The most revolutionary tool in health care is in your pocket.
Today, 64 percent of American adults own a smartphone.
And whether it’s an Android or an Apple, tech and health care leaders agree that it
is transforming how people take care of themselves.
With a massive health care industry and access to an innovative, entrepreneurial community,
leaders in this new front of health services—called digital health—say that the Denver metro
area is poised to become a hub for digital health technology.
It’s a sign that Colorado’s reputation as the healthiest, most active place to live in the country—home to an equally fit workforce—will be intact for years to come. It’s a good thing, because like every other service, there’s a push for ease and convenience in health care that only technology has been able to advance.
“Technology is enabling patients to act as they do as consumers in other industries to really drive change,” said Prime Health co-founder Jake Rishavy said. “Everybody’s got a patient engagement device in their pocket now.”
What is Digital Health?
Put simply, digital health is where technology and wellness meet. So whether you’re talking
with your doctor over a video chat instead of coming in for an appointment or tracking your latest run with an app, if you’re using technology to change how you take care of yourself then you’re part of the digital health revolution.
It’s an idea that already permeates our lives in other areas.
Consider banking. Just a few decades ago you’d visit a bank branch to make a deposit. Fastforward
to today taking an image of a check on your phone—or not even using checks and instead sending money through payment apps like PayPal, Square Cash or Venmo.
“I see digital health evolving just like every other industry,” said Scott Rotermund, cofounder and chief growth officer of Welltok, whose health optimization solution CaféWell works to improve health through incentives and personalized guidance. “Every other industry is gaining more and more success based on the amount of hassles that are being removed for the end-consumer where you’re making things so easy for them.”
It’s an area where health care has frankly lagged, if not dragged.
“I think that in terms of adoption of health information technology, health care has probably been well behind the rest of the world in terms of adopting computers to electronically store health information,” said CORHIO CEO Morgan Honea.
Making You Healthier, Keeping Money in Your Pocket
Through digital technology, leaders in the space see an opportunity to address two looming
issues: curbing preventable diseases and slowing, if not retracting, the increase in health
costs.
For businesses, providing health care is a major operating cost, which has led more and more
employers to enact wellness programs with the aim of creating a culture of wellness and eventually lowering costs.
In Colorado, the average annual increase in premium costs over the last three years was 7 percent—increasing some $2,000 for individuals from 2003 to 2013, according to a recent study by the Commonwealth Fund. The cost of premiums ate up 19 percent of the state’s median income in
2013.
And, with more than 50 percent of health care costs being driven by things that are
preventable, insurers like Cigna have focused their digital tools toward addressing these to
bring premiums down.
“All of our health and wellness solutions are geared towards guiding customers in making
better choices in their health to hopefully not only make their lives better but also reduce
cost,” said Cigna Marketing Director Shawna Dodds.
But often the costs of adopting new technology, lost productivity or the fear of creating an
impersonal doctor-patient relationship have been causes for delay among health care providers.
CORHIO, short for Colorado Regional Health Information Organization, is working to improve
health information exchange, working with doctors, hospitals, health plans, patients and more to make electronic health records efficient to update, with the ultimate goal of providing better care and reducing costs.
As health care costs continue to grow and consumers have more access to information about their health and find more and more convenience elsewhere, a shift is beginning.
“We’re at this point where to really reduce unnecessary costs in health care it will require a cultural shift,” said Colorado HealthOP CEO Julia Hutchins. “Technology is a huge enabler of the shift in having the information necessary to make good choices about not only how much does it cost but do I even need the care at all?”
Cigna launched its Health Matters program in January, which provides health coaching tools for its members to meet goals, from weight loss to quitting smoking. The program includes suggested mobile apps (which Cigna curates from the tens of thousands of health-focused apps available) and challenges, paired with interaction with a health coach.
“More and more clients are asking for this digital space,” Dodds said.
But, despite the demand, there wasn’t much support for companies looking to offer innovative solutions in this space until recently. In 2012 the Denver South Economic Development Partnership, where Rishavy serves as director of innovation, partnered with Innovation Pavilion to launch a nonprofit
that would serve as an accelerator and industry association, making connections and identifying critical issues for these companies’ success. Prime Health was born.
And, the urgency to address rising costs and finding tools for better, preventative, efficient care is palpable.
In February, Denver played host to 10.10.10, which brought together 10 leaders to address
10 “wicked” issues in health care in 10 days—an ambitious undertaking—and one that not surprisingly didn’t yield any quick fixes.
“The solutions to the big problems probably couldn’t be coming fast enough,” Rishavy said.
But, it did put a spotlight on the region.
Growing an Industry
Health care and technology have long been major industries in Colorado, and with its collaborative culture, it’s no surprise the two have intersected here to form a burgeoning digital health industry that boosts some 120 companies.
And there’s interest in creating a pipeline to these fields. In January, Kaiser Permanente awarded Denver Public Schools a $650,000 three-year grant to support career and technical education in health and bioscience. The aim is to reach more than 2,000 students at CEC Middle College, Compassion Road, Florence Crittenton and Manual High School.
With over 192,000 people in the region already employed in health care, and that number projected to grow, educators and business leaders are working together to create more pathways to these in-demand fields.
“Health care is one of the fastest growing industries in the Denver metro area. There are so many opportunities now and in the future that will require different levels of skills and training,” said Donna Lynne, DrPH president of Kaiser Permanente Colorado. “This program does an excellent job of preparing high school students for a career that begins right after graduation or for further studies through a tailored college program. Colorado needs a well-educated and well-trained workforce of the future, so we’re very excited to help make this program possible for Denver youth.”
At CEC, students are exposed to a variety of health care career paths as freshmen and then select an area of focus. One myth they’re trying to debunk is that the program isn’t academic, said Career and Technical Education Director and CEC Middle College Principal Scott Springer, who adds that each program embeds traditional courses of science, math, English and social studies.
