Today’s healthcare environment looks radically different than it did several years ago. An industry based almost exclusively on in-person engagement had no choice but to embrace technology to provide care. According to the American Medical Association, telehealth accounted for less than 1% of provider-patient interactions pre-pandemic, and more than 50% of providers had their first experience using technology to treat patients remotely in the early stages of the pandemic.
Telehealth is just one example of how technology has transformed healthcare in recent years by 2021, 88% of U.S. physicians used electronic health records (EHRs) daily. According to research from Annals of Internal Medicine, providers spend 16 minutes a day on average with each EHR, meaning providers are spending hours every day using technology to manage patient care.
Technology helps all corners of the healthcare ecosystem — physicians, payers, healthcare organizations, policymakers, and biopharmaceutical companies — communicate effectively with patients to ensure they are receiving the proper care precisely when they need it. Below, we will discuss how technology can enable the highest levels of care and improve the system’s effectiveness.
Putting Data Insights at the Point of Care
The healthcare world is shifting from a fee-for-service (FFS) model, in which providers are evaluated and compensated based on the number of available services, to a value-based care (VBC) model, which focuses on the quality-of-care patients are receiving. Shifting from FFS to VBC empowers high-quality, cost-efficient care benefits providers by helping them fulfill the Triple Aim framework laid out by the Institute for Healthcare Improvement:
- Improving the patient experience of care
- Improving the health of populations
- Reducing the per capita cost of healthcare
A successful VBC model requires collaboration between payers and providers. With legacy FFS models, providers are focused on offering as many services as possible, while payers are looking for ways to spend the lowest fee for those services. VBC incentivizes providers and payers to work together: providers achieve lower costs by offering fewer services, while payers benefit from an overall healthier population and a subsequent reduced need for further care. Access to robust data analytics capabilities at the point of care is critical to enabling this collaboration and the success of VBC.
With robust analytics, payers and providers can track and monitor KPIs associated with VBC, such as hospital readmissions, patient engagement, and population health, and use that data to identify areas for improvement. For example, if there is a higher-than-normal rate of 30-day readmissions, providers and payers can work together to determine how to provide better initial care. VBC enables a 360-degree approach to healthcare that ensures all parties are getting the best bang for their buck.
Streamlining Clinical Data Improves HEDIS Scores
Healthcare Effectiveness Data and Information Set (HEDIS) standards, a set of 90+ benchmarks across six aspects of care developed by the National Committee for Quality Assurance (NCQA), improve quality of care, optimize medical practices, and empower an overall increase in the effectiveness of healthcare. HEDIS quality measures include immunizations, diabetes care, and medication management. More than 200 million people in the U.S. have plans that use HEDIS measures, allowing consumers to conduct cost-benefit analyses of health plans to find the best option. Healthcare stakeholders are vested in improving HEDIS measures, as higher scores close gaps in care and encourage preventative care in the name of decreased costs. Unfortunately, payers encounter numerous roadblocks in the quest to boost HEDIS scores:
- Administrative burden: Comprehensive and accurate clinical records are necessary to improve HEDIS scores. An increased volume of data, particularly in recent years, has strained healthcare organizations as they try to collect, analyze, and report information, leading to decreased provider satisfaction and increased physician burnout.
- Lack of technology adoption: Though providers are increasingly realizing the importance of technology, adoption has been slow and has begun to stall. For example, only 1 in 5 physicians use emerging technologies, such as artificial intelligence. Without proper IT adoption, data analysis and, thus, HEDIS calculations become exponentially more difficult.
- Low preventative screening rates: When providers fail to provide adequate preventive care, it harms HEDIS scores. Preventative screenings are critical for treating deadly diseases, such as cancer. However, the Centers for Disease Control found that screening rates for cervical, breast, and colorectal cancers have fallen below established benchmarks.
Payers and providers must work together to address these issues and improve HEDIS performance. One solution is adopting a technology platform that streamlines the collection and analysis of healthcare data and provides a sole source of truth. Technology can augment human efforts to identify and close gaps throughout the healthcare network. With a data-driven approach, healthcare stakeholders can compare patient data against the six HEDIS benchmark sets to identify improvement areas.
Using Technology to Communicate Point of Care Messaging
In the era of telehealth and VBC, pharmaceutical marketing is shifting away from traditional methods to bring value to the healthcare environment. Large-scale adoption of EHRs gives pharmaceutical companies the data necessary to interface at the point of care with providers and offer real-time targeted messaging. Research shows that 78% of providers prefer to receive personalized product updates via EHRs, making it a win-win.
Pharmaceutical companies can empower providers with valuable information on medications at the point of care, including prescription recommendations, a rundown of common side effects, and information on what medications fall under a patient’s insurance coverage. Marketing teams can disseminate information on clinical trials in a simple, reader-friendly manner that highlights critical information without getting bogged down in the technical details. Studies show three-fourths of providers prefer simplified language that minimizes confusion and allows for quick action.
Pharmaceutical companies can also use technology to help physicians minimize patient costs and maximize patient access to resources. For example, offering coupons and other financial assistance information has proven helpful. Furthermore, Accenture found 69% of providers believe digital patient education is more critical now than pre-pandemic, while 65% said pharmaceutical companies have an increased role to play in helping patients access services like labs and imaging centers.
Myriad Uses, Myriad Benefits
The bottom line is this: technology has a role to play in every sector of the healthcare ecosystem. It strengthens relationships between patients, providers, payers, and other stakeholders. It simplifies access to care, decreases care costs, and improves outcomes for all parties. The healthcare world must embrace the benefits of technology today to empower a healthier world tomorrow.
Tom Langan
Tom Langan is the president and CCO of Veradigm.
