FREE SAMPLE CHAPTER:

It Takes a Village

by Kevin Pereau

CHAPTER ONE
HARVESTING LESSONS LEARNED

If you have read my first book The Digital Healthcare Revolution, I want to welcome you back. If you haven’t read that book, you will not miss a beat in exploring how you can benefit from digital health in the pages ahead.
As you know, technology doesn’t stop innovating—ever. And the innovators don’t stop trying to develop technologies that solve problems. So here we are again, exploring healthcare, one of the timeliest topics anywhere.

As we look back on the last 10 years, I believe there are some realities we can agree on. We know that this time has certainly been disruptive. Healthcare regulation, and the increased levels of investment that it spurred have exerted a profound effect on how health plans, payers, and providers service your needs. And more importantly, on how they interact with us. To boil it all down, they have become more accessible than ever before.
We can now connect with greater ease to our healthcare providers and clinicians and other stakeholders within healthcare that can help us live life to the fullest. And increasingly, we can do that without even going in to see a doctor.

AN AGE OF HEALTHY CURIOSITY

All these changes have awakened people’s curiosity about their own health and engaged them in learning how to best manage their health to stay fit and healthy.

This change didn’t just happen because staying fit and healthy is fun to do, but it’s easy to get addicted to the endorphin rush of tracking what happens during a workout. We have discovered the

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rewarding processes of how tracking our BMI, body fat, weight, blood pressure, cholesterol, and other data can be used for our benefit in a variety of ways.
There aren’t enough gadgets for some people who belong in the fit and healthy category. That said some of us are monitoring to manage ongoing or chronic conditions. We might require a persistent nudge or device to track something, or a clinician to help stay the course and learn how to thrive with our condition.

For people who are fit and healthy, we’ve made great strides. But to help us understand better what else is taking place, let’s revisit some lessons learned from my last book The Digital Healthcare Revolution.

THREE PHASES OF DIGITAL HEALTHCARE

Digital Health 1.0, 2011- 2014

This was the time when we dispelled the popular myth that people wouldn’t engage in, much less care about, their health. You would frequently hear healthcare executives say, “We can’t get members or patients to engage when it comes to their own health.” We saw the flaws in this thinking when thousands of healthcare apps appeared overnight, and new marketplaces flourished. The first wave of health tech innovation designed from the ground up to treat healthcare like a shopping experience came from outside of the industry and the data was designed to be share-able.
“We just can’t get people to engage” is now yesterday’s battle cry. If anything, there seems to be a growing appetite among consumers to become more involved in their healthcare. Consumers are donning Fitbits, buying bathroom scales that keep ongoing data about their daily weigh-ins, and taking other steps to gather and monitor their data.

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People became more engaged in their own healthcare and wellbeing. This explosion of digital health apps dispels the popular myth that people won’t engage, share or be held accountable. We had never given them tools like this before and they couldn’t download these new healthcare apps fast enough.

Digital Health 2.0 2014-2019

The app explosion soon gave way to the platform explosion. Big data was the new battle cry. You sometimes hear this described as the quantified self movement—a time when people warmed to the idea of using devices to track just about everything. The smartest people in the room could look backwards and tell you what just happened and why. We even got good about predicting what would happen next.

Digital Health 3.0, 2020 – present

I like to call this period, connected health. When I wrote The Digital Health Revolution, we were only on the cusp. Now, we are living it. Consumers are fully engaged and collecting data that is being fed to analytics platforms that help us decide what to do next. The focus has shifted from understanding what just happened to how to manage to better outcomes. We are making our data actionable by connecting it to the stakeholders who help keep us healthy and leveraging their keen insights. We are working with coordinated care teams who use the data captured by digital health assets to keep us well, not treat us after we become ill.

Historically, healthcare has been about treating people when they are sick, with not much emphasis on keeping them healthy. But that is now changing.
The myth that people won’t engage in their health and wellness has now been absolutely obliterated. People have embraced Google Fit, Apple Health, and many other tools because it is as easy as turning on their smartphones. The adoption was so sudden and so

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widespread that it caught many in the industry by surprise. From health plans to providers, nobody expected people to dig in and sustain engagement at this level.

We’ve learned a lot about people and what motivates them, and they do want to be healthy. Curiosity was definitely a driver. Suddenly we started measuring everything. The quantified self movement has given way to connected health and actionable data, and we can’t generate enough data about our own personal health fast enough.

Increasingly, we are doing this in near real time. If you’re a patient monitoring a chronic condition and you have multiple stakeholders helping you monitor your condition, it is no longer a shock to you that the clinicians, nurses and doctors within your provider network will all have access to the same data while being able to take action at the appropriate time to help you.

But at the same time, are we addressing the root cause of what’s causing poor health in the first place, or simply taking care of problems as we see them arise? We have spent much of the past decade connecting everything within healthcare.

