Healthcare disruption “isn’t necessarily about startups toppling industry giants but rather a theory about how to make products and services so much more affordable and accessible that they can transform industries and improve the lives of a widening population.”
You may want to skim this assignment before choosing a topic. In this assignment, you will be looking at innovations and disruptors that make healthcare more affordable and accessible to improve the lives of people facing specific health issues. In healthcare, an effective disruptor will improve the quality of care, lower cost or increase access of healthcare to patients – in an effective and scalable manner.
For purposes of this assignment, the disruptor may be at any stage from a concept or something that is already introduced to the industry.
You may reference information from class or guest lecture, but you will need outside sources. Be sure to cite your sources for information that you include below, and put any direct quotes in quotation marks (linked to footnotes). See the document on Citations in the Assignments folder. Some of the responses may not be based on research but rather your thoughtful consideration of what you’ve learned so far through class lectures and other course materials.
Your responses can be succinct; bullet points are encouraged and are more appropriate than an essay format. Present your findings in the spaces below. Then save your document and upload it to the Canvas course website when it’s completed.
1. Choose a patient population of interest. What are 2-3 challenges faced by patients in this population? Where possible, please give data specific to the patient population you chose.
- According to the American Heart Association estimates approximately 7.3 million Americans living with cardiovascular disease are uninsured (American Heart Association, n.d.a). Many insurance plans exclude pre-existing conditions, which can limit patients with heart disease of insurance options. Without optimal coverage, many patients delay treatment or medical care, which can lead to more detrimental outcomes (American Heart Association, n.d.b).
- Medication adherence is another barrier that patients with cardiovascular disease face. The primarily issue lies with the cost of medication and instruments required to help regulate the disease. According to the American Heart Association, approximately 1 out of 4 heart patients do not take their medication as prescribed to them. While there are many barriers to why a patient may not be able to adhere to their treatment like the fear of side effects, the cost of medication and medical instruments is the most common (American Heart Association, n.d.c).
- Lastly, another challenge that cardiovascular patients face is the education and support to change risk behaviors for heart disease. Behaviors such as unhealthy diets, low physical activity, and smoking, are risk factors for developing heart disease. However, if these behaviors continue during heart disease treatment, it can often be difficult to overcome the disease (Mcclellan, Brown, Califf & Warner, 2019). Addressing the issue of care improvement in patient lives is as important to maintaining medical care.
2. Choose 3 recent innovations or disruptors that have the potential to impact at least one of the challenges you cited above. For each, please give (a) a description; (b) the type of innovation/disruptor it is and (c) the potential impact it may have on the patient population you chose.
The type of innovation/disruptor will likely fall in into the categories we discussed in class – care delivery disruptor, technology/big data enabler; personalized care enhancer, cost/access facilitator, legislative driver.
- Medication Delivery Services
(a) Popular pharmacies, like Walgreens and CVS, have implemented medication delivery services where prescriptions can be delivered directly to a patient’s residence. In addition, companies like PillPack are a fully online prescription delivery service. However, PillPack creates individual packets of medications, labeled with the medication name, dosage, and frequency (PillPack, n.d.).
(b) Walgreens, CVS, and PillPack are acting as a cost/access facilitator. Patients with cardiovascular disease may have limited mobility and time to reach pharmacies to receive their medications (American Heart Association, n.d.c). These pill delivery services provide accessibility to those patients and increases medication adherence.
(c) The potential impact that the cardiovascular disease population may have is an increase in medication adherence. By increasing the ease of receiving medication and eliminating the inconvenience of a daily, or weekly, prescription, it reduces the risk of patients defaulting their treatment. Additionally, older patients may be at risk of not taking their medications due to confusion about prescription dosage and names, as well as how frequently to take the prescription (Pérez-Jover, Mira, Carratala-Munuera, Gil-Guillen, Basora, López-Pineda & Orozco-Beltrán, 2018). Companies, like PillPack, that work to package the medication in clear, efficient way for consumers, increases the chance of older patients adhering to their treatment.
(a) Smart Technology, such as smart pill bottles, smartphone applications, and wearable sensors, are focused on improving medication adherence, especially in older adults with cardiovascular disease. Medical smart pill bottles focus on the weight of the bottle to ensure that the patient has taken their medication that day or focuses on the action of opening and closing the bottle (Aldeer, Javanmard & Martin, 2018). Smartphone applications are also common in alerting the patient to take their daily medications. Applications, such as Medisafe Medication Management, can also provide additional information about their prescriptions and any interacting drugs (Aldeer, Javanmard & Martin, 2018). Lastly, wearable sensors are also becoming popular among chronic disease patients. Electrocardiogram patches are wearable sensors that track the patient’s heart rate and help monitor the patient (BioSpace, 2019).
(b) Smart technology companies are acting as technology/big data enhancers. They also act as care delivery disruptors when these programs track data for healthcare professionals to provide better care with more information about their patient.
(c) The potential impact of these technology devices is an increase in medication adherence and a better quality of care for patients. Reminder applications and smart pill packaging can help those who may forget to take their daily medications and adhere to their treatment regimens. Additionally, devices like the electrocardiogram patch can help track a patient’s heart rate and provide more information to healthcare provider about how to best treat their patient.
(a) There are a variety of medication assistance programs available to cardiovascular disease patients to help with the cost of medication. These programs are often based on income and age. The PillPack program allows individuals to only pay their copay for the medication, lowering the cost for some individuals (PillPack, n.d.). Medicare covered individuals are able to be covered for their prescriptions and tools, such as the Medicare Prescription Drug Plan Finder, aid patients in finding the best costs for their treatments (American Heart Association, n.d.d). However, the Affordable Care Act mandates that health care plans cover at least one drug per category. This expands the coverage of medication and becomes more affordable for patients to receive their prescriptions (HealthCare.Gov, n.d.).
