By Andrea Tait
The healthcare system in North America is facing what can be called an existential crisis: the sustainability of our healthcare. According to a Harvard study published in the Journal of the American Medical Association in 2018, the quickly advancing challenges presented by an aging population, increasing chronic disease and overcrowding of expensive healthcare access points like emergency departments threaten the very heart of our healthcare system. Additionally, current hospital-based models demonstrate a rapidly increasing cost curve, but do not show an increase in good patient outcomes. Several trends are emerging that will help transition to sustainable healthcare.
The rise of community-based care
Health information technology provides a necessary tool that healthcare providers, payers and governments can leverage to reduce costs and improve patient outcomes. These tools will play an increasingly important role, but must use existing digital health information exchange (HIE) systems and support patient needs across the continuum of care focusing on home and community-based care, and treating people outside of the hospital. Standard HIE platforms, which have been an important step in integrating health information and supporting more integrated care, run the risk of continuing to accumulate data without quality improvement tools to help clinicians determine what information is important and monitor patient outcomes. While digital health solutions and quality indicators are well-known to some healthcare providers, they are less commonly used by homecare providers who have traditionally focused more on functional supports and less on monitoring outcomes.
Home- and community-based service providers do some of the most important work in healthcare, providing eight out of 10 hours of paid services to the elderly and people with disabilities and chronic disease, according to the National Database of Nursing Quality IndicatorsTM (NDNQI®). In order to control healthcare costs, homecare providers are rapidly diversifying their traditional lines of services beyond case management and basic home-delivered care to include care transition services and those traditionally delivered in acute care settings. Providers will need to capitalize on performance data and rapid innovation, including virtual solutions for treatment and chronic disease monitoring.
The role of a more engaged patient
Another emerging opportunity is the shift from informed patients to those who participate in their own care. Healthcare providers will need tools to assist them in embracing patients who are more informed and wish to play an active role in planning, delivering and monitoring their own care. This will involve more than sharing patient health information, applicable data and research. Healthcare providers need tools that will help them understand, align with and work towards patient goals. Digital tools, like remote patient monitoring solutions, have the power to assist patients and the rest of their care teams.
The change from big data to more actionable data
As HIEs and electronic health records in North America have matured, managing excess data and an increase in provider “screen time” have become challenges, contributing to provider stress and burnout. According to a Medscape Lifestyle report published in 2017, 51 percent of physicians report levels of burnout higher than their peers in other environments after controlling for hours worked, age, sex and other factors.
The shift from big data to actionable data will see a larger focus on presenting meaningful data to clinicians. Using analytics and predictive modeling, analytics tools will provide a way forward on what information is most important at any given time. Analysis of results and trending indicators will assist care teams by providing more meaningful and actionable data quickly and easily.
In order to truly transition to a value-based care model that more effectively manages disease, healthcare providers must transition from a focus on personal health information, mostly around traditional test results, to include social determinants of health data. Data including social and economic factors, as well as health behaviors, has a significant impact on disease management and prevention. These important data sources will need to be included in disease prediction and management models going forward. This will present a significant shift in thinking about how we manage disease, which will need to account for a patient’s individual environments as a key contributor to their overall health
The move to population health
Population health and analytics tools will also support the continued move to value-based care in the next decade. As a way to control escalating costs while simultaneously targeting better healthcare and chronic disease management outcomes, value-based care will monitor outcomes that are valuable to the patient and the cost of delivering those outcomes. In order to accomplish this, digital health tools will need to integrate payer and provider data that support risk-sharing frameworks, and assist providers and payers in determining where systems and processes are using population health tools.
The 4 P’s
Healthcare delivery and the digital tools that support population health must become predictive, preventative, personalized and participatory. As the next decade heralds some fundamental challenges to our healthcare system, it is imperative that we harness the digital tools and empower our population to participate in their own care in order to maintain a sustainable healthcare system we can rely on for generations to come.
Andrea Tait is the Vice President of Client Value at Orion Health where she supports the company use technology to deliver enhanced value to healthcare providers and patients.