Leveraging Data to Drive Quality Outcomes in Healthcare

The healthcare industry is experiencing a rapid rate of change at the local, regional, and national levels. The transition from pay-for-service to pay-for-value and utilization-based reimbursement will continue to drive fundamental business model evolution for healthcare organizations and the supporting technology will require increased agility, scalability and respond rapidly to the changing dynamics.

Providers are tasked with making available better care for more people while successfully balancing quality, cost, and access.  Enabling this stronger focus – or transformation – is a broad range of healthcare information technology innovations and emerging industry business models that parallel the evolution of healthcare from hieroglyphics to 21st century emerging technologies!

Nationally, healthcare is on everyone’s radar and proposed national healthcare changes place healthcare under the microscope.  The US government, a leading consumer of healthcare is actively devising standardized benefit plans, restructuring the payment for services rendered to payment for outcomes and attempting to squeeze any perceived excessive cost from their payment model. Quality and outcomes are the standard buzz terms that are used to monitor results minimizing the complications and choices made by patients. Instead of holding the patient accountable for poor lifestyle alternatives the government stresses the partnership between patients and physicians but holds the healthcare industry responsible for patients’ poor lifestyle choices. 

The cost of healthcare is driving changes to health services. The traditional healthcare model is being redefined to address the continuum of care structure – from the initial point of contact with the healthcare provider through to supportive care, such as, post-acute services (rehab, home health, palliative care, etc.) – a structure that uses patient data at a rate not seen before.   Standardizing medicine, standardizing services and protocols is an attempt to remove medical and cost risks from the cost equation. Specialized health facilities are addressing unique services and are providing disease treatment centers (e.g. cancer centers) focusing their talents and resources to improve patient outcomes. Regionally, payers and providers are stepping in to manage healthcare choices closer to home. By creating localized spheres of influence, patients are being buddied up with patients with similar disease states to create centers of support and influence.   

The shifting from costly acute care facilities to more cost effective settings has also had an impact on cost. New clinical devices as well as new drug therapies are being developed to improve upon the current medical offerings. Medical devices can be used from the patients’ home environment to provide blood/glucose monitoring or daily weight fluctuations. Individualized heart monitoring capabilities allow the patients to continue with their daily lives while still providing clinical input to the physician.  Tele-medicine allows for the reading of x-rays, MRI and CT scans, granting a greater degree of physician and patient mobility.    And all powered by the collection and dissemination of accurate healthcare data.

Develop your strategy to optimize your investments in your people, process and technology! Manage the change.