Recently, Susan Sharer sat down with Jim Traficant, Managing Director, Federal Health, Accenture Federal Services, to discuss the positive disruption occurring in healthcare today: How it is fueled by the Federal Government and private sector; how the two will come together; and what must be at the heart of innovation, as part of Accenture’s newly published 2018 Digital Health Tech Vision.
What is Driving the Disruption Taking Place in Healthcare?
Historically, Healthcare has been very physician-centric in the sense that patients were unlikely to question advice from a knowledgeable and experienced physician. This is changing, however, as information becomes more centralized and distributed to the edge. Patients are taking a more proactive role in managing their own Healthcare and have access to more information – both their own and more general information around health and wellness. That dynamic, coupled with technology acceleration, is enabling a disruptive future state that is playing out in many dimensions.
What Are Some of the Clear Disruptions You’re Seeing?
Perhaps the biggest disruption is the integration between the Federal Government and private sector, from the DoD side with TRICARE and from the VA side with Community Care. Healthcare providers are beginning to recognize that effectively managing a service member’s health, from enlistment until the end of their life, requires collaboration between private and public partners. We’re just getting to how that alignment will ultimately be managed and what the care experience for those who serve will ultimately look like. Another example is the healthcare.gov model with a federally funded marketplace being undergirded by private sector payers. There’s an interdependence emerging that we didn’t see before. We’re just beginning to understand how this process will be defined and what it will look like.
Technology is another major source of disruption in the Healthcare industry. As consumer wearables and home and remote monitoring evolve, we can offer virtual services anytime and anywhere. We’re doing work where we intervene in cardiac care after patients are discharged to keep them from needing to return to the hospital. When clinical interventions like this can happen beyond hospital walls, it benefits both the patient and cost of care.
DoD is strategically advancing Health Information to strengthen force readiness. Sensors, IoT and analytics allow integration of data into an individual readiness profile. This advanced sensing and processing is redefining what Healthcare providers are responsible for and the role they play in care delivery. Human judgment will always be required, but better data will enhance a clinician’s expertise.
There are non-traditional players and new entrants coming into the Healthcare industry from consumer markets who will disrupt how care is delivered. Today’s mega-mergers and collaborations are bringing at-scale business strengths and disruptive consumer engagement models certain to shift traditional models and economics of care. The commercial entrants from adjacent industries will force the traditional players to react and rethink their market strategies. All of this will ultimately touch Federal Health. It will be up to all of us to take advantage and shape how this ecosystem will benefit Federal Health.
How can Industry and Government Prepare for the Disruption?
Disruption, by its very nature, is unexpected. We’re seeing the pace of disruption accelerate in Federal. DoD and VA are in a once in a generation modernization. DHA is taking over the Military Treatment Facilities in October. VA is redefining how it will partner with DoD and the private sector to deliver care and benefits. This is all unprecedented.
For technology to be truly disruptive in health, it must be clinically-led and outcomes-focused. Clinicians, all the way up to senior tiers of leadership, must champion the culture change that goes with technology transformation. For DoD to move from Tri-Service to a unified model is a major shift, as is having both DoD and VA on a common system with shared workflows and business processes. Once clinicians embrace and lead the movement toward these future states, then you can look at key issues like improved care quality, improved access and how technology can enable transformational outcomes.
We’re shifting from a model of managing illness to managing wellness. That’s part of the quadruple aim in the military around readiness. This transition is essential for us a nation to realize the value of our health economy. We must define the clinical and business outcomes we are striving to achieve, as well as the tools that are available and required to achieve those outcomes. We can’t invert this paradigm and focus on the technology and then try to make the experience fit the tools.
Instead, we must develop patient-centered experiences and expand the boundaries of care virtually in a model that meets consumer needs. Consumers have the control and want the same liquid, brick-and-mortar to virtual engagement experience available in other industries. The best care experiences should be comparable to the best virtual experiences in ecommerce.
