A recent infographic from PBS highlights health care waste in America. One portion compares what was spent on health care in 2009, $750 billion, to what this amount of money could pay for in comparison -- sending every 17- and 18-year-old in the U.S. to a state university for four years, including room and board. Take a minute to digest that fact.
If you ask pretty much anyone if our health care system is broken, the resounding answer is "yes." If you then ask what the solution might be, you get a less-universal response including everything from "eradicate unnecessary testing" to "reverse the provider payment model to focus on performance." The reality is there is no simple fix for a problem of this size, and in order to solve the bigger problem, you have to start with just a piece of the problem vs. the sum of its entirety.
Take the shift to electronic health records (EHRs), for example. There's been quite a bit of healthy banter as of late in relation to EHRs and whether they actually lead to improved patient care, whether providers are improperly using them to "copy and paste" patient notes and "upcode" the care provided to increase reimbursement, and whether they're creating a chasm between clinicians and personalized patient care.
It's easy to criticize and complain about change, especially when it involves essentially turning an industry, and the way they've conducted business for years, on its head. The shift from paper to digital health records has not been a walk in the park. Clinicians have struggled with how to alter their workflow to adjust to this change and patients have had to accept doctors typing their notes in real time vs. focusing on "face time." The industry and all involved parties have made sacrifices, and we all have complaints about EHRs. Still, I'm a strong believer in focusing on the future and offering solutions instead of echoing problems. Having worked at technology companies for 25 years, I see health information technology (HIT) as a way to make strides, even if that stride is a series of baby steps.
Solutions? What Solutions?
Today, technology is forcing us to evolve the way we live and work. The same technologies you and I use, like smartphones and tablets, hold potential to help the health care industry tackle hurdles -- like the continued push for EHR adoption and the need for new ways to provide care to rural areas. One part of solving the problem of health care involves finding ways to improve efficiencies by taking intuitive consumer technologies and applying them to the "business" of health care.
As clinicians have become more familiar with technology, they're hungry to use mobile devices as part of their workflow and to improve the patient care process. Nonetheless, there are obstacles when it comes to using mobile apps in a health care setting: major obstacles like patient privacy, wireless interference with equipment and actual usability of the device. Let's face it, many of us text, but those texts tend to be truncated because of the headaches associated with mobile keyboards -- or lack thereof. In an effort to address the usability issue and conform to growing demand from an increasingly-mobilized health care workforce, EHR vendors are making strides in the creation of mobile EHRs integrated with voice recognition so that doctors can dictate into the patient's chart, without the time and frustration associated with "pecking" a patient note.
Telehealth is another solution that offers promise for downsizing health care costs while also addressing portions of the population who might not have easy access to a doctor. By leveraging an "online" patient visit, both doctor and patient can save time and, in turn, money. Additionally, with interest regarding preventive care and the "quantified self" on the upswing, increased focus is being placed on another facet of telehealth -- remote patient monitoring. Industry estimates state that remote monitoring could lead to savings of 20 to 40 percent by reducing unnecessary hospitalizations and identifying chronic problems early on. While still in its infancy, the possibilities surrounding telehealth hold the potential to help solve present and future obstacles -- including the expected shortage of doctors and the increased health care needs of aging baby boomers.
Automation as Opportunity
Any good business looks for ways to automate processes in order to free up their workforce for bigger challenges, and yet health care lags behind. Think about the changes airlines have made over the last decade. When you go to the airport, your first interaction is typically with a machine that spits out your ticket instead of a person employed by the airline to provide this service. In an effort to remain viable, airlines have looked for ways to cut costs through automation without sacrificing the flying experience for customers.
From a health care standpoint, it can be difficult to determine where best to automate because lives are on the line. Nonetheless, part of the reason we've reached the health care price point that we have today is because of the fear of change and its impact on patient care. There are key areas where automation makes sense, such as coding and billing. By leveraging technologies, like natural language understanding and computer-assisted coding, providers can cut time and costs associated with business processes, such as the actual documentation of patient care. Finding ways to use technology to streamline processes and free up staff for larger priorities is yet another way health care providers can begin chipping away at inefficiencies.
Big Data, Big Insight
With increased pressure to do more with less, providers need to take a hard look at how the information they capture could be used to impact patient care and their bottom line. Today, big data and data analytics are just starting to take center stage in the health care industry. The ability to map trends, identify internal weaknesses from a single clinician or across an integrated delivery network, and/or even create predictive models that help determine at-risk patients in advance of calamity -- each of these is possible if a provider is able to unlock the power of their data.
From a data perspective, health care should take a page from the telecommunications industry as they've been successfully tapping into data for years. Specifically, they use insight into customer data to improve customer service and, in turn, customer loyalty. While customer service may not be the main focal point for health care per se, opportunities related to using technology to streamline data capture, accuracy and application are endless. As we see increased regulatory pressure and scrutiny when it comes to quality of care, health care providers will have no choice but to find ways to use data to drive efficiency and accountability across the care continuum.
Aim High But Keep It Simple
Mobile technology, telehealth, automation and data analytics -- what do they all have in common? Each helps solve specific problems associated with the increasing cost and inefficiency of health care. Additionally, they each tie back (some more indirectly) to improved patient care. Point being, technology, while seemingly burdensome at first glance, holds the power to help fix the "Rubik's Cube" that is health care. We, whether providers, patients or industry partners, each share one responsibility in the endeavor to get health care back on track, to leave things -- at least in some small way -- better than we found them.
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