The Opioid Crisis

The number of deaths in the U.S. from prescription opioid overdose has more than quadrupled in the last 15 years and the number of deaths due to heroin and fentanyl use and overdoses has surpassed these numbers. The DEA released a National Heroin Threat Assessment Summary in 2015 after they had issued a nationwide alert that identified fentanyl as a public health and safety threat. In this summary, they observed a spike in overdose deaths in several states, with Ohio, Maryland, and Massachusetts in the top three spots.

A recent report released by The National Institute of Drug Abuse (NIDA) revealed that the use of vaping devices has dramatically increased among America’s teens. In just one year, the number of 12th graders that reported using some type of vaping increased from 27.8 percent in 2017 to 37.3 percent in 2018. Within the same group, nicotine vaping increased nearly 10 percentage points and marijuana vaping increase 9.5 percentage points in one year.

There are many parts working together in our bodies and research has shown that those individuals needing treatment for more than one condition of the mind and body, die on average more than 10-25 years earlier than those that do not. Many medical professionals and researchers believe that this is an increasing trend and that the number of individuals with co-morbid conditions will continue in the years ahead.   Even more important, is that many behavioral health disorders are often overlooked by non-psychiatric physicians and general practitioners.

Affordable Care Act

The Affordable Care Act (ACA) was signed into law on March 23, 2010, by President Obama. Since that time the Republican party has tried without success to repeal or partially repeal this program. According to the Centers for Medicare and Medicaid Services, as of  2018, there were approximately 11.8 million consumers that selected or were automatically re-enrolled in Marketplace Healthcare plans.

Since the 1970’s our population has faced an increasing number of chronic health concerns. Many of these have been related to lifestyle choices that lead to the most common non-communicable diseases, including obesity, physical inactivity, sexual behavior, and substance use (tobacco, alcohol, and drugs). During this time, these “lifestyle diseases” have been addressed by looking at personal choices, behavior, and responsibilities. Recent research though suggests that an individual’s actions are strongly influenced by their own physical and social surroundings. Many of these studies have shown that alterations in one’s environment may be an effective tool for changes in behavior.

Digital Health has been a hot market space in recent times with investors collectively pouring $26 billion since 2010 and over $7.2 billion just last year.  Mobile health or mHealth apps were seen as a crucial element in managing chronic conditions like diabetes and asthma, by helping patients take care of their lifestyle and medications.  In fact, mHealth Apps were the largest funded category in digital health, with over 325,000 apps available by end of 2017.   

Imagine a patient just diagnosed with a life-changing chronic illness such as diabetes, arthritis, asthma or a combination of these illnesses. A patient’s knowledge might range from complete unfamiliarity on these conditions or just a basic understanding from episodic visits to the clinic. And in most cases, patients have lots of questions that go unanswered like how it will change their daily routine? What therapies are best for them? Are there any clinical programs they can be part of?

Only 10% of health is determined by care received at a doctor's office. Other factors like economic stability, residential environment, education, food, and community play a significant role in health outcomes. Individual behavior, including, where we live, what we do for a living, and what services we have access to make up 60% of our health. Clinical advice when combined with focus on individual behavior and social factors can result in superior health outcomes.

Industries that have matured on managing customer satisfaction, like airlines or retail, understand that expectations around service quality, delivered quality and communication are key drivers of consumer satisfaction.  One mantra that has become universal is - small variations in delivered quality can result in significant differences in satisfaction/complaints, depending on how expectations and communication are managed. 

In healthcare, the availability of new data sets (variety) and the pace at which the data changes (velocity) is driving the rapid adoption of Big Data techniques.  New data sets from social patient reviews, physician payments, sensor/ personal medical devices, and patient behavior are leading the change.