The Future of Elder Care

Last weekend I moderated an amazing group of presenters for Harvard Business School's 17th Annual Healthcare Conference, debating the future of elder care throughout the world.

Discussants were

Geoff Price - Oak Street Health, Chief Operating Officer

Susan Diamond - Humana, President of Home Solutions

Neil Wagle - Devoted Health, Chief Medical Officer

 We started with a statement of the problem - in many countries such as Japan, the Nordics, Germany, Italy, and the United States, societies are rapidly aging.   Birth rates are declining.    Costs are rising and access to clinicians is becoming more challenging

 We delved into several major themes - the role of home care, the rise of digital health, and the evolution of financial models that incentivize wellness over sickness.

Mayo Clinic is building home hospital capabilities and, later this year, will evaluate these efforts in two sites.    Through this early work, we'll learn about the supply chain, telemetry, command center capabilities, staffing, and the characteristics of patients best suited to home hospital care. 

 All of the panel members agreed that the future belongs to delivering high quality care in the right setting at the right cost.   Medicare Advantage reimbursement models, accountable care organizations, and alternative quality contracts all focus on reducing total medical expense while sustaining quality/safety/patient satisfaction.     If home hospital care reduces cost while improving outcomes, I believe that refined reimbursement models for home care will emerge.

Delivering digital capabilities - telemetry, communication, and care orchestration to elders requires a comprehensive technology strategy.   Many homes do not have fast, reliable wifi.    LTE and 5G cellular networks will be increasingly strategic for home care.     It's likely that a technology services partner will be needed to keep home-based devices configured, secure and stable. 

Just gathering the telemetry as part of elder home care is not enough.   Algorithms and analytics are needed to turn raw data into action, filtering signal from noise.   It's not yet entirely clear how to understand the precision/accuracy of remote monitoring, how to interpret individual variation, and when to ignore false positive signals.

Mayo Clinic is also launching a remote diagnostics and monitoring capability over the next year, via a platform approach that connects telemetry to novel machine learning algorithms, supporting patient wellness.

We also discussed the digital divide.    As we create more digital interventions to the home, we must meet patients at their level of technology comfort, literacy, and affordability.    We'll need organizations that can help patients access care, optimize the use of devices in their home, and encourage follow through with care plans.   

The future of platform components to enhance elder care is bright and an ecosystem of supportive businesses will be needed.  I look forward to being part of that journey.