By HARRY GREENSPUN, MD

As technology-enabled home health becomes more pervasive, how will consumers respond? What concerns and reservations will they have? Will they readily adopt new technologies? Deloitte conducted focus group research to better understand consumer expectations and preferences for receiving health care services in the future, focusing on care in the home.

In general, consumers are optimistic: To them, the benefits of technology-enabled home health far outweigh the risks, and they are eager to try it. For the unwell, home health technology can help manage their conditions and slow disease progression. For caregivers, it can offer peace of mind. For the healthy, it can provide the tools and support to maintain healthy behaviors.

Even though interest is high, we heard some concerns. Consumers value the personal nature of health care and the patient-doctor relationship. Many are concerned that increasing reliance on technology will erode the relationships that they feel are already threatened by the fragmented nature of health care, decreasing face time with doctors, and difficulty establishing and maintaining those meaningful relationships. While it may seem obvious that technology should reinforce and facilitate relationships rather than supplant them, consumers’ previous experiences with technology temper their enthusiasm.

Technology-enabled solutions that are perceived to intrude on people’s privacy, such as sensors that monitor an individual’s sleep quality or motion patterns at home, face resistance. Education may be required to effectively convey the benefits of such monitoring; consumers are then able to evaluate the pros and cons, and many are amenable to the tradeoff.

As more care moves to self-care, consumers want to have influence and control over their own care and health information. They expect to learn about new technologies and to be actively involved—as patients or caregivers—in deciding which technologies are used for their care, how they are used, and what data will be disclosed and shared.

Companies—whether newcomers or traditional players—developing the technology for home health are expected to negotiate a number of challenges:

Addressing interoperability and building a unified patient record may require unprecedented levels of collaboration among multiple stakeholders (e.g., providers, health plans, patients, wellness vendors, home health agencies, and social services).

Redesigning provider workflows should take into account changing roles and responsibilities of individuals on the care teams, the fluid nature of the teams, and the cultural shift from a provider-centric to a patient-centric model of care. We expect the most acceptable solutions will incorporate care teams because consumers trust their physicians and want those continued relationships.

New technology solutions will serve diverse segments of users; among them, patients, caregivers, physicians, and care team members. Their needs, technology platforms, and comfort with technology will vary and issues, such as health conditions, disease stage, culture, income, and education will come into play. For example, a solution that might be appropriate for someone with diabetes who is highly engaged and tech-savvy will likely be different from a solution for a caregiver of someone with dementia.

Sustaining consumer and provider engagement in technology-enabled home health may be one of the greatest challenges. To be able to customize engagement approaches, stakeholders will need to earn customers’ trust and develop in-depth understanding of their needs, limitations, and preferences. By involving future customers in solution design and testing, stakeholders will be able to not only derive useful early lessons but also inform engagement approaches that will lead to sustained use of the solutions.

Key takeaways:

We explored two areas of potential uses of technology enabled home health:

1) managing chronic conditions and 2) promoting healthy living.

By combining participants’ reactions to our pre-developed scenarios with their own ideas for the future of health care, we gathered rich insights on consumer attitudes and preferences on technology enabled health, summarized below:

Solutions to manage chronic conditions

• “Passive” approaches to remote monitoring have strong appeal, especially among older (45-64 year old) research participants. Reconciling ethical concerns against the convenience of the monitoring is a complex trade-off negotiation regardless of age.

• Participants express desire for greater shared decision making, where decisions about their care or the care of their loved ones are made collaboratively with clinicians.

• Control and choice are important: e.g., consumers want the ability to scale up or down the level of physical environment and biometric monitoring.

• Physicians and other practitioners on the care team enjoy the greatest trust from patients and are in the best position to provide education to patients and caregivers on pros and cons of home health technologies.

• Participants who used home health in the past as patients or caregivers report positive experience; without a physician’s or hospital’s referral many would not have known of home health options. Their experience informs nuanced and thoughtful perspectives on the future of home health technologies. Solutions for healthy living

• In situations of acute illness or preventive screenings, younger consumers are more open than older participants to self-service options, such as using lab kits delivered by drones to perform lab tests. Older participants lean toward house-calls from a nurse or lab technician. Solutions for chronic conditions and healthy living

• New communication methods (such as online visits) are expected to strengthen patient-provider relationships and increase access to care.

• Convenience and ease of use are key considerations in every application of technology-enabled home health. Solutions that deliver compelling benefits while reducing patients’ and caregivers’ burden are more likely to enjoy acceptance and sustained use.

• Approaches to consumer engagement should take into account many factors, e.g., personalities, lifestyles, comfort with technology, and communication preferences.

• Participants are perplexed that their patient information today is scattered; they believe they and their providers should have complete and easy access to this information.

As the director of Deloitte LLP Dr. Greenspun serves health care, life sciences, and government clients on key innovation and clinical transformation issues. He has been named one of the “50 Most Influential Physician Executives in Healthcare” by Modern Healthcare, co-authored the book “Reengineering Healthcare,” and has served on advisory boards for the World Economic Forum, WellPoint, HIMSS, Georgetown University. Prior to joining Deloitte, he served as the Chief Medical Officer for Dell.