Look around you. If you are in a room with more than a few people, it is likely one of you has a chronic disease. In fact, according to the Center for Disease Control,
“Six in ten Americans live with at least one chronic disease, like heart disease or stroke, cancer or diabetes. These and other chronic diseases are the leading causes of death and disability in America, and they are also a leading driver of healthcare costs.”*
I’ve been very transparent about the fact that in my family, it’s Type 1 diabetes, with three of our four children diagnosed and under treatment. Type 1 diabetes can’t be prevented, but a significant proportion of chronic diseases can be prevented. Currently, the cost of this epidemic is crippling and the high personal toll to those who become chronically ill is devastating to the individuals and their families as well as to the economy in lost productivity. The CDC reports, “90% of the nation’s $3.8 trillion in annual healthcare expenditures are for people with chronic and mental health conditions.”
Our spend on healthcare is hurting our global competitiveness, but even if the spend were to stay the same, if we were able to prevent even a portion of chronic disease, we could reallocate those funds in more economically beneficial ways – such as research for rare forms of cancer where we are making slow progress. We could spend on innovations that could be exported for financial gain instead of the unnecessary consumption of dollars chronic disease is causing in this country. Globally, a quick comparison to other similar modern countries like Japan and Australia show the U.S. trailing dead last for mortality rates. The scope of the problem is staggering in terms of money and human pain, and there’s a lot of work to do. The Partnership to Fight Chronic Disease estimates that 164 million Americans will be affected by a chronic disease by 2025 So while right now you may be tempted to stop reading and go to the gym, there’s more we can do today to change where we are by 2030. Let’s explore how we can turn this around.
There has been some progress with legislation and healthcare policy work, but there is more we can do to accelerate progress. The cloud and cloud-based technologies offer significant potential to address this problem more effectively. Payers offering high deductible plans are now permitted to provide chronic disease prevention services in ways that involve cloud technologies that enrollees can use even prior to meeting their deductible. Some payers offer incentives such as Amazon gift cards for logging exercise or other wellness activities, typically monitored through cloud-based apps. Employers have, in some cases, created a gamification model in order to promote wellness. And wearables working with cloud-based apps are helping track and build awareness of activity that can boost wellness across a mix of generations and lifestyles.
Progress is being made to address chronic disease and its care in the cloud. As noted in this article from Forbes, personalized digital health is the future for chronic conditions. Using analytics including AI coupled with personalized apps that inspire action and ownership of one’s health is one of the best ways to address the problems our country is facing. This opportunity is one of the most exciting aspects of the healthcare cloud, compelling payers, providers, life sciences and healthcare IT companies to take advantage of the cloud’s powerful and accessible AI and digital services. Here are a few examples of how healthcare organizations are working to reduce chronic disease in the cloud.
Internet of Things (IoT)
IoT offers potential only limited by our ability to imagine and innovate. The ability to connect health monitors is huge. The broad adoption of Apple Watch and FitBit supports the foundation of nutrition and exercise necessary to address obesity and other chronic conditions. In the U.S., obesity costs $480.7 billion annually which is equivalent to nearly 10% of the U.S. GDP. I spend a lot of time in meetings and airplanes and when it’s later in the afternoon and I can see that I have less than 10,000 steps, I’m much more likely to opt for stairs or walking to my hotel than I was before I had the smartwatch.
A customer I’ve worked with developed a remote patient monitoring device that is a wearable heart monitor and is very useful for its consumers. And, going back to my family’s ongoing challenge with Type 1 diabetes, my kids are using a continuous glucose monitor (CGM) that connects to an app on their smartphone. This app sends their actual blood glucose count to their phone, so they know when to take action to dose more insulin or cut back to get blood glucose into a safe range and prevent ER visits. The same app sends information to my phone and my wife’s phone so we can monitor the health of our children 24/7, and can intervene when necessary with calls or texts when we are apart. There is significant research on the benefits of continuous glucose monitoring to reduce hypoglycemic and hyperglycemic events, and once you’ve been through even one of those serious events, you’re desperate to prevent them.
Social Determinants of Health
The cloud’s role in understanding and addressing health disparities across geographic regions has grown in both the amount of accessible data and its usefulness. There are identified regions of the country where there are systemic issues: poor access to primary care; poor access to health intervention, or healthy food, or good air quality or safe places for exercise – all of which can increase your likelihood of entering a chronic state. Cloud-based solutions provide access to data that highlights those regions, enabling healthcare organizations to support the health of target groups better. And because the properly designed and managed cloud is more secure than on-premise silos, it provides confidence to disparate teams to share data. Cloud-based solutions are acquiring a reputation as a trusted steward or destination for that data when it’s secured properly – which often requires the help of third-party experts, a worthy investment in your cloud strategy.
When I worked in healthcare as the Vice President of IT at a large hospital system, we took advantage of the cloud for population health work. It provided a way for large hospitals that were competitors to bring data to a safe, secure, and neutral place in which to perform population health analytics. Data at that scale can provide such timely and useful insights – insights we used to improve health for patients and earn improved reimbursement for providers.
Machine Learning and Artificial Intelligence
One of the big attraction factors of the cloud is that it is incredibly scalable – in both up and down. This creates an ideal environment for machine learning, which can require significant compute resources at key intervals. Working in a secure cloud environment, we are able to burst out data sets and inexpensively expand until we complete the study, then scale back to save money. The learnings from these cases are incredibly useful. We are seeing machine learning and artificial intelligence being used to identify genetic mutations that can cause cancer. It is also being used to predict the risk for disease and diagnosis while assisting with prognosis and treatment.
Machine learning requires cloud.
We are at a crossroads in healthcare right now where we face a growing epidemic of chronic disease, but also have emerging technologies at our fingertips that, when used properly and securely, have the potential to improve the problems we face dramatically. The choice and the future are ours.
A secure, health cloud holds the key to helping us use and share data to gain better insights, then take action to improve the quality of life for millions, and the U.S. economy in the process.