Tell us More about Telehealth
Mobile health adoption has tripled from 2014 to 2018 and the use of wearables has quadrupled during the same period. This is fueling a connected health ecosystem and enabling models of virtual care not previously possible. VA is leading telehealth for our nation, strategically extending clinician capacity to deliver care to the edge, where Veterans live. We’ve also seen VA’s success in providing care seamlessly across state boundaries. The DoD announced their strategic intent to leverage the VA’s model. We expect to see a continued convergence of strength between these two agencies and a full continuum of wellness and care solutions based on telehealth delivery to achieve aligned outcomes.
We are also seeing great success with the VA’s virtual care for mental health. Other large-scale systems like the UK’s National Health Service (NHS) have also effectively delivered various types of virtual services for mental health care. Telehealth is moving from a technology focus to effective clinical practice at scale.
VA has also used telehealth successfully to address PTS and traumatic brain injury, delivering care appropriately and thoughtfully in an ideal healing environment, often the Veteran’s own home. This is where the Federal Government is leading and setting the bar for industry.
Where do Technologies like Artificial Intelligence come in?
We’re seeing emerging trends where technology is taking us from the Internet of Things to the Internet of Thinking. Machine learning and AI continue to enhance the knowledge base for the delivery and management of care.
The key is using technology to drive clinical outcomes, not using technology for its own sake. There will always be a level of judgment required in medicine. The question is, how do we take more routine tasks and improve them, while enhancing the available knowledge upon which our decisions are based?
There are many examples of how AI is being applied in medicine. At Harvard Medical School and Beth Israel Deaconness Medical Center, researchers have garnered attention for using AI to bolster the combined power of humans (pathologists) and technology (machine learning) to diagnose breast cancer biopsies faster and more accurately. A typical pathologist practices at about 96% accuracy and machines by themselves at about 92%. Put them together, we see accelerated speed and a predictable improvement to 99.5% accuracy. This is a perfect application of being clinically led with outcomes enabled by technology – in this case, AI.
What about Collaboration Between Public and Private Sector and with Government?
DoD and VA have long been pioneers in applying research to clinical practice, not only to benefit Federal Health, but broader U.S. Healthcare. In fact, I’m a beneficiary of VA’s pioneering work in liver transplantation and personally experienced surgeries performed in private hospitals that leveraged VA innovation. U.S. Military Health not only benefits those who serve, but is a tremendous diplomatic force representing the goodwill of the American people abroad. When the Ebola crisis emerged, the world turned to U.S. Military Health to address it. DoD Readiness of the Medical Force often partners with private sector trauma centers to enhance readiness skills of clinicians preparing to deploy.
The VA is the largest health system in the United States, and DoD is a global, powerful diplomatic force. These agencies are going through IT modernization at the same time, aligning the model of continuous care and being thoughtful about aligning with and even driving industry transformation. The Federal Government really has an opportunity to use the VA and DoD model to drive Healthcare nationally because of their scale, breadth and the fact both are at the core of an integrated Federal – private network. The business case for an integrated health system stems from the more than a trillion dollars infused into the system by the U.S. Government. DoD and VA are leading the way for integrated care delivery and integration with the private sector can help us achieve the transformation needed for those who serve, their families – and our own.
Setting Aside Competition
Our companies naturally compete, so we all appreciate opportunities to collaborate and cooperate in a shared forum, to focus outside our own lanes and to discuss the innovation occurring in adjacent markets. People who serve in Healthcare generally – and for certain Military Health and VA – share a passion for making a difference, and that is highly motivating and fulfilling.
Jim Traficant is the Accenture Federal Services Managing Director for Federal Health. He has more than 25 years of executive and operational leadership experience in Government, commercial and international markets. He served as President of ASM Research leading the AFS acquisition and growing it fourfold in three years. He previously served as President of Harris Healthcare Solutions where he created a business from an idea and expanded to over one thousand employees across six countries in five years. In addition, he serves as U.S. Advisor for the Global eHealth Foundation. His industry experience includes Aerospace & Defense, Intelligence, and Healthcare as well as M&A, product development, and IT services. He was awarded Federal Computer Week’s “Federal 100” as well as G2XChange’s “FedHealthIT 100” for his leadership in Federal Health and was also featured in Gary Shapiro’s New York Times bestselling book, “The Comeback: How Innovation Will Restore the American Dream,” for his compelling Healthcare story and innovative solutions for Healthcare transformation. You can find Jim on LinkedIn and Twitter.