Rising costs are making traditional healthcare options unsustainable and creating the case for more significant disruption in the healthcare industry. The US Department of Labor’s Bureau of Labor Statistics estimates that by 2026, the healthcare industry will employ over 23 million individuals—more than any other sector, including the retail industry and state and local government. The Centers for Medicare and Medicaid Services (CMS) estimated that US healthcare expenditures grew nearly 4 percent in 2017, reaching $3.5 trillion, or $10,739 per person.
We are now seeing government step in to essentially force legacy players to find new ways to both raise the level of care efficacy and significantly reduce costs. As a result, CMS continues downward pressure of reimbursements, and the White House is reportedly preparing an order to cut drug prices for Medicare. This follows on the heels of an executive order recently passed aimed at encouraging adoption of lower cost, home-based alternative treatments that have the potential to reduce the billions of dollars spent on treatments for those with chronic kidney disease. What this means is that companies and providers who can create effective technology-enabled solutions, and build value-add ecosystem partnerships for self-care will be likely winners over those who find difficulties innovating on their business and care models.
We know these kinds of solutions can be successfully deployed within highly regulated industries—fintech has proven it can be done. CMS is even loosening regulation on new technologies that extend care beyond the four walls of a hospital. With advancements in remote monitoring devices, telemedicine capabilities, and an explosion of digital health and wellness tools and therapies, self-care is more possible that ever before—even for those with complex chronic conditions. But while the tools and technologies for self-care may be in place, we have yet to overcome the mental, emotional or psychological hurdles that many individuals may face when opting in or out of self-care opportunities. There are a number of factors that create both challenges and opportunities for this emerging area, including the increasing costs across all healthcare, large ailing populations and rapidly aging generations, and an overall substandard experience for many healthcare outlets.
Our population in the US is aging and ailing. According to the National Council on Aging, chronic conditions account for 75 percent of the nation’s spending on healthcare. Nearly 80 percent of older adults have at least one chronic condition, and 77 percent have at least two. But deteriorating health is not just limited to our aging population. According to research published in JAMA, we have experienced skyrocketing rates of obesity in the past decade alone. Nearly 4 in 10 American adults over the age of 20 are considered obese, up from 3 in 10 just a decade ago, and obesity rates in youth are also on the rise. According the CDC, the rates of Americans diagnosed with diabetes are rising as well. And according to the National Institute for Mental Health, nearly 1 in 5 adults in the US experience mental illness. The good news is that the field of medicine has made dramatic improvements in our ability to diagnose these chronic conditions. But the system is not designed to manage the scale and magnitude of our population’s disease burden. Simply put, the supply of clinical practitioners and modern healthcare facilities pales in comparison to the demand for healthcare services.
Scheduling delays, long wait times, billing complexity, and a lack of access to quality care all create a suboptimal healthcare experience. Many of the recent investments and efforts to create more patient-centric experiences have failed, largely because they are created as point solutions and fail to recognize individuals as whole people with lives that extend far beyond specific transactional needs. As a result, adoption remains low. Self-care provides an opportunity for individuals to receive care on their terms and in the context of their own environments, free from many of the hassles encountered in today’s health system.
When individuals are diagnosed with a chronic condition, they are bombarded with an avalanche of information, much of which is unlikely to be heard, understood or retained because they are still reeling from the life-altering news. Providing information in digestible and simple ways, while finding the right moments along an individual’s health journey to make them aware of their self-care options will be critical to the success of any solution. If introduced too early, an individual may have grown accustomed to alternatives and be reluctant to change. Finding moments when an individual (and ideally their primary caregivers) are emotionally available and open to self-care can lead to a more informed, aware and empowered individual—one who may be more likely to consider adopting self-care regimens.
Self-care regimens can be intimidating. Wound care, pain management, medication management, treatment management and the like can be perceived as complex, uncomfortable and fraught with risks—no matter how benign the treatment. This fear can be paralyzing, lead to complacency or purposeful avoidance, and can turn an individual off from ever considering self-care. Recognizing and acknowledging this fear, no matter how irrational it may seem, and designing experiences that alleviate these fears can help individuals understand the real risks (or lack thereof) of their self-care options. Designing trainings, instructions and decision support tools that aren’t just functional but also demonstrate empathy can lead to increased adoption of self-care.
Even if an individual has overcome the initial fear associated with self-care, self-doubt may continue to rear its head throughout the self-care regimen. The more complex or critical the self-care regimen, the worst these feelings can be. We are, after all, our own worst critics. If an individual must go long periods of time between check-ins with a medical professional, they may experience anxiety and uncertainty around the efficacy of self-care regimens or their own ability to properly carry out their self-care regimen. Finding opportunities to boost confidence through the self-care journey, whether through simple validation moments or through more robust and personalized feedback, can go a long way to ensuring sustained engagement with self-care routines.
Healthcare is part science, part art. We can’t yet anticipate with 100 percent certainty how an individual will respond to self-care regimens. And more likely than not, many self-care regimens will require support from medical professionals at one point or another in the journey. Designing a solution that enables individuals to seamlessly connect with professionals, whether it be live or asynchronously, can significantly enhance adoption of self-care. Instead of feeling alone and unsupported, individuals may take comfort in knowing they are in good hands—even if those hands are primarily their own.
Self-care may represent the single greatest opportunity to achieve our triple aim. Not only does self-care have the potential to dramatically reduce costs, if done well, self-care has the potential to improve outcomes and experiences as well. Today’s healthcare providers have the opportunity to capitalize on decades of innovation and technological and scientific breakthroughs to create self-care tools that people will love and continue to use. At frog, we’ve been creating products people love for over 50 years, both in healthcare and beyond. Now, we’re ready to help our healthcare partners get in the game when it comes to a new era of supplementing healthcare with self-care.