Shift Happens: Disrupting the Delivery of Healthcare

Shift happens. Yes, go back and read that again—shift happens, and while it means change, it doesn’t have to be the bad kind, like its verbal cousin. And all across the healthcare industry—an industry that is being restructured before our eyes in response to pressing clinical and business realities and governmental reform—disruption and shift are occurring faster than most are willing to accept. Data-driven healthcare is generating a rapid technology transformation that requires looking far beyond the traditional electronic health record (EHR) to a changed, connected information landscape. While we do not know to what extent the industry will move, we do know that success in this next-generation environment will require healthcare organizations to look deep within themselves for information, while making fundamental transformations that require them to be more integrated, more collaborative, and more analytical—but also more mobile and socially connected, and more supportive of both clinician and business workflows.

What this means is that we can no longer employ traditional systems with separate information baskets to provide the information we need, when we need it. If the old model records illnesses and treatments, with separate documents for tests, medication, patient instructions, and billing, today’s model must incorporate standards-based system integration, cloud technology, interoperability, mHealth, telemedicine, analytics, business process management, and even social media to deliver not only patient-centered care, but person-centered care—a term that will quickly rise to the forefront.

But until we connect siloed and fragmented data sources, we will lack the full scope of information to treat patients. And until our medical records are ‘synced’ and easily sharable—much like the multiple devices we carry around on our person—our records will remain separate, keeping providers from seeing a patient’s full medical history. This is exacerbated even further when there are multiple specialists involved in the care of a patient—each provider maintaining separate records and systems, often unavailable to other providers. As a case in point, a 2013 IDC Health Insights white paper indicated that Medicare patients with at least five chronic conditions may see 14 or more physicians in a year.

We often lose sight of that, however, and just the same as Dr. Steven Nissen (Cleveland Clinic) so truthfully stated, in that “when medicine became a business, we lost our moral compass.” We overlook the role of patients-as-consumers, and fail to see that that there can be no Meaningful Use unless we keep the individual receiving care at the center of it all. We lose sight that connected care—integration, sharing, workflow, and mobility—across the enterprise, not to mention continuum of care, is what will truly drive industry transformation and alter the way we deliver more precise, more personalized medicine.

This disruption means we’re starting to see a next-generation healthcare environment developing from a fundamental industry shift—a “Healthcare 3.0” landscape where the communication lines among provider, patient, and payer converge, and where hospital consolidation and market disruption by new entrants increase the requirement to communicate with each other.

Person-Centered CareThrough this shift, patients are no longer passive receivers of a diagnosis—they are consumers and active participants in their own care. They demand access to their personal health information wherever they are, and not just in the form of the old-fashioned paper files or X-rays. They want the ability to quickly and securely share their complete electronic health record with other providers. They want this ability from any mobile device, right from their pocket, in a way that makes their information easily accessible, quickly transferable, and downloadable without a hitch. They also want to contribute to their own healthcare decisions as conveniently as possible using mHealth and telemedicine tools.

At the same time, healthcare information management itself must be disrupted. A 2015 HealthLeaders Media survey indicated that 81 percent of healthcare institutions rely on an EHR, while 95 percent expect to do so within three years. Yet the EHR today only contains 50% or less of available patient data, presenting, at best, an incomplete view of the patient record. Unstructured and fragmented data across multiple systems, and even paper records, will continue to block even the most committed institutions from success until they are able to retrieve all forms of information, and assemble that data in a form that is clinically actionable. In addition, the expense of maintaining legacy systems will continue to siphon away the resources needed to move forward.

But technology alone is merely a tool, and without proper analysis and workflow, cannot itself improve patient health outcomes, or lower costs. Systems and processes that manage this information in a way that optimizes its value, are needed, and having them in place are among the most fundamental changes providers and organizations must adopt before they can distinguish between valuable data and a data dump. And in a landscape Healthcare Toolboxwhere costs are expected to double—to $4.5 trillion by 2019—non-essential patient information creates waste in systems, and potentially in treatment precision. This wasted expense increases healthcare costs, as well as health insurance premiums.

The simple EHR remains a tool, and must become part of a larger, integrated record if the industry expects to realize true meaningful use, that is better quality, safety, and efficiency with patient engagement, and privacy. True meaningful use requires big data, and the ability to unlock its power in ways that lead to better patient outcomes, less waste, and fewer health disparities. Every patient encounter needs a precision response that serves the patient—and in doing so, benefits the healthcare organization with lower costs. This data-driven healthcare needs integrated patient records, interoperability, accessibility and usability for optimal workflow, and flexible infrastructure. And until these elements are in place, institutions will keep falling behind with rising costs and decreasing quality.

So yes, shift happens. And in healthcare, it’s happening everywhere, and it will continue to happen whether institutions are ready for it or not because patients (i.e. consumers) are demanding it. If they ignore the changes taking place around them, institutions will be left to fail to their own devices.