Walgreens: Investing in the Power of the Patient

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Thanks in part to Affordable Care Act reforms and the rise of digital health, patients now have more skin in the game, more health care tools at their disposal, and more information than ever before to take charge of their own health.

Dr. Harry Leider, CMO and Group VP of Walgreens, speaking on a panel at last week’s Digital Healthcare Innovation Summit in Boston, said health care providers must find a way to adapt to the schedules and demands of patients, who have more say over how their health care dollars – and their time – are spent.

“Traditional providers are learning that they [patients] are not willing to take a half-day off from work, figure out what to do with their kids, to get routine care,” he told the panelists. “People are busier, the information technology has made it easier to get solutions without having to spend a half-day somewhere.”

It’s no surprise, then, that pharmacy retailers are placing big bets on consumer-facing health care opportunities.

In the past few years, the pharmacy-services giant CVS Health has made big investments in this area, dropping tobacco sales, expanding its MinuteClinics, and also establishing a drug ad-herence program. Now with Walgreens’ recent announcement of its $9.4 billion acquisition of Rite Aid Pharmacies, it has effectively overtaken CVS to become the leader with 46.5% of the market to CVS’ 30.9% share.

But Walgreens is looking to get bigger on the back end as well. Also, just this week it announced an upgrade to their mobile app which improves its functionality and also expands their telehealth services to 25 states (previously available in only 5 states). Walgreens’ other health care investments hint at its level of commitment, including its partnership with controversial laboratory services company Theranos and a recent announcement that it has partnered with health information tech giant Epic to install that firm’s electronic health record software across all of its health care clinics.

Walgreens is banking on its huge presence to provide easy and convenient access to the next generation of health care consumers. “Everybody knows Walgreens,” Leider said. “We have 8,300 stores, 25,000 pharmacies, and over 1,000 nurse practitioners in our clinics.” He also emphasized that half of Walgreens are located in ethnically diverse areas, with a large number of especially high-risk populations, which gives them a unique opportunity to influence health care outcomes. “Take the average diabetic patient. Diabetes is an epidemic in our country, but especially among diverse populations. First of all, a diabetic, if they’re lucky, sees a primary care doctor two to three times a year. The average diabetic comes to our pharmacy counter 20 times a year. So the opportunity to provide systems that can solve problems is greater because of this.”

Walgreens has started a digitally supported Healthy Choices Program, which rewards consum-ers for walking, weighing themselves, logging blood pressure and blood glucose levels, commit-ting to smoking cessation, and setting other health goals. In addition, it offers digital health coaching, pharmacy checks, and even virtual doctor visits.

Roughly 800,000 people have signed up, Leider said. About 500,000, of those patients are sharing their personal health data with Walgreens. What the company has found thus far from its collection of these data is that engaged users (who are actively tracking their weight) lost an average of 3.3 pounds more than non-engaged users and 1 out of 6 lost more than 10 lbs. In addition, Walgreens found that its engaged users have overall healthier behaviors and better drug adherence.

Still, he’s not a blind advocate of digital health: “I don’t think digital health alone can solve the problems you’re talking about.” Leider insists that Walgreens is not trying to usurp the tradition-al establishment but rather be a resource to providers. “We really see ourselves as supporting traditional providers and adding value to the ecosystem. We’re not gearing ourselves up to do primary care,” he said. “So our strategy really is to provide a low-cost option for care and to partner with health systems and providers.”

Going forward, Dr. Leider would like to see a greater transition to value-based care. “Despite what everybody’s saying, most providers are still trying to keep the beds full and have the most number of visits. So, for all this tech to be funded and sustainable, it’s got to be the right envi-ronment to really reward people for staying well.”

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This article was originally published at www.digitalhealthcaresummit.com.  

Books: The Patient Will See You Now

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Einstein once said, “The most important decision we make is whether we believe we live in a friendly or a hostile universe.”  I suspect that readers of Eric Topol’s latest book, The Patient Will See You Now, might be polarized along these lines as well.  The ideas expressed might fill some with fright, while others, with delight.

Dr.  Eric Topol, a cardiologist, geneticist, and researcher from The Scripps Institute and editor-in-chief of Medscape, attempts to get readers up to speed on the rapidly developing innovations in healthcare.  That’s a daunting task, considering how many individuals and companies are experimenting in this space and how quickly progress is being made.

He begins the book by making a convincing argument that the digital age, with the cell phone being its best emissary, is bringing about revolution in society and healthcare akin to when the Gutenberg press was invented, which made reading accessible to the masses. Just as education was democratized, he argues, so is healthcare becoming democratized. In the not-so-distant future, patients will have all healthcare knowledge at their fingertips and as a society, we will move away from the paternalistic paradigm of traditional medicine.

Increasing accessibility to health information is fostering increased patient engagement and helping to drive innovations and advances forward.  He devotes a chapter to discussing the influential role that Angelina Jolie has played as a change agent in shaping the patient’s role in the future of healthcare, with her courageous decision to preemptively have a bilateral mastectomy to prevent breast cancer, after finding out that she is a carrier for the BRCA1 gene.  His point was driven home with the actress’ announcement this week that she has now also undergone a prophylactic bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries) to prevent ovarian cancer.

In this information age, patients are more knowledgeable about their personal health, the medical research out there, and their options.  In Dr. Topol’s opinion, healthcare organizations need to move towards transparency at all levels, with regard to clinical information, medical knowledge and research, and that (with consent and precautions to protect privacy), this information should be aggregated to create what he calls “massive open online medicine” (MOOM).  Aggregating and applying machine learning to this data has enormous potential to prevent and cure disease and cut healthcare costs.

Particularly interesting was his description of an individual’s “geographic information system” (GIS), which is a comprehensive health “map” of a patient, looking not just at their genome, but other “-omes”, such as demographics (phenome), vital signs (physiome), anatomy (anatome), DNA/RNA (transcriptome), proteins and metabolites (proteome and metabolome), microbes (microbiome), DNA packaging (epigenome), and the environment (exposome).  Treatments of the future are likely to be very individualized based on a patient’s unique GIS.

He discusses some other fascinating innovations (too numerous to list), including the plethora of smartphone apps and wearable devices, a variety of diagnostic tests being done via mobile devices, the rise of telehealth services, genetic testing and research, the quest for transparent, fully interoperable, and secure medical records, and new tools to decrease morbidity and mortality related to medical errors.

This was an information-dense, engaging read.  For those interested in the healthcare innovation space, it’s a must-read.

What I most appreciated was his optimistic view of the future of medicine in the digital age.  Clearly, Dr. Topol believes we live in a hopeful, friendly universe.