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Innovations in Caregiving: Looking Beyond the Horizon

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Smita Nikam, Chief Medical Officer, MundaiiAs the health industry continues to evolve, striking the right balance between innovation and compassionate care is eminent. Despite widespread adoption to new digital solutions and collaboration, health organizations struggle to achieve optimal patient outcomes and lower delivery costs. According to CMS projections for 2018-2027, the national health expenditure growth is expected to average 5.5 percent annually, reaching nearly $6 trillion by 2027. Over the projection period, key economic and demographic factors are expected to be the major drivers of health spending. Digital health transformation holds a strong promise to improve several aspects of medicine including patient engagement, cost saving and better patient outcomes. Global digital health market is estimated to cross $200 billion in next 5 years. Demand for new reliable digital tools is rising and so is the consumer maturation.

Will digital health be a catalyst to achieve a sustainable future?

Technology has transformed organizations and disrupted the traditional approach towards care delivery. Globally, as value-based care takes center stage, the geographical boundaries will disappear. Patients will have access to medical care across health systems even from remote locations. Recently, the U.S Department of Veteran Affairs launched new features that enable veterans to have more direct access to their health information and share it with non-VA providers. Having said that, current path of Health IT is an unchartered territory. The pace of change is accelerating, and the healthcare community has some major challenges to address. Over the last decade, increasing burden of chronic medical conditions and the lack of resources that streamline the workflow have been major barriers to a healthier America. Physicians are often frustrated with EHR models with disorganized clinical data that creates inefficient care. Extracting meaningful information, fundamental to accurate diagnosis and treatment, is tedious and has been said to lead to professional dissatisfaction and burnout.

How different are millennials from baby boomers in context of healthcare?

By 2020, millennials will be the largest generation and comprise half of the American workforce, far exceeding the baby boomers. With a spending power of 1.4 trillion U.S. dollars these value conscious consumers share some unique characteristics.

Digital health transformation holds a strong promise to improve several aspects of medicine including patient engagement, cost saving and better patient outcomes


Increasing global connectivity allows them to explore career opportunities domestically as well as internationally. They are more likely to research their ailment, focus on flexibility before deciding on a physician or health insurance. Moreover, millennials are more likely to seek medical opinions online, and use apps or platforms that allow storage and easy transfer of digital health records. These attributes could serve as the foundation for data liquidity across health systems and better patient care.

There is an increased awareness about data privacy and security across all age groups. Baby boomers continue to seek an active lifestyle and social engagement as they age. Traditional approach to care delivery with physician taking the lead role in decision making process could potentially deprioritize patient experience. We see a shift where patients want to participate in their care and live independently. Interestingly, not everyone wants complete autonomy. Some rely on medical experts to collaborate on the best solution and help them navigate the complex terrain. At Mundaii we observed these patient preferences and built features that offer more choices to users. Increasing engagement in mobile technology, video-chat follow-up visits tend to improve compliance, avoids waiting room time and reduce no shows.

What is the role of AI in the new era of patient care?

Artificial Intelligence has rapidly evolved from mere data storage in 1950s to faster processing speeds and Machine Learning in 80s to self-driven algorithms. In last few years AI has made exponential progress. It’s Deep Learning component is unleashing health technology and makes us wonder what is next!

Automation of care in a controlled setting has the potential to deepen our understanding of various aspects of medicine. Machine Learning based score can predict hospital readmissions more accurately than standard score. Such compelling data can help create future E-solutions that focus on prevention. However, there still exists significant skepticism about AI potentially replacing the doctor patient relationship.

How is the ageing population affecting health care delivery?

Today, the average life expectancy for the U.S. population is 78 years. By 2030, it will be 83 years and 1 in 5 Americans will be over 65. There is a consistent shift from nursing home care to assisted living communities and elderly parents living at home. Science has enabled early detection and cure for many diseases and cancers but the prevalence of chronic conditions like heart disease, dementia etc. is higher and these have the greatest impact on older adults. For many families this means grown children providing care to parents or planning long distance care giving. According to Linda Fried, a renowned gerontologist, preparing for this demographic shift will help us keep the aging population engaged, active and healthy.

Any tips to help Health IT startups thrive? One of my personal favorite quotes by Albert Einstein serves as a constant reminder, “No problem can be solved from the same level of consciousness that created it.” In my opinion, understanding the consumer needs, recognizing the market opportunities, observing inefficiency in the system, creating a structured action plan and then tweaking it as needed to match the dynamic healthcare landscape is crucial. Forming a strong connection with the team members and preparing them to handle challenges even in your absence is the key to successful organization.