Technology is revolutionising healthcare delivery by engaging employees in their wellbeing. It may even help to contain medical inflation, says Sam Barrett
Having one’s health problems diagnosed by a computer was unthinkable a few years ago but digital advances and our increasing reliance on technology have made this notion more acceptable.
“It’s the digital age,” says Jelf Group managing director of healthcare and group risk Iain Laws.
“It started out in shopping before moving into banking and now into much more personal areas, such as our health. The fear factor’s gone as consumers have seen how empowering technology can be.”
The phenomenon has also been observed by Aviva UK Health medical director Dr Doug Wright.
“Technology makes it much easier to access healthcare services,” he says.
“This can help employees to manage diseases but also means they can engage more with their health and wellbeing.”
Employees are benefiting in particular from so-called virtual GP services.
Available from many medical insurers and cash plan providers, these services enable employees to have an appointment with a GP via webcam or video link. Appointments can usually be arranged within a couple of hours, offering a major advantage over the traditional method of seeing a family doctor.
“It’s a really popular service,” says Health Shield sales director Peter McAndrew, whose company offers a virtual GP surgery through its cash plans.
“It’s easy to use and, as well as replacing a visit to their GP, it’s been used by our members while they were on holiday or to arrange a prescription.
“Our EAP provider will also allow employees to book video counselling, which can be taken in the office to minimise absence.”
The convenience of this service brings considerable benefits for both employees and employers. While a two-week wait to see a family GP is expected to become the norm this year, an appointment with a virtual GP can greatly reduce the length of the illness while ensuring the employee does not worry unduly about their health problem. It can also reduce absence caused by the journey time involved in visiting a family GP.
However, “whether you’re trying to make an appointment with your GP surgery or with a virtual service, there’s still a finite number of GPs in the UK”, says Laws. “The queue never really goes away.”
In response to this problem, some insurers impose limits on the number of appointments an employee can access each year. Others, such as Aviva, are selective about which employees are offered the virtual GP service.
“We’ll provide it to employers that want it and are willing to promote it,” says Wright.
“The initial findings are very positive but we’re still in the test-and-learn phase.”
Technology can also help overhaul health insurance through wellbeing strategies.
Laws says: “We’ve already seen the socialisation of health with initiatives such as virtual GPs, wearables and gamification, but the next evolution will see greater personalisation. This will be a major step forward.”
As an example, online health-risk assessments are a standard part of many medical insurance and cash plan schemes, giving employees a simple score and access to generic health information to enable them to make improvements. But Aviva UK Health head of client management and propositions Ally Antell says these will become far more personalised over the next 12 months.
“The next wave of this technology will move to a platform that makes it much easier to connect with data from wearables and from an employee’s smartphone. It will also draw in big data, such as the information held by the NHS, to give health advice and information that is as personalised as possible,” he says.
More personalised health advice has the potential to engage employees further.
“Employees will be able to monitor as many areas of their health as they like,” says Laws.
“This could mean they get messages to help them eat a more balanced diet or improve the quality of their sleep. In addition, with these apps pulling in much broader information – for example, where the employee shops or where and how they like to spend their leisure time – health nudges will be tailored to the individual. By recommending small changes that are personalised, these services are much more likely to result in health improvements.”
Beyond a healthier workforce, employers can receive other benefits. Antell says that, although it will remain essential to keep employees’ data anonymous, the granularity of the information will make it more valuable to employers too.
“They’ll be able to get a much better view of health issues across the workforce,” he explains. “For example, if an employer sees there is a risk of a large proportion of the workforce developing diabetes, they can implement a health initiative to help employees reduce this risk.”
The potential for this type of initiative to improve employees’ health and wellbeing has prompted Aviva to roll out such a programme to all of its corporate clients, rather than just its healthcare clients. This will see up to 3 million employees given access to a technology-based health and wellbeing programme.
Extending take-up in this way can bring significant benefits. Wright says the data could feed into other products and even influence the way Aviva views pricing.
“If employees make significant health improvements, there is the potential to reward them in some way,” he says. “We’ll be able to gain much more insight into what’s happening.”
