Posted: 08 Oct. 2019 5 min. read

How might population health change with the future of health?

By Sarah Thomas, managing director, Deloitte Center for Health Solutions, Deloitte Services LP

I recently returned from a population-health conference in Scottsdale where I highlighted Deloitte’s vision for the future of health. Some of the other speakers shared strategies they’ve used to reduce costs and improve health outcomes among their high-risk populations. We heard presentations on social determinants of health, opioid addiction and abuse, strategies for combining population health with behavioral health, and ideas to support older people who need long-term services. I was impressed with the success of these programs, but it was sobering to hear about the challenges some health systems and health plans continue to face when trying to combine data with change management. I also heard many of the same concerns I’ve been hearing for years around needing to demonstrate the return on investment (ROI) for population-health programs.

One of the most interesting sessions profiled a health system that is using artificial intelligence (AI) to sift through data to identify the highest-risk patients. Once identified, care teams proactively reach out to these patients with focused care management. It was interesting to hear that the program’s developers do not know exactly how the AI finds these high-risk patients.

Over the past year, Deloitte’s Center for Health Solutions has published a number of reports, blogs, and news items outlining our vision for the future of health and its likely impact on health industry stakeholders and outside organizations that are interested in moving into this space. My presentation went through a thought process of considering what the term population health might mean once the trends we see converging play out.

Here are a few of my thoughts on the challenges we face today, and where I expect we could be 20 years from now:

  1. The definition of health will likely change: Despite our growing knowledge around the drivers of health—and the fact that this knowledge is being integrated into population health—our industry remains largely focused on care. Population health is no different. The measures of success typically include reduced emergency-room (ER) visits, fewer readmissions, and better care quality. By 2040, we expect the definition of health will extend beyond physical and behavioral health to include spiritual, emotional, and even financial well-being. Similarly, the definition of population health will likely evolve along a similar path, and the measures of success and ROI will likely change with it.
  2. New data streams could help support population health: At best, today’s population-health professionals have access to claims data and medical records. Sometimes they also have access to data collected from individuals related to social determinants and their other health needs. We know that the data are often incomplete, sometimes not easily shared, and often lagging. Fast forward to 2040 when we expect radically interoperable data to be prevalent throughout the health system. Not only do I expect many of today’s challenges will have been solved, but I also foresee new data streams flowing into population-health programs. This could include genetic information, biome data, personal priorities for well-being, and an understanding of which behavioral-economics strategies are most motivating. I expect we will also gain deep insights into our health that have been generated by highly evolved AI technology. This information should be easy to understand and could be used to improve our health or maintain our well-being.
  3. The definition of success is likely to change, enabled by technology: The success of a population-health strategy is often measured by the number of frail high-needs individuals who are kept out of the ER. However, a patient’s overall satisfaction and confidence that they are okay should also be considered when evaluating these programs. In some cases, simple technologies like telephone services have helped support improved outcomes. In other cases, more sophisticated remote-monitoring technologies have been required to meet patient needs.

Consumers’ attitudes are likely to change vis-à-vis technology as well. When I talk about Deloitte’s vision for the future of health, there seems to be a perception that consumers—especially older and lower-income people—don’t want or can’t use technologies. But many of the stories I heard at this conference indicate that this is not really the case. Technology doesn’t replace a patient’s relationship with their clinicians. Rather, it supports the relationship.

I expect that by 2040, many more digital natives will rely on technology to get care that is coordinated, accessible, convenient, and effective. People who grew up surrounded by technology will likely use it proactively to spot potential health issues before they become symptomatic, which can mean less curative care will be needed. I also expect that population health will work with consumers’ maturing understanding of what contributes to their overall well-being.

It is fun to think about all of these potential implications. Here is a slide I shared during my session.

Population health table

I spoke in-depth with some conference participants about what they thought the future will hold and how we might get from here to there. One group of population-health professionals said they work in rural areas where people they serve might be three hours away from any health care facility. Some of them do not have electricity in their homes, much less internet service (though they do often have cellphones). Although the people who attended my informal break-out session agreed that many aspects of our future-of-health vision are plausible, they wondered what a technology-dependent future might mean for rural populations.

While rural populations might be far from formal care settings, some people might live close to a grocery store or retailer. In the future, retail settings might become hubs for in-person and virtual health visits with clinicians. Given the growth of retail health activity, this idea was popular in my group.

Even when we see major changes in what we mean by health and what our industry works on, there likely will continue to be groups of people who face challenges. But I am seeing enough evidence of change already happening in consumers’ attitudes and expectations that I think we will see healthier populations in the future.

 

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Sarah Thomas

Sarah Thomas

Managing Director | Center for Health Solutions

Sarah is the managing director of the Center for Health Solutions, part of Deloitte LLP’s Life Sciences & Health Care practice. As the leader of the Center, she drives the research agenda to inform stakeholders across the health care landscape about key trends and issues facing the industry. Sarah has more than 13 years of government experience and has deep experience in public policy, with a focus on Medicare payment policy.