How digital transformation can benefit the entire health care ecosystem

5 minute read 8 Nov 2019
By

Adlai Goldberg

EY Global Digital, Social and Commercial Innovation Life Sciences Leader

Keenly focused on capturing opportunities and managing impacts created by the digital megatrend for the life sciences clients.

Contributors
5 minute read 8 Nov 2019

The digitalization of services and entire business models promises better results for health care companies, payers and patients alike.

The health sector is faced with the challenge of delivering more care to more patients, on a more personal level, but for lower cost. This seems an impossible equation. Yet there is a solution. Through increased collaboration, innovation, and the ability to scale new developments, companies can succeed in today’s connected ecosystem.

These are big asks for an industry that works to incredibly long lead times and is subject to such strict compliance. But as we’ve seen in a multitude of other sectors that have been reinvented, digital transformation is the answer.

Digital-first companies are changing the rules of competition and creating value at a far greater rate. And health care companies that operate with a digital-first principle are integrating the three levers of business transformation – human centricity, technology at speed and continuous business innovation – to deliver better outcomes for all stakeholders, from patients to payers such as hospitals and insurance companies.

In our work with world-leading health care companies, we’ve identified two key areas where digital transformation can help deliver a step-change in operations and value for all stakeholders.

Individualized cell and gene treatment

In the near future, cancer treatment will increasingly become individualized: in a clinic, a doctor will take blood or tissue sample from a patient, then send it off to a lab for bespoke gene sequencing and reengineering, and then the enhanced sample will be returned so it can be reinfused back into the same patient to specifically target cancer cells.

This requires a highly accurate supply chain, and timing is critical: the sample needs to reach the patient in a very specific timeframe, otherwise it is no longer viable, which requires real-time tracking. The patient also needs to be at the clinic at a specific time to receive their unique treatment. If one part of the supply chain is delayed, the whole process has been wasted.

PointellisTM meets this requirement: it is a blockchain of identity built on Microsoft Azure that links together patient, clinic, lab and logistics company and guarantees data security. It helps patients get their individual cancer treatment in a faster and more secure way, and is an industry imperative if individualized therapy is to become a reality at scale.

Outcomes-based health contracts enable payers like hospitals and pharmaceutical companies to come together and assess the true costs and risks of adopting (or not) a drug or treatment.

Health outcomes-based contracts

Many health care systems across the world simply can’t afford to give patients access to new medicines because of rising demand due to factors, such as people living longer and a trend toward more unhealthy lifestyles.

This has led to health care being structured and incentivized with a strong focus on short-term cost savings. The emphasis is very much on inputs, rather than outputs and value delivered. For example, payment is based on number of operations carried out, injections given or pill packets prescribed.

This leads to a lot of wastage, such as medicines that don’t work as well as they should do or unnecessary procedures and referrals. The result is significant cost in the health care system.

But if pharmaceutical companies could show payers (such as insurance companies) and providers (such as hospitals) how drugs could save money or deliver more value in the long term, more patients could benefit.

And if this new type of engagement happened on a digital platform, it could be implemented and scaled rapidly.

In response to this, some health care companies, providers and payers are collaborating on outcomes-based digital contracts, such as a “Health Outcomes Platform.” This allows transparent, end-to-end, seamless contracting between all parties to improve patient outcomes and reduce total health care costs.

The aim is to encourage the parties to take a broader perspective, beyond just the clinical outcome, and instead start to think about three dimensions:

  1. Clinical outcome: did the person survive? Were they cured?
  2. Economic outcome: did the intervention or drug get people out of hospital beds quicker? Did it help with a quicker diagnosis and intervene before the disease progressed? Did it prevent a more expensive procedure further down the line?
  3. Humanistic outcome: did the patient’s quality of life and the general patient experience of their health care improve?

Outcomes-based digital contracts enable payers, such as hospitals and pharmaceutical companies, to come together and assess the true costs and risks of adopting (or not) a drug or treatment. And by digitalizing the contract on a dedicated platform, all stakeholders can get transparency around the performance of a contract using dashboards, and even use analytics to predict performance.

Digitally transformed health care is leading the way

Both of the examples described above demonstrate how digital transformation is helping life sciences organizations meet the challenges of their industry. The transformative mindset of these digital-first players is changing the game.

Already, pharmaceutical companies are successfully trialling new connected devices, such as asthma inhalers that can monitor drug delivery to individual patients on a global scale. They are using machine learning and AI to monitor online forums and report to regulators on adverse effects. They are bringing patients closer to physicians through health reporting apps. And they are enabling online communities of support for patients, which can help them manage and defeat the diseases they suffer from.

Whether it’s patients who can get better treatment faster and improve their quality of life, payers such as health care providers who can improve their services and lower costs and risk, or pharmaceutical companies who can get better commercial results – for every stakeholder in the health sector, digital transformation can help build a better working world.

Summary

Digital transformation can help health care companies deliver better drugs and treatments to more patients, and at the same time reduce costs and risks for payers such as hospitals.

About this article

By

Adlai Goldberg

EY Global Digital, Social and Commercial Innovation Life Sciences Leader

Keenly focused on capturing opportunities and managing impacts created by the digital megatrend for the life sciences clients.

Contributors