Evolving in the Digital Age: How Health Care Apps Are Improving Care, Costs

^{By Julie Gould}

Pat Keran, vice president of UnitedHealthcare, highlights the major benefits of using an application as a health care resource, explains how apps improves patient care and lowers costs, and also reviews the challenges of app usage. 

Transcript: 

Julie Gould:  We spoke with Pat Keran, vice president of United Healthcare. Mr Keran highlights the major benefits of using an application as a health care resource, explains how apps improves patient care and lowers costs, and also reviews the challenges of app usage.

Please tell us a little bit about yourself.

Pat Keran:  My name is Pat Keran, Vice President of UnitedHealthcare, been with the company now for close to 15 years, with the vast majority of my 25-year career being in technology. Anywhere from e-commerce, to data security, to innovation, where I had been the last seven years, before coming into my product role now for the last, roughly, seven months.

JG:  Can you highlight the major benefits of using an app as a health care resource?

PK:  Absolutely. First of all, we're in the digital age today. The use of applications is astounding. You look at your personal lives, and how we use applications for a variety of things, if it's retail, if it's banking, if it's health care, the benefits of that really increase in regards to what we can do.

If we were talking five years ago, it might be as simple as looking up certain information, but now, you can actually do things like conduct telemedicine visits. As we look at health care today, first and foremost. I don't know if you know this step, but there's over 300,000 health care applications in the top digital stores out there today.

I'll be touching on some of things that I think is going to be coming forward in regards to a lot of these applications here. What we need to do is we need to break it down into more of a practical way of how we're using these applications for our health stores in things that we're doing today, things like transparency.

Now, as people are on their mobile app, they're able to look at what does the cost of a health care service going to be for me? If I have twisted my knee, and I think after talking to my doctor, I might need knee surgery, what is that going to cost? I can start using this application in the way I needed to act from an intelligence standpoint to help me with decision-making.

I mentioned telemedicine. It's hopping on in more of a secure methodology, but using it like FaceTime, and you're meeting with a doctor in regards to the care that you need on more of an on-demand type of service.

It's getting information about how much do I have within my health savings account today. Then using that, and actually paying my bills through this app. You're finding that the intelligence and the applicability of mobile apps, such as our UnitedHealthcare app, becomes a lot more prevalent in decision-making and actually facilitating health care.

JG:  How can applications, like the UnitedHealthcare app, improve care for patients and also access to care?

PK:  Again, we're in that digital age today. How we now utilize these applications now become a lot more sophisticated in how we're engaging individuals in care today.

Right off the bat, first thing that most people do within their apps today from a health care standpoint, is they look for a doctor. They look for someone that's available to them within their area that they could meet with.

Symptom checking is another one that most individuals start using. From a health care standpoint, is how do I now take symptoms that I have and utilize this to drive some kind of next best action?

Using that as a way to meet with a doctor, and have a visit that's going to last somewhere around 10 minutes, if that, for things like low-acuity type of care. Flu, colds, pink eyes, fevers, rashes, something that may be important for me to get looked at right now, but maybe I can't get into my primary care doctor for a week or two. I can very simply do an urgent care through a video visit here.

Then the impact of these digital applications, these digital assets, become vital now in how we engage members with care ongoing. That's going to continue to grow as we start evolving to areas such as chronic care, complex care, and using things like remote patient monitoring and other devices like that.

We are going to continue how we improve the type of care we're offering to our members, not only through what we call in-office visits or brick-and-mortar visits, but how we use the digital assets, like the UnitedHealthcare app, to provide that type of care from a remote, virtual standpoint.

JG:  How does the use of phone applications and/or telemedicine services lower the cost of care? Can you give a comparison of the cost of care in a hospital or an office setting, compared to that of someone using telemedicine services?

PK:  That's a great question. As we look at one of the barriers of care today, it is cost. There's a lot of realization out there by members and individuals there of what a cost of a particular service is.

Doing that comparison then, if we were to go to lower cost of care up to expensive cost of care, things like a virtual visit. We're looking at under $50 for that visit. Again, within 10 minutes, on-demand service, 7/24, 365.

Then if you look at the other cost of care, and of course there's going to be variability, depending on people's individual insurance plans, and of course, the markets that they're in as well, here, too. Your office visit, typical office visit could be somewhere around, let's say, $120 for that visit.

If you look at urgent care, that's probably going to be a little bit more, maybe $150, $170 a visit. Then as you go all the way up into emergency care, that could be $740, $1,000 a visit for that type of care.

This is really an interesting statistic. We did a model looking at all of the types of care that individuals go into the emergency room for. 25 percent of those visits actually could have gone through a virtual care. Now, you're taking something, on average, let's say an emergency room visit of $740, and you could have gotten it done for around less than $50.

Pretty significant savings when it comes to using virtual visits or telemedicine as another care path. Of course, the caveat here is that an emergency service is an emergency service. Meaning that if I have a broken arm, telehealth is not going to be my path. You're going to go to emergency care. It's the low-acuity type of care that is going to be best fit for a virtual visit.

JG:  What are the challenges of using applications as health resources?

PK:  One of the things I had mentioned early on, when you have over 300,000 health care apps at the various digital stores there, that's completely overwhelming here. Of course, as I look at my personal situation, I have three or four health care apps I use on a regular basis. There are many, many others, individuals, very similar in nature, that are using multiple different apps.

If I use these health care apps, there's not really a digital hub or connector for all of these applications. If I'm using a weight loss app, maybe a nutrition app, a telemedicine app, and maybe I have some other apps as well here, too, when it comes to health care, they don't talk to one another.

That becomes then a hindrance in regards to looking at the holistic individual when it comes to their health. What we want to do here is with these challenges, we want to start structuring now things like more of a hub model, where we can create a dashboard where we have these connections into these various applications. Remote patient monitoring devices like an Apple watch, a Fitbit, Garmin, etc.

How do we bring this information together to now get a better holistic picture of the individual? Interoperability is a huge challenge in trying to do all of this as well here, too. Those are some of the major challenges, other than people just simply not knowing that health care services are available, like a telehealth visit, or the price of care and the differentiation between do I need to go in to see my doctor, versus can I do it via a virtual visit, or do I need to go to an emergency room?

There's multiple different challenges, even outside the applications, that individuals need to be aware of. We can now progress through digital, through creating these hubs, through communications, through awareness that all of these tools and services are available.

JG:  Do you find that older adults have more challenges understanding these applications and this use of technology?

PK:  Julie, that's a great question. As you look at the older population, what they have is the technology is actually emerging for them to become a lot easier in using it.

As I look at certain iPad applications that are developed more for an older population, I look at caregiving as another opportunity that caregivers are actually engaging with their loved ones that they're caring for through digital tools like applications as well here, too.

The adoptability is becoming better. I think there's a long ways to go in how we do it and how we make it easier for that population. It is definitely a emerging area that I think you're going to find a lot of growth in.

Not just applications, but as you look at things like remote patient monitoring, the way that you're using artificial intelligence, like these voice assistants, the Google Homes, the Amazon Echoes, etc., in how we can now engage in yet another way with that population for their health care needs. It's definitely emerging, definitely an area that has a lot of growth and opportunity.

JG:  Can you give a future prediction? Do you see more apps, like the UnitedHealthcare app and other apps that are available, becoming more common and more popular?

PK:  It's a great question. I don't know if I see more apps. I think what we're going to see is we're going to see the connectivity of apps.

As I mentioned a little bit earlier today, 300,000 health care apps that are out in the stores that anyone can download today, how do we start bringing that together? It's going to be more in the connections and the pipes that need to be built to get to a more holistic understanding of that individual.

I can pull in my weight loss information. I can pull in my nutrition information. I can pull in my insurance information. I think you're going to see a lot more of that type of connectivity getting to more of the whole person.

Then again, I think you're going to start seeing the greater emergence of remote patient monitoring that's going to lend itself to, again, understanding the whole of the member. Things like we're doing some pilots with Dexcom, which is a continuous glucose monitor.

Having that synched up with the diabetes program that you're on and actually integrating that information into a digital app so that we now can monitor diabetics, as an example. You're going to find through our individual health record launch and tool that we're bringing out there --again, on our digital platform -- is that we can start pulling in record information now, giving us a better understanding again of the holistic member.

JG:  Finally, overall, is there anything else you would like to add?

PK:  I would like to say this digital app, digital products, in general, a very exciting, quick-emerging area here. There's a lot in the marketplace today when it comes to apps, remote patient monitoring, artificial intelligence.

I think you're going to start seeing the culmination of these things come together and not be so siloed, offering, again, greater insights of the individual here. By putting in our digital framework with the UnitedHealthcare app, it's going to lend itself to make these connections much easier for us than to really work with our members where they want to be within their health state.

At this point, I think there's a lot of excitement, a lot of growth, and a lot of opportunity to continue giving people the access to care and not necessarily having to take the time away to actually get into the brick and mortar. We can do a lot more from a virtual standpoint.

You're going to see a large push, a large trajectory, and a large adoption towards virtual care.