Transformation Fuels Opportunities For Healthcare Leaders

Scott Overholt

By Scott Overholt, chief business officer, Vyne Medical.

Healthcare is ever evolving and constantly shifting in response to consumer trends, regulatory changes and new technologies. Typically, these changes take place gradually with adoption rolling out bit by bit until finally reaching the tipping point among hospitals and health systems. We have observed this in recent years with transitions related to value-based care, electronic health records and interoperability, to name a few.

The impact of COVID-19 on the healthcare industry is unlike any of the changes we have seen in recent years. The change was sudden, swift and required immediate action from every healthcare provider regardless of size, setting or demographics. The pandemic allowed no time for committees, focus groups or research teams to develop lengthy strategic plans. As an industry, it tested our ability to adapt, act quickly, think creatively, and take calculated risks when necessary. The pandemic represents a sea change in healthcare that as leaders, we are all just beginning to grasp.

Business transformation

One area of significant change is the transformation in healthcare business models and connections between providers. Even before COVID, healthcare had observed a significant increase in merger and acquisition activity. The past year accelerated this trend as organizations form partnerships to better weather the lingering impacts of the pandemic.

Small hospitals that have taken bigger hits have sought to be acquired by larger health systems in order to survive. Conversely, large systems with more diversified portfolios and existing services such virtual care and digital functionality are growing as a result of these new acquisitions, partnerships and technologies. As organizations merge and seek to standardize their processes, there is a renewed focus on business function integration and centralization. The result is a more integrated delivery model with increased connections and data sharing between providers.

Collaboration

According to a recent PwC survey, 73 percent of healthcare executives said they were beginning to collaborate or had plans to collaborate with other care providers and payers as a result of the pandemic. Hospitals have significant opportunities for growth in this new environment of integration and collaboration.

As providers begin to share data on emerging services such as hospital-at-home and remote patient management, for example, hospitals can work together and with payers to help ensure that these services remain affordable for patients. Managed care contract discussions will also help providers learn how to build expenses into contracts and protect necessary reimbursement.

Data integration plays an important role in facilitating collaboration among providers. Sharing data between systems helps ensure that the right information is available to the right resources at the right time. It also helps automate common manual tasks by auto-populating patient data from one system to another. Care becomes more efficient, coordinated and seamless as a result.

Data Security

While there is great reward, risk also accompanies shared access to patient data. Recent survey data suggest a strong correlation between security breaches and the number of patients willing to share their health data. In 2020, the number of reported patient data breaches in the U.S. was 447, a 36-percent increase since 2016. Somewhat correspondingly, just 71 percent of patients said they were comfortable sharing their health information among healthcare organizations in a 2020 survey, as compared to 84 percent in 2016. When data breaches trend upward, consumers are less willing to share their information.

Risks have amplified over the past year, as many organizations have been unable to invest in security projects during the pandemic. According to Becker’s Hospital Review, “When hospitals’ revenues declined due to canceled elective procedures in response to the pandemic, many organizations were unable or unwilling to finance large-scale security projects at a time when attacks were increasing.”

As hospital revenues improve and data sharing becomes more prevalent, there is a greater need for vigilance in protecting the security of patient information. This is especially true as more healthcare employees now work in remote environments. Paperless environments and protected access to patient data are a must. Providers also need strong partnerships with their solution vendors and IT infrastructure teams.

All parties should understand the complexities of interpreting regulatory requirements and exchanging patient health data. For example, certifications from organizations such as the Health Information Trust Alliance (HITRUST) can help providers in selecting partners proven to appropriately manage risk by protecting and securing sensitive, private health data.

Care Delivery

Perhaps the most noticeable shift in patient care has been the widespread availability of telehealth services. According to a report released in March 2021 by Rock Health and the Stanford Center for Digital Health, 43 percent of 7,980 consumers surveyed used live video telemedicine in 2020. A recent survey from PwC showed that many health organizations plan to offer virtual visits in 2021, particularly for certain specialties such as mental health, family medicine, obstetrics and gynecology, and pediatrics. Overall, telehealth visits increased 33% in 2020 compared to the previous year, and the telehealth market is anticipated to reach $191.7 billion by 2025.

In addition to telehealth, the industry is seeing new entrants to the primary care space. Some companies sell telehealth and tech-enabled care delivery directly to employers. Others offer digital concierge services, promoting the ability to get a second opinion or prescription within 60 seconds, 24 hours a day. Still others provide surgery benefit navigation services, contracting with providers to offer bundled rates for self-insured patients. Even Amazon is in the mix, matching patients with medical teams in 50 states.

We’re observing something unique in the industry – a paradigm shift in where patients go to get their care and how they receive it. We see it in telehealth, consumerism and nontraditional delivery models nationwide. This movement, encompassing both technology and remote access, requires a change in how we engage patients and a continued focus on the consumer. As we step into this new territory, there is great opportunity through collaboration, integration and innovation in healthcare.


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