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Expert Insights

Insights

The Center and its partners -- GE Healthcare, IBM, Lenovo Health, Nokia, and UPMC -- represent various facets of the health information technology community and serve as global thought leaders on subjects vital to the evolving health system: access to care, improving outcomes, infrastructure and efficiencies, consumerism, and data.

Access to Care

Patients should be able to readily obtain medical services and information, and providers should have access to the most up-to-date information about their patients. Access to care is a complex, multi-faceted and incredibly important factor in overall population health—especially preventative care. Access to care is affected by provider supply and health care information technology capabilities, payer plans and even government policy. Affordability, availability, accessibility, accommodation and acceptability all factor into and influence access to care.

Technology is improving access to care through virtual health care, smart home health, connected medicine and care coordination.

Virtual Health Care

The increasingly widespread adoption of telemedicine means many physicians and specialists no longer need to be physically located within a close geographic range for patients to benefit from their services and expertise. HIMSS Analytics estimates that 51 percent to 53 percent — or 2,900 to 3,000 — of U.S. hospitals will have installed telemedicine technology by 2020.

Smart Home Health

Remote care management platforms operate by connecting a smart phone or tablet through Blue Tooth technology to devices such as monitors, sensors or scales; the connected device sends data and alerts to an application on the phone or tablet, which is then accessible to care providers. Remote care management gives providers greater visibility into patient health, which can help them catch health challenges before they escalate, allowing for early remediation and potentially preventing hospitalization.

Mobile-first Technology

Ubiquitous care extends beyond the home to include support for on-the-go consumers. Convenient care and applications that consumers take with them wherever they go include wearables linked to mobile apps.

Care Coordination

Integration—easy, appropriate, even automated information-sharing—remains a tremendous challenge in health care. Improved integration and care coordination have the potential to influence access to care in these ways:

Improving Outcomes

To realize improved outcomes, a connected and coordinated health system must empower clinicians to provide high-quality care in any setting. Along with lowering costs and giving patients a better experience, improving outcomes is key to achieving the shift to a value-based health system. While Americans pay more for health care than most other industrialized nations, health outcomes in the U.S., such as life expectancy and infant mortality, rank at the bottom compared to those same countries, according to the Organization for Economic Corporation and Development.

“Despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions.” – The Commonwealth Fund New technologies and payment models are driving the U.S. health system toward better results for patients and higher value.

Value-based Payment Models

Providers should be paid based on the quality of the care they deliver, not for the quantity of procedures they perform. The Centers for Medicare & Medicaid Services (CMS) is leading the charge in shifting from quantity to quality through Alternative Payment Models. Under the initiative, CMS is moving half of all traditional fee-for-service payments under Medicare to value-based payments by 2018.

In 2016, CMS said it had shifted $117 billion of Medicare’s $380 billion in fee-for-service payments to Alternative Payment Models the previous year. At the same time, CMS also said those value-based programs had generated $411 million in savings by reducing hospital-acquired infections, lowering readmission rates and other initiatives.

Some of the most important models, legislation and concepts steering health care toward value-based payment include:

Technology Solutions

A number of new digital health tools have emerged in recent years that harness data analytics, electronic health records and other technologies with the aim of helping clinicians improve outcomes for patients. Several of these tools include:

Infrastructure and Efficiencies

As the health care system works toward the Triple Aim of lowering costs, boosting quality and improving patient satisfaction, many unseen but vital operational and financial functions must be improved. The future of health care demands that services be delivered using fewer resources. Harnessing data, using new digital tools and promoting integration are key factors.

New technologies are bringing greater efficiencies to health care infrastructure and operations, including bringing data analysis to hospital supply chains and using natural language processing to more accurately capture data from medical records.

Ultimately, improving operational and financial infrastructure and creating efficiencies in health care can lower costs for providers, payers and patients.

Financial

At the heart of providing greater value in health care is the need to make financial operations more efficient. A range of technologies are aiding health systems to achieve greater control over their finances:

Operational

The processes involved with delivering care—from diagnosis to prescribing medication to ordering tests to invoicing and payment processing—fall within operations. As in other areas, new technologies are playing an important role in improving operations infrastructure and efficiencies. Examples include:

Consumerism

The medical industry is facing pressure from increasingly empowered consumers who are demanding more information, greater choice, better value and enhanced technology that will make their experience in health care more efficient, enjoyable and less costly.

In the shift toward consumerism in health care, organizations must make an effort to provide exceptional customer service. Consumers seek demonstrable value from services and products, which must fit their lifestyles and beliefs. Health systems, technology providers and others are responding with a host of solutions aimed at attracting, engaging and retaining patients as customers. These include mobile apps, telemedicine options, online portals for communicating with providers, and other technologies. “Providers of care are starting to realize that they need to compete in the marketplace just like any other business does.” Paul Crnkovich, managing director at Kaufman Hall

Data

Data is the lifeblood of a value-based health care system. Health care organizations can’t improve – become less costly and produce better outcomes – without collecting, measuring and analyzing data from every process and interaction in the patient journey. Key technologies and strategies involving data include network, cybersecurity, unique patient identifiers, internet of medical things and big data analytics.

Network

Data can’t move without robust information technology networks, which control and facilitate operations, storage, communications and more. A robust, forward thinking vision around network infrastructure is paramount to modern health systems—it must be secure, stand up to incredible bandwidth requirements, and be frequently maintained as new solutions and threats disrupt the landscape.

Internet of Medical Things

Experts are predicting rapid growth in IoMT adoption: a recent report estimated 87 percent of health systems will have IoMT technologies deployed by 2019 as health systems look for opportunities to capture more data from their devices, systems and patients. The value of the IoMT market is expected to reach $163 billion by 2020. Health industry leaders need to be ready if they want to harness the technology for value-based care.

Cybersecurity

Patient health data has become valuable to hackers – driving up cyberattacks on health systems. Cyberattacks targeting patient data jumped 300 percent between 2014 and 2016; and the U.S. health care industry is spending an estimated $6.2 billion a year in fines and other costs related to health data breaches. As a result, cybersecurity is moving to the top of the agenda at health systems.

Unique Patient Identifiers

It is estimated that 10 percent of medical records are duplicates in the average health IT system. Misidentification of patients and duplicate information entered into health records can cause misdiagnoses, unnecessary tests, and inappropriate treatments, all of which hinders the ability to improve patient care and drives up medical costs. Unique patient identifiers are a key technology in solving this problem.

Big Data Analytics

Data analytics is a cornerstone of improving outcomes in health care. Health systems can’t improve what they can’t measure. Several key terms are:

McKinsey has estimated that big data analytics could reduce waste and inefficiency in health care by more than $300 billion a year.