To paraphrase Charles Dickens, these are the best of times and these are most volatile times when it comes to our nation’s health care delivery system. One thing I know for certain amid all the uncertainty is this: Far too much time, effort and talk have gone into the political side of our health care system and not enough of the same into the actual delivery of health care so we can improve patient outcomes.
I’ve spent 20-plus years working at the intersection of technology and health care delivery and have seen close up a lot of the good technology can do.
Technology has been effective in other areas of our lives. Think about all the changes we’ve seen in how we travel, bank and shop; services and the level of service are more ubiquitous in those industries.
Every one of those revolutions in the other industries, such as in the financial industry — think online banking from our living room couch — weren’t possible just 10 years ago. They completely changed the relationship between the consumers and the folks who have the information.
We’re watching a similar moment in health care. So, it is natural that doctors and hospitals have questions about how they will provide service in the future. How do they adapt without giving up value, how do they make choices about the technologies that will help them, how do they spend the right amount of money on IT to get the right return? Those are all the things on their minds.
Think about the everyday aspects of health care: We wind up in the hospital or we end up in the doctor’s office and sometimes we have to repeat the same procedures and then give the same information we just gave during the same visit three floors down in the same building. That kind of inefficiency is a key ingredient of what we need technology to address.
Doctors depend upon what they know when they make a decision about their patient’s care. If they don’t have enough information, ultimately they fill in the gaps with the best experience and medical knowledge they have, and make the best decision they can. For the kind of accountable care intended in the Affordable Care Act to work, we need to solve the problem of lack of information; by getting complete information about patients at the point of care, at the moment of truth, so that safe, effective decisions can be made is essential.
The other key element is being able to then utilize that information to measure and improve performance. You can’t really improve things you can’t measure — that’s just a fact of life. Accountable care won’t succeed without these two elements.
The common denominator is patient information: we need to better collect information, not just from the doctor’s office, hospital and emergency room — the traditional places where information has been collected — but also in a patient’s home. Patients with chronic conditions or patients recovering after procedures need certain data measured. For instance, they need to measure how quickly their blood is clotting, how they’re doing with their glucose values, etc. Being able to measure that in their homes and transmit it immediately to caregivers is a key ingredient to improving patient outcomes.
We need to make more easily available all the information on a patient from all venues of care, but we also need to protect, keep secure, and harmonize the data so health care providers can immediately see what’s happening with a patient, without having to wait for dozens of textual reports and look for needles in haystacks with the very limited time they have.
We then need to make the information easy for all to use in identifying any gaps of care, alerting doctors, patients, care managers, and their care teams so that action can be taken to address potential issues that may affect a patient’s safety, help improve their healthcare outcome, or help prevent an unnecessary cost.
After that information comes together and is made available, we need to analyze that information using software to deliver near real-time reports so patients can see how individual doctors are doing on their performance measures, see how a doctor’s practice is doing compared to others, or a community can better understand its overall health status. Most importantly, data review will allow health care professionals to fine-tune, refine and improve healthcare outcomes.
Dealing with the politics of health care reform is to be expected, but it’s time we also focus on how we will actually achieve the outcomes that patients and doctors expect from our modern technological advances.