Healthcare

One of the first words that come to mind when I think of medical care is hygiene. Let’s face it, poor hygiene practices in a healthcare provider’s facilities can cause major issues and possible loss of life. Consumers of healthcare services, trust that their provider is taking every precaution possible to protect them from disease or infections that can occur if proper hygiene is not practiced. 

Return on investment. It’s something every business calculates—from marketing efforts to large equipment purchases to capital improvements. We want to know if our investments in the business are paying off.

There’s no denying it—healthcare data has gone digital. The days of paper health records are fast disappearing, and if the Centers for Medicare & Medicaid Services have their way, we won’t be going back. CMS has built meaningful use of electronic health records into its plans for a number of years, and the healthcare industry is responding.

Recently, I received a call from a close friend who wanted advice because his small company had been the victim of a ransomware attack. A hacker had locked the company out of all significant business applications, compromised all the backups, and wanted $250 in the form of Bitcoins to unlock the system. The IT manager tried to restore the systems without paying and without success.

At a recent national conference, I heard top executives from some of the largest healthcare systems in the country discuss their business models and their healthcare delivery transformation during the past several years. We can count on the Geisingers and the Mayos, as well as other large systems, to lead the way, but I was struck by the extent of their progress towards offering value and outcomes to patients rather than the traditional models present today in many systems. They are doing, quite successfully, what many smaller systems are only beginning to debate. They are proving that new models can deliver better patient care and still be profitable.

While attending the Healthcare Financial Management Association Region 9 Conference in New Orleans, we learned that bundled payments are near and healthcare facilities should start preparing now.   

Bundled payments consolidate reimbursement into a single payment for the care and services related to a specific procedure or episode along the continuum of care. These payments are designed to incentivize the coordination of care among various health care providers, such as physicians, hospitals and post-acute care facilities, as well as to emphasize accountability for the cost and quality of care provided to patients. The Centers for Medicare and Medicaid Services estimates that by 2016, 30 percent of Medicare payments will be value-based and will expand to nearly 50 percent by 2018.   

In the past several months, I’ve had the opportunity to discuss trends in the healthcare industry with some of the best minds in the business, and one topic keeps coming up – population health. What has surprised me is that everyone I talked to places a different emphasis on aspects of the larger concept. It’s as if there isn’t a universal agreement on the definition of population health.

I think it’s safe to say that the focus of population health is to improve chronic disease management, reduce risk factors and improve gaps in care, but there are a number of strategies available to reach those goals.

Leaders in the hospital field are already pursuing integration to improve patient outcomes and reduce the ballooning cost of health care. The Centers of Medicare and Medicaid Services' quality initiatives, and now the Affordable Care Act, demand a new health care model that brings hospitals and physicians together to coordinate the continuum of care for improved patient care. One emerging trend to enhance care coordination is clinically integrated networks, or CIN.

Now that we have easier access to Electronic Health Records (EHR), it should be easier than ever to use data to find best practices and reduce variations in care that hurt patient outcomes. Right? 

In theory, that’s right. In practice, it’s a whole other ballgame. EHR is a great repository of information but it does not magically perform analytics. Also, how do you grade the usefulness of data and how and when it is collected? 

Here are 3 areas to evaluate whether the data you are accumulating can drive better health care decisions for the patient and improved processes and efficiency for hospitals and providers: