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Getting health care right

Living Health: Now we do the remarkable

Today, our organization announced a six-year strategic agreement with Google Cloud. Together, we will build the state-of-the-art technology platform behind Living Health, a new, highly personalized, model for health that puts people and their clinicians at the center of a simpler, better coordinated experience.

While Highmark Health and its affiliates have earned a reputation for disrupting “how it’s always been done” in health care in recent years, this agreement launches a new era and sets us on course to deliver more deeply transformative changes in the future. With that in mind, we want to take a moment to explain the thinking behind our Living Health model, and how we will work with Google Cloud during this exciting collaboration.

Karen Hanlon, Highmark Health’s chief operating officer, introduces the six-year collaboration with Google Cloud.

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To bring the Living Health experience to life, we’ve entered into a six-year collaboration with Google Cloud. With this leading technology partner, we’ll collaborate to build the innovation engine to fuel Living Health. It will leverage world-class advanced analytic and artificial intelligence capabilities and skilled resources to supercharge Highmark Health’s existing clinical and technology capabilities, and to take the tools that help people navigate their health care and the health care system to the next level.

Let’s fix what’s broken

Karen Hanlon, Highmark Health’s chief operating officer

Karen Hanlon, Highmark Health’s chief operating officer

It’s not a radical idea to say that the U.S. health care system is broken, and its costs are unsustainable. In fact, whether you’re talking with individuals, clinicians and caregivers, insurers, employers, or pretty much anyone else, you will likely hear the same complaints about how health care is done in this country: It’s too complicated, too frustrating, and too expensive.

In our roles as chief operating officer and chief medical and clinical transformation officer, we are proud to be part of an extraordinary team of leaders, innovators, and do-ers at Highmark Health who have taken up the hard questions, and hard work, of building a better system.

That starts by taking a step back and clarifying our purpose. The goal isn’t just “better health care,” it’s better health — for everyone. For too many people, there is little or no support for health until something goes wrong. By the time they seek traditional health care, their health has often already worsened and issues are more difficult and expensive to address.

Another fundamental problem is that both the health care system and a person’s health experience tend to be very fragmented, like this:

Complex health experience

The health experience is literally “broken” into many disconnected pieces. It’s confusing and time-consuming. Worse, critical data doesn’t always make it from one piece to another, and opportunities to improve health are frequently missed.

When we formed Highmark Health in 2013, we took on the work of connecting more of the health experience by bringing together payers, providers, health and wellness support, and others in our version of what some call an integrated delivery and financing system. Much of what we’ve done since then has been about creating a more holistic, coordinated approach to a person’s health. Instead of asking people to figure out the health system, or multiple systems, we have asked how the entire health experience should be re-engineered with them at the center.

We take pride in what we’ve accomplished, including new facilities closer to where people live, coordinated care teams and care models for our customers, innovative care management and home care programs, investments addressing social determinants of health, and more. Yet we also saw that just improving the integrated delivery and financing model wasn’t enough. Daring to imagine what a truly remarkable health experience should look and feel like for customers and clinicians, we realized that no one had a system that could deliver that experience.

And then we focused our organization’s strategy on building it.

Living Health: Let’s build a better system

We call our new model Living Health, because that is what it’s about: living a healthy life, and being supported in living a healthy life, every day. Instead of the reactive focus on how to treat and pay for health problems, the model we are building will be proactive, supporting each customer’s health in the ways that they choose. This isn’t just about improving traditional health outcomes and trying to lower the total cost of health care; this is about improving each person’s quality of life. It’s what we mean when we say our mission is to create a remarkable health experience, freeing people to be their best.

Fundamentally, Living Health will do two things. First, it will continue to break down traditional health care silos, in our own organization and with like-minded partners everywhere we do business, through what we call a blended health approach. The ideal “blend” effectively removes the frustrating barriers and gaps between silos, so what an individual experiences is a seamless flow of helpful information, support and care across their health journey. In other words, it’s about the individual, all the time, not about which brand or entity is serving the individual this particular time.

Second, it will make the most of available technology and data to bring the health experience into the 21st century. Our collaboration with Google Cloud will enable us to build the Living Health Dynamic Platform, a holistic, personalized set of health supports and solutions leveraging world-class analytics, artificial intelligence, interoperability and transparency. Like the entire Living Health model, this state-of-the-art technology platform will enrich the relationship between the customer and their clinician, making it easier to share real-time, actionable information and proactively engage in health. Remember that diagram above? Living Health will be just the opposite:

Simple health experience

Living Health will connect the people and devices supporting a person’s health — not just clinicians, but care managers, nutritionists, pharmacists, customer service reps, wearable devices and phone apps, and more. It’s also about whole health: physical, mental, wellness, social determinants — anything impacting the ability to live and feel your best. As is already true in many parts of our business, our new model will integrate support from community and social organizations to help with things like food insecurity or transportation issues where appropriate.

Another key element of Living Health is what the illustration above calls “curated health design.” The traditional health care paradigm uses too much one-size-fits-all thinking. Health needs are different from person to person, and change over time, so health solutions should likewise be “dynamic” enough to adapt. From a technology standpoint, without compromising data security or privacy, we believe digital health solutions can, and should, offer the personalized experience people get in online shopping, banking, news, entertainment, and other areas of life.

Our mindset with Living Health is to take the information and preferences that a person provides us, apply the analytics we co-develop with Google Cloud, and create a proactive, dynamic and readily accessible health plan and support team that fits their unique needs. That will include what we normally consider in a treatment plan — what screenings are due, which doctors to see, what medications to take — but also proactively provide information and recommendations relevant to a person’s physical, mental, and social health in real time. The digital platform will be a bridge between customer and clinician, tailoring information according to what is most useful to each. It will effectively extend what is best about one-on-one interactions between clinicians and patients, and make it easier to have those interactions in a timely way.

Dr. Tony Farah, chief medical and clinical transformation officer of Highmark Health, offers a high-level overview of how the Living Health model will improve the health experience for both patients and physicians.

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What we’re talking about is a customer experience designed to be engaging, simple, and a doorway to a world of health advice, support, services and resources that customers can use on demand, customized to their location and condition. The physician gets the parts of the plan that are more useful to them, allowing them to stay in touch with their patient in real time and to address changes in the patient’s condition, without having to wait for an office visit or a test result, because the relevant information is proactively made available to them. This system makes life simple and easy for the patient. It allows the physician, supported by the person’s health team, to focus on the important things for each patient, and to intervene at the right time to prevent disease or health deterioration.

Welcome disruptors: Google Cloud

Shortly after Highmark Health CEO David Holmberg wrote about “welcoming industry disruptors” last year, we kicked off a comprehensive, rigorous review process to choose the best “building partner” to help us create the Living Health Dynamic Platform. Among several leading organizations, Google Cloud stood out as the most innovative and dynamic collaborator in terms of talent, technology, and expertise.

Just as important, Google Cloud shares our sense of urgency and purpose in reinventing the health experience. Each of us was already disrupting traditional health care, but combine our long history as an industry leader and understanding of our customers, with Google Cloud’s technology capabilities and Artificial Intelligence/Machine Learning expertise, and you have a real disruption dream team that can build a better model even faster.

Part of what made Highmark Health an attractive partner for Google Cloud was that, through our Clinical Transformation Office, and working closely with clinical teams at Allegheny Health Network (AHN), we had already built the foundational elements for this work. By taking a number of populations ranging from those considered high medical risk to those who have chronic medical conditions, we were able to eliminate silos, change workflows and use predictive analytics while placing the patient and clinician at the center. This resulted in improved health outcomes and experience across the board, prevention of condition deterioration, and a reduction in the total cost of care. The collaboration with Google Cloud will accelerate our path to achieving this transformation on behalf of the populations we serve.

Dr. Tony Farah, Highmark Health’s chief medical and clinical transformation officer

Dr. Tony Farah, Highmark Health’s chief medical and clinical transformation officer

An additional attractive capability was the VITAL Innovation Platform, our unique, test-and-learn environment for validating clinical solutions. Leveraging the payer and provider components of our organization to evaluate clinical outcomes, cost impact, and patient experience, VITAL helps accelerate solutions into the marketplace that can change an individual’s health or life. Similarly, our clinical validation capabilities will have a key role in testing solutions developed as we build the Living Health Dynamic Platform.

We want to emphasize that our unique Business Associate Agreement with Google Cloud was carefully designed to ensure the integrity of all customer data. Built on Google Cloud’s secure, reliable infrastructure, privacy, security and data ethics will be guiding principles of the Living Health Dynamic Platform. Highmark Health will lead the collaboration and control access to and use of its customer data using rigorous long-standing organizational privacy controls and governance. Data and information governance measures will be enhanced further by a joint Highmark Health-Google Cloud Data Ethics and Privacy Review Board, which will ensure that uses of information are consistent with defined data ethics principles.

Data security and privacy are top priorities for us, as evidenced by five years of HITRUST certification and other industry recognitions. For more insights on this aspect of our collaboration, please read a Q&A with Richard Clarke, our chief analytics officer, and Omar Khawaja, our chief information security officer.

What’s next?

We’re at the start of the Living Health journey. As we build the Living Health Dynamic Platform and evolve our model in the months ahead, we’ll share more details in the media, at industry events, through sites like this and our social media channels, and on a new website: Living Health.

Clinically and operationally, Highmark Health is uniquely qualified to take on this ambitious, industry-changing leadership role. Our blended health approach is already breaking down old paradigms and barriers. Seeing the whole health experience, from both the individual and clinician points of view, we understand where the frustrations and obstacles are. Through our collaboration with Google Cloud, we will put technology to work removing those frustrations and obstacles.

Like many organizations, we have dedicated extensive resources this year to responding to COVID-19. From a business perspective, some people might ask whether this is the right time to advance bold transformational changes. But the pandemic has reinforced our belief in the need for change, and our resolve to lead that change. This is exactly the time to roll up our sleeves, fix what’s broken, and take on the work of building a system that is simpler, smarter, fairer, and healthier for all.

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Highmark Health and its subsidiaries and affiliates comprise a national blended health organization that employs more than 35,000 people and serves millions of Americans across the country.

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