“What’s great about career and tech is that it brings everything together,” he said. “With these programs it’s more like how the real world works.”
CEC graduate Karla Quezada agreed. After graduating in the nursing pathway, she worked as a certified nursing assistant (CNA) and is now focused completing her nursing degree in December.
“I think that it was a solid foundation for becoming a CNA,” Quezada said. “It got my foot in the door in the right direction.”
The nursing curriculum at CEC is more focused on the “analog” practices and soft skills that focus more on patient interaction, but “it’s important they understand more how to use digital to their advantage,” said medical careers teacher Lynda Freund.
Quezada learned more about electronic records and other digital health tools on the job. Even a robot. While observing at Sky Ridge Medical Center she saw this tool that allowed a doctor to meet with a patient virtually. More than just Skyping, he was able to turn and better interact with the patient.
“It was just amazing,” Quezada said.
Sharing Information
If there is a buzzword for the digital tech space, it’s interoperability or integration—the mammoth task of breaking down decades of silos among health care providers, from doctors and hospitals to pharmacies and labs.
That’s the challenge facing CORHIO, which is creating a system where no matter what insurer you have or doctor you visit, your health information—such as recent test results, medications, allergies and medical conditions—is accessible.
“Really our job is about making sure the right information gets in the right hands at the right time,” said CORHIO CEO Honea. “For us, it’s really been about getting systems to talk to each other.”
Meanwhile, for those working in the provider space, it can be just as challenging to navigate the digital space, where mobile apps number in the tens of thousands and grow each day. In addition to creating a complete health record for someone, they’re working to blend other tools that track a person’s health.
It’s no easy feat considering that with all these options “there are plenty of tools that disintegrate care,” Hutchins said.
Welltok works with insurers like UnitedHealthcare and Kaiser Permanente, to organize that chaos and present it in a way that makes sense and is relevant to the consumer.
“(Selecting digital tools for health is) an overwhelming and daunting task if you’re a consumer,” Rotermund said. “Once we start to organize that chaos for them the healthier and smarter decisions will just happen because it’s that much more convenient for them.”
Going Digital at Work
Digital tools are more often becoming components of workplace wellness programs in companies large and small, from providing employees with wearbles like FitBits to apps and online fitness challenges.
Those in the digital health realm say rewards are the most effective strategy for getting people on board with wellness programs at work. While incentives vary, they can amount to several hundred dollars in savings on premiums. In 2014, Cigna distributed $80 million in rewards to its customers, who completed 1.6 million health goals.
When the opportunity to lower health premiums is an incentive, employees are more likely to
participate in a wellness program, with 75 to 80 percent taking part, said Interactive Health Greater Denver Area Sales Director Lisa Kwiecien.
Then add an online peer-to-peer network and you create a space for support—and accountability, Rotermund said.
Interactive Health creates wellness programs for employers and health plans, and keeping participants motivated is key.
“If you can get someone to stay a little healthier each year … they’re going to stay motivated and stay in the program,” Kwiecien said.
And it’s becoming more about culture of workplaces.
“More and more companies are understanding that to make this work and really see this out long-term we have got to build a foundation of really supporting this culture of well-being, and we feel that this will yield returns in the longrun,” said Sarah Sweer, Cigna’s region manager of well-being.
Health Care Made Just for You
In the age of cognitive computing, where your personal preferences can be learned based on
previous data, a personal health plan is a reality.
Welltok has partnered with IBM, using its supercomputer Watson to predict users’ needs and make suggestions to improve health.
“You can literally in real time start to adjust and personalize based on that individual consumer,” Rotermund said, whether reminding a user about his next doctor’s appointment or suggesting recipes that include favorite ingredients or removing those that could trigger allergies. “Personalization is one
of the key things we do because one size does not fit all.”
Eighty-six percent of clinicians believe mobile apps will become important to patient health management in the next five years, according to a survey by PricewaterhouseCoopers.
Dr. Steve Haley agrees.
“I think the digital future will be applications that physicians will prescribe,” said Haley, who is vice president and chief medical informatics officer at Colorado Kaiser Permanente Medical Group.
And it gives consumers more ownership of how they take care of themselves.
“We can’t expect physicians to do everything, and an engaged patient can accomplish great things with the right tools,” Lynne said.
And, there’s more focus on using time more efficiently, which will ultimately save people money, Honea said. For example, starting this summer, Kaiser patients will be able to have “video visits” with their doctor and not have to leave home.
All Eyes on Colorado
With events like 10.10.10, there’s not only interest in solving looming health issues, but also of involving the companies and brain power of those who are driving innovation in the digital health space.
And there’s even more on the horizon for Colorado organizations. Prime Health is working with a leading research university to create a test bed for digital health products, building on its current work to accelerate the growth of early stage digital health companies and to create connections among those
companies and large providers, who would be the ones most likely to use their services.
“We want to create one of the leading digital health ecosystems in the country,” Rishavy said. “This will be another differentiator for Colorado.”
Meanwhile, CORHIO is creating an opportunity for developers to plug into their data architecture—so that they can understand how it works and build solutions inside a tested platform.
And with companies like Healthgrades and Welltok that have been headquartered in Denver for decades, digital health could be the next economic calling card of the metro area.
“No one has claimed the digital health headquarters for the country. To me there’s no greater opportunity than for Denver to claim that, because if you think about a healthy state, there’s no question that Colorado is the first to come to mind,” Rotermund said. “And we’re starting to be known as a little tech hub. For us to marry the two there’s a golden opportunity. We feel committed to put Colorado on the map and do our part in making it the epicenter for digital health.”
Sara Crocker is the communications manager for the Denver Metro Chamber of Commerce.