(b) Programs aiming to reduce the cost of prescription drugs are cost/access facilitators. The Affordable Care Act works as a cost/access facilitator and a legislative driver. Medicare and the Affordable Care Act are in place to provide more coverage of prescription drugs.
(c) The potential impact that the Medicare and the Affordable Care Act have on medication coverage can help improve medication adherence by allowing prescriptions to be more accessible to patients. By lowering the cost of prescriptions, it reduces the risk of people halting their treatment due to a lack of prescription availability.
For the remainder of the assignment, please focus your answers on ONE of the innovations or disruptors you chose in Q2
Chosen Innovation: Technology to Aid Adherence
I specifically chose technology to aid adherence as the innovation to focus on because it is a system that is still continuing to grow. New advances in technology are always coming out and trying to improve healthcare. Technology specifically aiming to improve medication adherence is especially interesting to me because it focuses on the behavior of the patient. Whether it’s the inability to keep track of pills or confusion about dosages, technology helps make daily treatments easier and individuals feel more independent.
4. (a) Articulate a goal for the innovation/disruptor that includes the challenge you initially identified. The goal should be an expectation of what should happen as a result of the innovation/disruptor being implemented.
(b) Then, identify a SMART objective that the innovation/disruptor may achieve. (SMART objectives are Specific, Measurable, Achievable, Relevant and Time-bound.)
(a) Implementing technology, including medical devices, smart pill bottles, and smartphone applications, will help encourage medication adherence in cardiovascular disease patients and lower the number of deaths due to medication non-compliance.
(b) By the end of December 2020, the mortality rate of cardiovascular disease patients who do not adhere to heart disease treatment will decrease by 5% with the use of technology innovations, including electrocardiogram patches, smart pill bottles, and smartphone reminder applications.
- A stakeholder that will be greatly affected by the implementation of technology innovations are medical physicians, specifically cardiologists. Cardiologists are medical professionals who diagnose and treat illnesses and diseases to the heart and blood vessels (American College of Cardiology, n.d.).
- Certain devices, such as the electrocardiogram patch, can be useful to physicians to help track a patient’s heart rate and detect irregular heart rhythms (Lobodzinski, 2013). Utilizing the data collected from these electrocardiogram patches can help track a patient’s progress throughout their cardiovascular disease treatment. Additionally, smart pill bottles and smartphone medication adherence applications are also capable of referring data to a physician as well. For example, the Medisafe Medication Management application is able to collect data from the patient and can be sent to their doctor as useful information about their treatment plan. Cardiologists can also use this application to help support patients that have multiple prescriptions with various dosages (Medisafe, n.d.).
- A behavior change that cardiologists may need to implement is encouraging patients to use the technology that will benefit both the individual and the physician monitoring them. Receiving a direct recommendation for a technology innovation, like the Medisafe application, from their cardiologist becomes much more credible to the patient. Another behavior change will be to understand and utilize the data from these devices to help adjust and regulate medications for the patients.
Using technology innovations to improve medication adherence increases the quality of patient care, and therefore, increases the total value. Utilizing these technological advances, like smartphone applications and smart pill bottles, are either free of cost or largely inexpensive. If the patients are able to improve adhering to their medication and physicians implement the information from technological devices to help make more confident decisions, it outweighs the cost of implementing these technology innovations into healthcare and increases the overall value.
According to the World Health Organization, health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. It is anticipated that the disruptor/innovation’s effectiveness will surpass everyone’s expectations, and the government wants to expedite the change that the innovation/disruptor will bring.
A particular policy lever that would be pulled to help expedite the change that technology innovations can facilitate would be to focus on the U.S. Department of Health and Human Service’s policy on Interoperability of Electronic Health Information. Specially, one rule, proposed in conjunction with the Centers for Medicare & Medicaid Services, focuses on supporting electronic health information being shared between patients and medical providers. The purpose of this policy to help encourage easy access for patients to their health information, but also for the use of this data to help reduce unnecessary procedures and tests (U.S. Department of Health & Human Services, 2019). This particular policy can be pulled to help bring technology innovations, like smartphone applications, electrocardiogram patches, and smart pills, into regular health care. It should also be demonstrated that being able to track a patient’s prescription taking habits and recording their heart rate will aid a cardiologist to better treat their patient in addition to the patient adhering to their medication. Additionally, making the process of accessing the electronic health information easier may also bring more patients to use the programs.
Another policy to use as a lever can be the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act). The purpose of the policy is to help expand electronic health information to be shared between doctors and hospitals. It also aims to reduce costs of healthcare by sharing data with patients (Compliancy Group, 2019). Using this policy as a lever will encourage medical professionals to participate in incorporating more technology into their practices. The HITECH act also provides monetary incentives to those who participate in utilizing electronic health records, which can also encourage medical professionals to use medical devices as well (Compliancy Group, 2019). By encouraging medical professionals and hospitals to use electronic information sharing as part of their health care, it becomes a much more common tool among their patients and something that can be familiarized among populations that may not be technologically advanced. By having the support of the medical professionals and hospitals wanting to implement more electronic health information sharing, it will bring more credibility to the patients about how technology can be beneficial.
There are individuals who believe that technology is a negative addition to society, whether their reasons are due to religious beliefs or due to technology’s currently large impact. Patients who prefer to limit their interaction with technology may opt out of using devices and applications that aid them in medication adherence.
Another special group that would likely oppose the use of technology to help medication adherence are people who are very conscious about their privacy. This particular group of people may not want to participate on a smartphone application that may risk sharing information about their personal well-being.