The healthcare industry is changing, with disparate parts of the overall system coming together to offer consumers a more comprehensive array of services. For this conversation, HRI spoke with PwC Principal Igor Belokrinitsky about the future of these integrated health networks, and what they could mean for the US health system.
How would you describe what the integrated health network of the future looks like?
It’s important to remember there isn’t one integrated health network. It’s not Skynet; there isn’t one ring to rule them all. As we see it, it is multiple integrated health networks in multiple regions and multiple communities, some collaborating with each other and some competing with each other.
We’ve seen that consumers are showing less trust across the entire healthcare ecosystem and they’re increasingly dissatisfied with the level of service and value they’re getting. That sentiment seems to be reaching a critical mass where it will overwhelm industry inertia and cause a reconfiguration where the industry business model will have to evolve from one that is transactional and one-off to one where competition is much stronger. We’re moving to a world of who has the trust of the consumer and who will have a longer relationship with them.
If a company wants to be successful beyond just delivering specific healthcare encounters and instead creating trusted, rich, long-lasting empathetic relationships, it has to be able to understand the consumer it is targeting across the clinical, behavioral, financial and social dimensions of their being. It has to engage with them at the right time and right place and right channel so that the consumer responds and reciprocates. It has to keep engaging them in ways that are convenient to them so that over time, they achieve better health while the system is better able to anticipate consumer health needs and bring a range of services to bear. We’re really moving toward a world of who has the trust of the consumer, who will have the longest relationship with the consumer, who will be rewarded with consumer loyalty and a higher share of consumer wallet. It’s about creating lifelong relationships.
HRI: You’ve referred to trust between consumers and institutions in thinking about how future integrated health networks form and function. Are there types of companies that can help serve as trusted brokers in networks like these?
Igor Belokrinitsky: Everybody says they care deeply about the security of their medical records but they seem less willing to do much or spend much to secure them. It’s going to get worse before it gets better because every new medical device that comes to bear creates another vulnerability. The government is very interested in securing private health data, but doing so can also create an obstacle to innovation. We’re pushing institutions to be more interoperable, which creates a potential to compromise confidentiality in the service of connectivity.
In an ideal version of the future, a health record is one that you control and you decide who to give the record to and how. There are high hopes for blockchain to improve trust and generate a single source of truth, but the next level is to create a system that’s secure and also user-friendly. We’re probably 20 percent of the way there. There are promising developments because entities are entering the space with a track record of providing this in other industries. Credit agencies, for example, have experience in creating a level of trust of security in the records they manage. That gives some hope that even if healthcare as a sector is different, it can’t be that different. If you can secure banking and real estate records, you should be able to do it for health records as well.
We’re really moving toward a world of who has the trust of the consumer, who will have the longest relationship with the consumer, who will be rewarded with consumer loyalty and a higher share of consumer wallet. It’s about creating lifelong relationships.
HRI: So how do you see these future integrated health networks functioning?
Igor Belokrinitsky: There are regional differences certainly, but key will be the convener of the network. More often than not we tend to think that’s a role that could only be filled by a large health system, but it doesn’t have to be that way. Hospitals are moving to the periphery of the health network, no longer the center of the universe. A physician group focused on delivering care and managing a patient population could be ideally positioned, as could a payer with contracts to network providers.
Retailers—consumer electronics ones as well as health care ones—are also moving into this space. Telecommunications companies can help to play a role in home health monitoring. That means companies that manufacture smart homes and the devices in them that can talk to a person’s health network have to be secure, easy to use and ubiquitous because they’re in your room, your car, your phone, even on your body in the form of smart clothing, smart tattoos and implantable medical devices. To us, these examples are not one-offs. Everyone is competing to see who is going to be the front door to healthcare.
These new integrated health networks will create winners and losers, but it won’t be necessarily pure cutthroat competition. In places where incentives are aligned, the goal will be addressing much larger issues that are beyond the reach of one singular organization and will deliver broader benefits. It’s almost analogous to the railroad boom in the 19th century in that we built more railroads than we eventually needed, but we found that some of the byproducts of the industry, such as unified accurate timekeeping, continue to deliver a benefit. A more modern example is the opioid crisis—no single entity can address opioids on their own, they require collaboration across systems, but even competing entities can find mutual benefit by working toward fixing the problem.