How Patient-centered, Value-based Care Will Drive Innovation in Healthcare

Fauzia Khan, MD

Guest post by Fauzia Khan, MD, FCAP, is chief medical officer and co-founder of Alere Analytics.

This has been a very interesting year for the healthcare industry, which appears to be on the brink of a real sea change. Government mandates are driving transformative discussions in the C-suite circles on topics such as meeting meaningful use Stage 2 and Stage 3 requirements, satisfying Accountable Care Organization (ACO) standards, care delivery models in the patient-centered medical home and much, much more.

With many worthy priorities for healthcare leaders and providers alike, where do we at Alere Analytics see the majority of our industry’s resources and attention going? The following are some of the top issues continuing to transform the healthcare industry this year and beyond:

Impact of Meaningful Use Stage 2

Physicians are now taking the steps to meet meaningful use compliance, which focuses more on how healthcare IT is used rather than what it is capable of doing. With that said, care coordination made possible through Heath Information Exchanges (HIE), EHRs and PHRs will become critically important as well.

Stage 2 also creates an urgency to demonstrate the use of technology to engage patients in their care and improve quality by reducing care gaps, ensuring understanding of chronic conditions and increasing adherence to necessary and critical treatment plans.

This urgency has made patient engagement an industry buzzword and a checkbox to cross off, but active, real-time patient engagement could be a real game changer. With patients engaged earlier in their treatments, and with the addition of real-time solutions, such as clinical decision support (CDS) and analytics, physicians would be able to provide personalized and immediate recommendations for care, triggering earlier interventions, reducing avoidable errors, and improving overall health outcomes.

Emerging Payment Models: The New ACO Frontier

Fortunately, it is becoming increasingly clear that reimbursement for care models must now be focused on the patient and outcomes rather than on services rendered. The ACO concept is a positive start, but determining which business model or care models will eventually win, still remains to be seen.

Improving quality and efficiency, rather than just simply reporting on it, places a heavy reliance on ACO-wide clinical and cost analytics. While many physicians will not enter into an ACO agreement because of perceived lack of return on investment, analyzing clinical outcomes based on real-world patient data will likely be worth the upfront investment.

Patients Increasingly at the Center of Care

Although the healthcare industry has made significant strides in making sure that patient data can be easily captured, accessed and reported on a timely manner, we still have miles to go. Technology innovations have created a wealth of patient-centric solutions such as EHRs/PHRs, HIE and CDS platforms, but many of them are struggling on how to capture patient data and build a longitudinal care record. Once we have figured out the connectivity piece, clinicians are enabled to focus on the best treatment plans using intelligent and actionable information to improve care quality while reducing costs for each patient.

This is definitely an exciting time for the healthcare IT industry, however despite all the attention paid to improving patient care, a very important group is conspicuously left out of the conversation—actual patients. With ubiquitous mobile devices and more people opting for home healthcare, many patients want to take a more active role in managing their own health, so why not invite them into the conversation? We expect and hope this to become more of the norm.

Like many shifts in healthcare, changes won’t occur overnight. It will take time. Moving treatment closer to the individual closes crucial care gaps, provides greater visibility, and accelerates decisions that lead to better outcomes.

Informed Decisions through Data-driven Intelligence

While EHR systems do a great deal to manage clinical data, many current systems do not contain the clinical intelligence and knowledge needed to effectively make the data actionable for the care team. To accomplish this goal, providers must acquire effective, real-time CDS and population management (PM) tools.

An integrated CDS and PM system allows healthcare providers to choose which clinical profiles they wish to actively manage and then ensure the providers receive alerts and notifications containing actionable information at, or near, the point of care. Simultaneously, the provider can also define custom patient populations to reach out to patients with specific care recommendations, especially when managing chronic diseases.

Continuing efforts to automate and modernize processes will enable healthcare organizations to provide more efficient workflows and coordination of care, which will reduce duplicate tests and prevent errors in conflicting treatments when patients have several doctors attending to them. In all, healthcare will become even more data driven, but more importantly, it will become more focused on wellness.

Increasing Role of the “Connected Home”

Connecting hospital systems have been an IT priority over the last several years in the healthcare industry. Although we have just barely embraced this model in the clinical world, what if technology platforms could also be effectively used in the home setting?

With CDS, patients could take a more active role in their own care. If the last decade was focused on inpatient, outpatient, and ambulatory data integration and interoperability, the next several years should focus on creating the “Connected Home.”

Data, at the point of care, in the home should be actionable, comprehensive, and increasingly accessible to patients, physicians, and payers. Whether that data is delivered through an HIE, EHR or a smart device, patient data needs to be accurately captured and widely available, which will allow for the best healthcare decisions to be made. In time, once we move treatment closer to the individual, this will accelerate clinical decisions that ultimately lead to better health outcomes.

With new regulations pushing the healthcare industry forward to ensure better patient management and care, it’s clear that CDS will be influential to changing the way care is currently delivered. It will improve health outcomes, while enabling healthcare providers to make the most informed, evidence-based decisions  made in in real-time, and at the point of care and beyond.

While much still hangs in the balance from a regulatory perspective, we continue to work with our customers, partners and the industry as a whole to offer the analytics and data needed to help clinicians provide safe, effective care to their patients while fostering the exciting future of patient data delivery.

Fauzia Khan, MD, FCAP, is the chief medical officer and co-founder of Alere Analytics (formerly DiagnosisOne). Dr. Khan provides direction and leadership to develop practical and scalable technologies that allow clinical decision support and analytic capabilities to be seamlessly incorporated into clinical workflows. She has expertise and passion for algorithm design, knowledge acquisition and engineering, as well as data mining and leveraging these capabilities to improve outcomes. Prior to forming DiagnosisOne, Dr. Khan was the Director of Informatics at UMass Memorial Medical Center with 10 years of experience in the hospital practicing pathology. She is the author, editor and primary visionary of the “Guide to Diagnostic Medicine,” Lippincott Williams & Wilkins, 2002.

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