Cash plan technology
Despite their Victorian roots, cash plan providers are also adopting technology to make their services more attractive to 21st century employees. Along with services such as virtual GP surgeries, many are utilising technology to simplify the claims process.
For example, Health Shield allows employees to submit claims online, with a photo of their receipt accompanying the claims form.
“We want to make it as easy as possible to claim,” says McAndrew. “If they log in, as well as having their claim form completed for them, employees can see how much benefit they have left. This can encourage them to get more value out of their cover.”
However, the risk from online claiming is that the process can become too easy, with both the potential to drive up claims and the danger of increased fraud. It is still early days for online claims, the process having been introduced only a year ago, but nothing so far has alarmed McAndrew.
“We closely monitor claims patterns but over the past year we’ve actually seen claims fall, with this trend happening to both online and postal claims,” he says.
“There is potential for more fraud, and we’ve changed our systems to ensure we detect anything suspicious through the online claims service, but I’m not convinced it will happen.”
Whether technology is used just to simplify the administration processes around health insurance, or to actually deliver healthcare to employees, it has the potential to transform the market.
“Technology offers huge promise,” says Wright. “It’s still seen as a bit far off but the effect could be very significant.”
Using technology to contain medical inflation
Whether via a dishwasher, a tablet computer or the CyberKnife Robotic Radiosurgery System, technology usually comes at a price. In the medical insurance market, however, technology may actually enable insurers to contain price inflation.
This can happen in a number of ways. Initiatives such as virtual GPs, which help employees get medical advice more quickly, mean illness can be treated earlier and probably more cheaply.
Such early intervention can also enable the delivery of more appropriate treatment. This is the case with triage services, which are becoming more commonplace.
Health Shield’s Peter McAndrew says: “We’re looking to introduce a physiotherapy triage service on our cash plans to help employees decide whether they need treatment. Rather than having a few sessions of physio, it may be more appropriate for employees to treat their problem themselves, with the service sending them a link to a video exercise.”
Health and wellbeing initiatives also play a key part in containing costs. When employees are engaged with their health, as well as making improvements they also become more aware of potential problems, leading to treatment being sought at an earlier stage.
However, while technology has the potential to help control costs, Aviva UK Health’s Dr Doug Wright warns that the effect is not instant.
“You can’t get away from the fixed cost of staff, which can make up a significant part of claims costs,” he says. “But, if you engage employees with their health, you can do more on the preventative side. This will help to drive down claims.”
Tech innovations coming down the line
A personalised smartphone-based platform for people with food allergies, an assistive aid to help those with walking difficulties associated with Parkinson’s disease and a Bluetooth colostomy bag sensor all received commendations at Axa PPP Healthcare’s Healthtech & You awards in April.
A joint initiative in conjunction with 2020health and the Design Museum, the awards aim to promote the use of technology in helping people to lead healthier lives and be more in control of their health and wellbeing. Winners included the following:
Ostom-i by 11 Health is a sensor that alerts users of colostomy bags to how full their ostomy pouch is so that they can decide when to empty it. The device clips on to any ostomy pouch and sends Bluetooth alerts to a mobile phone or tablet app.
SlowMo (left, click on image to enlarge) is the first digital therapy platform for paranoia, which provides self-management tools to help sufferers take control of their lives. It empowers users to visualise their thoughts and the fast-thinking habits associated with paranoia, and to slow down for a moment, to manage their upsetting thoughts.
Patients Know Best by Dr Mohammad Al-Ubaydli is designed to empower patients to manage their own care by giving them a copy of, and helping them to understand, all of their health information.
With patient consent, it helps clinicians share information and engage with patients in new and powerful ways through a secure, encrypted patient portal and information exchange system.
FoodMaestro is an intelligent search platform for food products that offers healthcare providers a new way to engage with patients about diet and nutrition, based on personal requirements. It reduces administration time, enhances productivity and increases clinical time. The technology has been developed with specialist input from the allergy and intolerance teams at Guy’s and St Thomas’ NHS Foundation Trust.