BY DENNIS ROBBINS, PhD, MPH, AND ROGER SANFORD
Healthcare in the U.S. is headed in the wrong direction. The 2021 World Bank’s report found that, without healthcare reform, U.S. health spending will increase to $2.5 trillion in the next decade. This trend is unsustainable. COVID has exacerbated the complexity of the entire world, and no place is this more evident than U.S. healthcare delivery. Hospitals are closing, healthcare workers are quitting and/or experiencing profound mental health impacts. Delays, constrained resources, lack of personnel and supply chain issues have eroded confidence and morale.
Peer countries spend substantially less and often have better outcomes. The Commonwealth Fund compared 11 high income economies’ healthcare across five domains – access to care, care process, administrative efficiency, equity and healthcare outcomes. Even with amazing technology breakthroughs, the U.S. ranked last on access to care, administrative efficiency, equity and healthcare outcomes.¹
PERSON-CENTRIC CARE IS DESPERATELY NEEDED TO SHIFT AMERICA’S HEALTHCARE TRAJECTORY
To succeed, we must refocus the discussion from healthcare and illness to health. Shift from trying to convince “patients” into engaging “people” individually to proactively pursue a healthier trajectory.
This change of mindset from an almost exclusive focus on sickness/services/delivery approach to a person-centric approach is profound. Digital health literacy is a key and critical component. Yet, as proven by the failures of big tech companies addressing healthcare, technology alone is only a part of the answer. Person-centric Care makes it all very personal.
Healthcare itself is overwhelmingly complex. It’s hard to know how the pieces fit together or how to best connect the dots. This is especially true in rural, underserved areas, exacerbated in times of illness and emergency. Rural Americans make up at least 20% of the U.S. population and face inequities that result in substantially more challenging healthcare delivery than urban/suburban residents. The lack of healthcare options within a reasonable distance can even be deadly. Left unaddressed, it becomes a crisis for the entire U.S. population.
Lack of resources is a major cause of the ongoing hospital closures, exacerbating the rural healthcare crisis. Home to the most vulnerable populations, geographic isolation ends up with them experiencing more chronic conditions, higher mortality and lower life expectancies. We believe we can help more hospitals to stay open, treating more people. When there is greater access to care, and when people have more health literacy, the rural-urban healthcare gap will begin to close. We all must be aware that meeting unmet needs and helping people get their lives back to recover from illness, accidents and injury is critical everywhere.
A NEW WAY TO SOLVE AN OLD PROBLEM
We are delighted to highlight a distinctive model designed to address these issues. An emerging Silicon Valley Public Benefit Corporation (Hcare Health) is leveraging the latest health information technologies to meet major unmet needs, especially in care support and equity. By focusing on preventing people from falling through the cracks, being misunderstood and becoming resistant to care, they have created a link between hospital care and the return home, supporting personal responsibility for recovery. This is accomplished with leading edge Ai (Aligned intelligence) and natural language processing to provide 24/7 access to information and support, high levels of data security and expanded agency of one’s personal health information.
They uniquely blended clinicians, engineers, data scientists, philosophers, ethicists, administrators, healthcare advocates, security experts, health policy makers, business leaders, Ai developers, blockchain experts, privacy experts and IT professionals collaboratively to interweave solutions toward a common goal: improving and making peoples’ lives better. It touches everyone.
THE DIFFERENCE: USING TYPOLOGIES TO UNDERSTAND AND RESPECT THE INDIVIDUAL’S WORLDVIEW
Typologies have been used widely in understanding differences in motivations and behaviors by companies and public sector organizations. They are not typically used to give the individual insights about their own behaviors or to personalize recommendations and educational material that meets them where they are. By doing so, the individual can build a deeper understanding of their own health challenges and become better equipped to meet personal health goals. In tests, people feel better acknowledged, respected and empowered to make positive change. This contrasts with being pushed into changes they are not ready for or that aren’t right for their personal situation.²
EASY IMPLEMENTATION CAN IMMEDIATELY REDUCE SUFFERING AND SAVE LIVES, TODAY
There is virtually no policy change that needs to take place to be used, making it an easy solution to integrate everywhere, especially into rural communities. Another interesting element of this initiative is the aspect of moving beyond the individual person being cared for. Hcare serves the community at large with a community health orientation, with a community engagement orientation, as well as a new “data foundation” financial model to benefit the community served. When it works in rural, it will work in urban and suburban communities.
