Healthcare innovation

The divorce of care from health in…

The divorce of care from health in…

Charity, care, cost, expense

Healthcare is used to define everything from medical services to prescription drug coverage.  Yet so much of the impact of healthcare is rooted in care – its human, emotional and social components. While “sick care” services are crucial, “well care” arguably plays an even larger role. As the saying goes, “an ounce of prevention is worth a pound of cure.” As the chasm widens between “health” and “care,” so too will the impact on our nation’s wellbeing. There is an urgent need to remind ourselves of the benefits of this forgotten side of healthcare. Further, we need to integrate social determinants of health (SDoH), cultural competence and empathy back into the delivery of health services to restore its balance.

How did health become more important than care?

A more accurate term for “healthcare” is now “crisis aversion clinical services.” Our healthcare system has been built to deal with emergent, urgent needs – we are better at fixing broken bones than managing chronic conditions. Our system is plagued with shortsighted financial incentives thanks to traditional fee-for-service models that have focused provider attention on treating sickness vs. providing longitudinal care. Sadly, providers aren’t compensated for delivering holistic, preventive care because it isn’t profitable.

Aside from misaligned incentives, providers don’t have enough time to spend on “care.” Providers spend on average 13-24 minutes with each patient and approximately 16 minutes after each visit on EHRs. Unfortunately, in many cases, the EHR is winning in the battle for provider attention. Training of providers has lacked incorporation of an understanding of a patient’s cultural background or empathy. Less than 10% of healthcare organizations incorporate SDoH into clinical workflows or train providers to capture social determinants during visits.

Ultimately, consumers feel powerless and unable to make informed health decisions. Many consumers cite a struggle to navigate the complexities of our system and how to meaningfully participate in their healthcare. This inevitably causes a cascade of long-term physical, mental and economic consequences. Yet most patients prefer shared decision making or patient-led decision making to own their health journey.

My experience in maternal care 

My third baby was born a few months ago. Despite my experience and healthcare background, there were plenty of moments that left me feeling powerless and uninformed while making decisions. Across three deliveries, I’ve had to fight for my own care (pushing to not be put on general anesthetic) and have been lucky to find champions in amazing providers (helping me get a child out of the NICU and safely back home). I’m not alone. My good friend from California, new mom of two, and partner at Maveron — Anarghya Vardhana — said it well:

“The system is not set up to help the average American stay healthy and feel empowered. My method for fighting for my family’s health has involved reading NIH papers, consulting European standards of care, and speaking with close friends who are doctors from top medical programs. The holistic, thoughtful, care that should exist simply does not.”

Her baby was born one week from mine. Two cities, two babies, same time, same challenges.

Care coordination, education, and access must be put at the forefront. Around 50% of commercially insured adults – especially men – haven’t visited their primary care physician (PCP) in the past year and approximately 25% of adults don’t even have a PCP. Whether this is because people simply do not understand the importance of primary care or feel discouraged after previous interactions, this trend must reverse if we have any hope of improving the state of affairs in this country.

Bringing health and care back together

While clinical and technological advancements continue to improve health outcomes, we will not be able to reap the benefits of these innovations without an overhaul of our current system. Every health encounter must meet people’s basic social needs. Ensuring that cultural understanding, trust, respect, and empathy serve is the bedrock of all provider / consumer relationships is crucial too. Health consumers want guidance on life-altering decisions and expect to be treated with personalized care. The importance of empathy and cultural competence exists throughout many populations and can be quite successful in driving improvements in overall health outcomes. While clinical and technological advancements continue to improve health outcomes, we will not be able to reap the benefits of these innovations without addressing care needs.

Digital health’s role in this transformation.

Digital health is at the forefront of this transformation as it successfully enables “well care.” New digital-led health and care experience and coordination services are helping to streamline connectivity between clinical and non-clinical care. Companies like Unite Us provide the information that links individuals, social service workers, providers, and communities. Transcarent has created a new health and care experience that empowers consumers with trusted guidance, unbiased information, and personalized Health Guides to help Members find the highest quality care options and providers, when and where they want.

Many digital health companies use technologies like AI and tech-enabled platforms to design and deliver culturally competent care and education. By providing personalized messaging, SameSky Health removes barriers to care and forms meaningful relationships to bring people to health. The company builds trusted relationships while guiding members through their annual wellness journeys, and encouraging dignity, autonomy, and companionship as they navigate disparate life experiences. FOLX Health is an LGBTQIA+ healthcare service provider built to serve the community’s specific needs through end-to-end virtual primary care, HRT, PrEP, care navigation, content, and community. The company delivers a new standard of healthcare that’s built to serve LGBTQIA+ people, rather than treat them as problems to be solved.

The pandemic also drove a surge in companies focused on meeting patients where they are. Medically Home created a tech-enabled platform to enable the delivery of medium – high acuity care, as the name suggests, from the convenience of a patient’s home. MedArrive delivers a highly trained network of field providers to give patients the hands-on care they need at home Additionally, investments in companies providing the right foundation have enabled more creativity in care delivery. Companies like Wheel and SteadyMD are offering enterprise-level telemedicine solutions to help their clients build and scale a telehealth offering. Commure solves healthcare system and dataset fragmentation problems and bridges systems for critical data, staff, and clinicians to stay connected and in the loop.  By offering the underlying infrastructure, technology, and/or workforce, these companies are enabling a more streamlined care delivery process.

Frustrated consumers will continue to disengage from their care decisions if we can’t find a way to bring care back. Consumers expect to be equipped with the necessary skills and resources to take control of their care decisions. Cost transparency, home testing, and retail health care are some of the emergent trends to satiate consumer demands. Without rapid transformation, this divorce will further exacerbate issues that the U.S healthcare system is already facing: an aging population, the rise in prevalence of chronic conditions, skyrocketing prices of healthcare services, and the dire provider shortage just to name a few.

Our country needs an equally weighted healthcare system that uses the best of care and health to drive improved outcomes for healthcare consumers. Digital health companies are playing a meaningful role in redefining healthcare and it is our job to continue building, investing, and partnering with them to support the transformation everyone desires and deserves, and build a system that we can all be proud of.

Photo: eakrin rasadonyindee, Getty Images

Jinal Shah, Harvard MBA/MPP Candidate ‘24 and Layla Behrouzian, Harvard MBA Candidate ’23, contributed to the piece.

Editor’s Note: Transcarent, SameSky and MedArrive are portfolio companies of 7wireVentures where the author is a partner.