And I think that it’s time to ask a question, and it’s a simple one . . .
What needs to connect to healthcare that isn’t connected now?
What are the drivers for the health problems we are facing? We realize that there are factors that cause stress. There are factors that cause diabetes. There are factors that cause hypertension and heart problems.

Typically, those factors are things that we do to ourselves, like lifestyle choices, but not always.

The take-away is getting healthier needs to be a participator sport. It is something in which we can all take an active role. But the process can be made more efficient when we take

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steps like aligning incentives for providers and changing reimbursement models.

We can only do so much with technology alone. At the end of the day, it really does take a village. It takes everyone rowing in the same direction.

That is what we will be exploring in this book:
Chapter Two will introduce us to some of the people who are driving innovation.
Chapter Three will let us hear from some of “the new disruptors” in the world of healthcare.
Chapter Four is about the role that nutrition is playing in the healthcare revolution.
Chapter Five will explore how schools are connecting to the world of healthcare.
Chapter Six will take us into the state of reform in healthcare.
Chapter Seven will be about life hacks and the role they play.
Chapter Eight will take us through the pandemic and explore the role that payers and providers have played, and how they have changed.
Chapter Nine will recap, telling us where healthcare has been so far, and make some predictions where we are going next.

MEET TWO INNOVATORS

Omada Health and Virta Health are two companies that are at the forefront of what is happening in our village – for the inventive ways they are using data to help patients better manage type 2 diabetes. That, we know, represents one of the loftiest challenges on the healthcare landscape—for people who suffer from the disease,

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to care providers, to payers, to insurance companies. In short, to everyone who is located anywhere in the world of healthcare.

What are these two companies doing to reshape the way we are dealing with this disease, which has reached pandemic proportions around the world?
Omada Health was founded in 2011 to offer a new way to help people with prediabetes reduce their risk of developing type 2 diabetes, and to help people who already have type 2 diabetes manage their disease more effectively. Today, upwards of 200,000 people are using Omada to lead much more healthy lives.

How do people sign up for the Omada program? You begin by visiting the Omada website, where you answer questions to find out whether you are at risk for chronic disease. If you are, you qualify to join Omada. A short time later, an Omada digital scale arrives in a box. It looks much like any other digital bathroom scale, but it contains a cellular device that communicates with the Omada care team and feeds data to the participant’s private profile.
That begins the process, which moves through two distinct phases of care. During the first phase—called Foundations— members get to know themselves better by tracking and submitting their weight, food, activity, and other data. They do so as part of a small group setting and they work with an Omada coach who gives advice on how they are managing their care, and what could be improved. After the first phase, they switch to Focus, where they are coached and supported on hyper-personalized goals based on their progress in Foundations as they make their healthy new habits part of their lives.

The Omada program works. Within the first year of participation, Omada members consistently lose significant amounts of weight. People who are pre-diabetic lose the amount of weight associated with a 30 percent reduction in the risk of developing type 2 diabetes, a 16 percent reduction in the risk of stroke, and a 13 percent reduction in the risk of heart disease. Those are verified

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statistics, because Omada conducts ongoing clinical studies of members’ health.

Virta Health, another remarkable innovator in the care of diabetes type 2, makes a lofty claim that it can back up with statistics. The company maintains that it has reversed type 2 diabetes in more than 50,000 of the company’s members.

That is amazing, when you consider where we were only five years ago—when anyone who claimed to have “reversed” diabetes was sure to become the object of skepticism, or worse.

After joining Virta Health and answering some screening questions, a new member receives a welcome kit that includes a “smart” connected blood glucose meter, test strips, a smart scale, and other supplies. That member is then assigned a team of monitors and care providers that includes a care coach, a physician-led team of medical specialists, educational resources that include diet and nutritional planning, as well as connections to a community of other Virta Health members who are also engaged in the process of controlling—and even reversing—their diabetes.

Both Omada and Virta provide a new generation of seamless care that cuts across the boundaries of nutrition, primary care, specialist care, exercise, and more. They are doing more than just gathering data, they are using that data to provide care and counseling in a frictionless way. Increasingly, they are taking action on your health data in near real time.

And although we will meet Jenny Craig again several times later in this book, let me mention it in this chapter because this weight loss/nutritional counseling company is at the forefront of designing and delivering care to people who would like to lose weight and improve their intake of healthful foods.
How is Jenny Craig moving the needle in the universe of nutrition and weight loss? Gathering and evaluating individual data is part of the process. But the company is forging new kinds

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of category-cutting business deals that are poised to cause notable changes in both the weight loss and healthcare industries.

Jenny Craig nutritional counselors can already be found in many Walgreens pharmacies and will soon be found in more. Note too that Walgreens is moving to provide primary care medical services. Plus, increasing cooperation between Jenny Craig, Walgreens and Krogers grocery stores promises a new way to integrate nutrition and meal preparation with pharmacy and even primary medical care.

Integrations like these are becoming the new normal and Walgreens is setting the standard.

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