give a future prediction? Do you see more apps, like the UnitedHealthcare app and other apps that are available, becoming more common and more popular?

I don’t know if I see more apps but I think what we’re going to see is we’re going to see the connectivity of apps.

As I mentioned earlier, there are over 300,000 health care apps that are out in the stores that anyone can download today; how do we start bringing that together? It’s going to be more in the connections and the pipes that need to be built to get to a more holistic understanding of that individual.

I can pull in my weight loss information. I can pull in my nutrition information. I can pull in my insurance information. I think you’re going to see a lot more of that type of connectivity getting to more of the whole person.

Then again, I think you’re going to start seeing the greater emergence of remote patient monitoring that’s going to lend itself to, again, understanding the whole of the member. 

For example, what we’re doing with some pilots with Dexcom, which is a continuous glucose monitor. Having that synched up with the diabetes program that you’re on and actually integrating that information into a digital app so that we now can monitor diabetics. You’re going to find through our individual health record launch and tool that we’re bringing out there—again, on our digital platform—is that we can start pulling in record information now, giving us a better understanding again of the holistic member.

Is there anything else you would like to add?

I would like to say this digital app, digital products, in general, are part of a an exciting, quick emerging area here. There is a lot in the marketplace today when it comes to apps, remote patient monitoring, and artificial intelligence.

I believe you’re going to start seeing the culmination of these various tools come together and not be so siloed, offering, again, greater insights of the individual. By putting in our digital framework with the UnitedHealthcare app, it is going to lend itself to make these connections much easier for us than to really work with our members where they want to be within their health state.

At this point, I think there’s a lot of excitement, a lot of growth, and a lot of opportunity to continue giving people the access to care and not necessarily having to take the time away to actually get into the brick and mortar. We can do a lot more from a virtual standpoint.

You’re going to see a large push, a large trajectory, and a large adoption towards virtual care. 

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