PROVIDING THE CRITICAL TRIFECTA: SPEED, SUPPORT, GOOD OUTCOMES
Each of us needs to be assured in a timely fashion that the right support will be in place to ensure good outcomes and peace of mind. This critical trifecta helps improve continuity of care, provides empowerment to the people and benefits the community. This values-driven platform seamlessly integrates behavioral health and clinical insights with excellent navigation and motivational tools.
Having an open-source platform powered for ease of integration, employing real-world typologies powered by leading-edge Ai and supporting motivation for adherence, will improve the situation in its first year. Enhancing decision-making is the right prescription to help people get and stay healthier after a life-changing event. By integrating mood, clinical and behavioral elements together to personalize the process, it creates “personalized care at scale.” It also helps motivate people to become more personally accountable.
To help caregivers and the people receiving care, personal typology, mood as well as clinical and behavioral elements are integrated to better personalize all communications. Using the Aligned intelligence platform, real-world typologies enhance decision-making and care, meeting currently unmet needs. The goal is to help people get and stay healthier.
PERSON-CENTRIC EMPOWERMENT IS DESPERATELY NEEDED, NOW
Shifting the balance to person-centric care by meeting unmet needs with agency cures many ills. Using world-class blockchain solutions provides seamless access to the personal health record, getting the key information we need when we need it. The focus is about what can be, not limited by what is. Integrating new technology, high-level personal engagement and better self-motivational tools creates a first-of-its-kind person-centric model of empowerment.
Helping people who have experienced critical illnesses and accidents and/or extensive surgeries get their lives back and adjust to new realities is critically important. Most lack the capacity and don’t have a clue how to answer, “How do I get my life back?” Since each person is different, we must accommodate those differences, personalize the communications and openly share information in the way that people understand and appreciate it. To motivate people to do the right thing, digital messaging must be structured to make it more meaningful, significant and important.
Digital, as we have learned from enterprise solutions and social media, can catalyze and spur new ways of thinking. Today, healthcare’s digital transformation is in the earliest stage. Hcare’s primary goal is to have connected health ecosystems that are useful, meaningful and important to the person. It can become a seamless and essential element in their life. Together with the care team and the individual, an ecosystem is created that leverages the technology to continually support their distinctive needs.
OVERACHIEVING SECURITY COMPLIANCE IS THE KEY
Giving secure agency to the person and their care team is essential. On the IT data security side, buttressing that concern with high tech safeguards and data privacy safeguards are baseline. Hcare’s Hkey gives the individual agency over their medical information with fingertip access and control. Deploying the strength of Web 3.0 with security and protections of advanced blockchain technology makes an immense difference.
A NON-DISRUPTIVE SOLUTION THAT CHANGES OUTCOMES COULD SAVE THE DAY
Big companies all too often focus on the technology and profit, rather than the person. Their pure technology, multi-billion-dollar efforts have failed. Why? There was no personal distinction; you could observe the words “person,” “individual,” “consumer” and “patient” appearing interchangeably in rapid-fire succession. This is the core of the fundamental breakdown.
They’re very different profiles, especially in relation to their own agency in health behaviors. People change; “patients” don’t. People will do whatever is meaningful or important enough for them to change; patients by definition are necessarily passive, subservient, wounded and vulnerable. Digital technology can help shift the focus from passivity to autonomy essentially from “patient” back to person.
A person engages only when something matters or is important enough to them to do so. Sustainable engagement does not and will not happen magically or easily. Despite the strong focus and attention paid to the engagement space, the reality is that it still needs to result in positive health behavior. Engagement strategy, unlike today’s existing healthcare system, is not a “one-size-fits-all” solution.
CREATING LIFESTYLE CHANGE IS DIFFICULT AND DAUNTING
The mystery of how to best engage the person lies at the core of this discussion and discovery. If we can help the person to engage, we can have a profound impact on bending the sickness curve and the related cost curve. Engagement is not dictated directly by populations, sex, race, ethnicity, size or shape. Solutions are based on a specific person at a specific time. Promoting short-term change or promoting healthy behavior is relatively easy. The big reward is to build sustainability, transforming an extrinsic motivation into an intrinsic one.
IT MUST BE PERSONALLY MEANINGFUL
True engagement and behavior responsibility require continuously available, personalized and targeted “nudging” that is distinctive and meaningful to that person. It needs to help engage, support and/or direct that person to continue down the right path. By making getting healthy less daunting and painful, we can catalyze change and enhance empowerment, putting the whole person in the game. A personal plan requires flexibility, as people transition from health into sickness and back from sickness into health.
Based on what is perceived to be of value, important or meaningful, people will make and inculcate choices. It is critical we help create strategies that give people information, support and encouragement to change the way they respond, adopt and embrace the changes in their lives to make a healthy difference, their own way.
IMPROVING LIFE: INTERWEAVING PEOPLE WITH TECHNOLOGY
Humans present a very complex value proposition. Traditional technology solutions attempt to reduce to a button push “just take one pill,” using dominating technology or some other ethereal remedy. These are neither available nor sufficient for shifting behavior (except possibly the introduction of the iPhone). An app or a portal alone won’t cut it.
Humans need humans. Having an experienced, multidisciplinary and interdisciplinary team in place is imperative. However, an in-the-home-visit episodic meeting with a person receiving care twice or three times a week is cost prohibitive. Often, it does not accommodate or is inadequate to meet the unmet needs of those who are recuperating or getting their lives back. Family care often falls short. Optimally, it is a weave of a highly scalable 24/7 expert availability, human caring, human insight and healthcare literacy for all concerned.
Shaping change warrants a multi-disciplined perspective that can aggregate evolving knowledge in a way that can be flexibly applied toward an array of objectives. This can add years to our lives and life to our years, and each of us is the key.
Only by deploying Aligned intelligence (Ai) NLP (natural language processing) coupled with motivational tools embedded with multiple clinical and motivational algorithms can we optimize meeting the needs of the person in their home. This proposed solution is for life, designed to maximize what exists by aligning it with what is needed.
Dennis Robbins, PhD, MPH, is a catalytic influencer committed to rejuvenating health/healthcare and committed to creating an actionable platform to shape and engage people to improve their lives, health and well-being. He wants to help each person become a vanguard rather than victim using AI, innovative technologies and science. His work on person-centricity leverages how we think about the culture of health, wellness and life, shifting the paradigm from patient to person.
Dr. Robbins has held faculty appointments in medical schools, schools of pharmacy, allied health and dentistry and taught a wide spectrum of courses in medical schools, public policy and business programs at such institutions as Harvard, Loyola, Singularity, Arizona State, Wayne State, Pepperdine, UNC and NYU. He has been recognized as among the top 100 speakers in the U.S. by the Governance Institute. His legacy of 11 books and more than 400 articles is complemented by a plethora of keynote presentations and panels. His innovations have been recognized in such national media such as Forbes, Hospital Ethics and Managed Healthcare, which honored him as among top 10 keenest thinkers in healthcare.
Roger Sanfordis the founder and CEO of Hcare Health, PBC. Motivated by the carnage during the pandemic, and drawing on experience from numerous successful start-ups, he turned his focus and resources to healthcare. An early AI and software creator, his background is in establishing platforms to support companies enrolling broad communities rapidly and successfully. He is known for creating geographic growth models and has been a valued advisor to Fortune 100 companies.
As a successful CEO/CMO in business, a Deans Graduate School Professor at Santa Clara University, Leavy School of Business and ITU, a strategic consultant, an analyst (Bloor), an investor, board member, community activist, producer/director (two award-winning film documentaries), facilitator and public speaker, he hopes to bring a fresh perspective to healthcare. Based in Silicon Valley, California, he’s been able to work with and get advice from some of the giants who changed our world. Hcare is the embodiment of his dream to leverage technology, business saavy and human capital to preserve and improve life and health.
REFERENCES
1. “Mirror, Mirror 2021: Reflecting Poorly: Health Care in the U.S. Compared to Other High Income Countries” New York: Commonwealth Fund, Fund Reports August 4, 2021.
2. We are indebted to Brianna Brownell of Pure Strategy whose leading work in Ai typologies has been a critical element in advancing this unique Aligned intelligence AI solution. All trademarks noted are the property of Hcare Health, PBC.
Image credit: ISTOCK.COM/ANDREY SUSLOV
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