The Change Healthcare Deserves: Righting the Wrongs of Healthcare Technology

Healthcare organizations are unique beasts. One of the unique things is the number of different participating groups- health systems, payers, accountable care organizations, payers, just to name a few.

However, unlike other industries, healthcare has patients, strict data management, specific billing requirements, and several compliance-oriented rules that just end up making healthcare operations complicated. Not to mention the added pressure of keeping it error free.

Conventionally, one would think all these different groups with varied needs would need different solutions and technologies. This variety is not just among the healthcare organizations but still many of them are logging into multiple systems of EHRs and other management systems. And there are hundreds, if not thousands, of different solutions available for each of these groups!

Since when did ‘MD’ start representing ‘Managing Data’?

It’s been a long decade for healthcare. The technology that once promised to simplify patient care has brought more issues than anyone ever anticipated. More distraction. More compliance. More regulations. More codes.

The 12-year technological beat down has led to an unprecedented rate of physician burnout and claims of a solution tend to fall on deaf ears. According to a 2019 healthcare finance report, 60% of physicians would not recommend a career in medicine.

Even after making remarkable investments in EHRs that comply with the regulatory guidelines, healthcare is still is swarming with questions such as:

• Why is my data fragmented and inconsistent? EHRs were supposed to solve this problem, turning out only to multiple the issue.
• Why is the modification of my EHR data feed structures such a complicated task?
• Without the data, I cannot take the necessary actions. But what should I do when the data I have is also equivalent to not having any?
• Why are my providers no longer the doctors I needed them to be?

These questions have been haunting the healthcare space for over a decade now. There couldn’t be better timing than now to actually change this scenario!

Driving the change with an integrated outcomes-driven approach 

Consider an example. There’s a provider network that looks after over 100,000 attributed lives in a value-based contract with a payer.

The providers would need just the right information on their computer screen with all the relevant details such as care gaps of the patient. They would need to analyze the state of population health and how satisfied their patients are, receiving care within the network. They would want to track their out-of-network activities and streamline their referrals. On top of it, they would want to monitor their performance against benchmarks and capture variances.

While at the same time, the payers would need structured data sets that allow them to have a holistic view of their population. They would want to know the risk of the population they are serving and capture the dropped codes. Most of all, they would want to gather insights that would help them create and manage health plans.

One would think that the providers and the payers would need different sets of applications. Although when you look at it, the data they both require is pretty much similar- EHRs, claims data, ADT feeds- to begin with.

The one thing that makes the biggest difference is the way they both leverage their data. The provider would want to gain a clear understanding of how his patients traverse in and out of the network to ensure they get the best care and remain within the network. The payer, on the other hand, would want to ensure the patients are being referred to the best providers within the network.

Looking at it closely, these two scenarios are the two sides of the same coin. Both these organizations want to manage their network efficiently, albeit for different reasons.

Out with useless data. In with actionable intelligence at your fingertips

As we get closer to the part where the end user would directly interact with the technology solution, it is important that we create action-oriented applications. Patient-Centric healthcare requires things done differently. Each patient deserves private, customized care with unique plans, a dedicated team, and outcome-focused goals.

It is not just the healthcare data that needs to be managed to deliver the care our patients deserve. We need to ensure that every other process works fine. The key to creating a 100% effective data-driven strategy to improve population health would require five major elements:

• Efficient healthcare data integration
• Powerful population health management
• Automated care management
• Point-of-care insights to engage physicians
• True patient involvement

Activating the healthcare data to power healthcare’s internet

There’s only one way to defeat the beast. We do it by making full use of the healthcare data around us and by delivering actionable insights right when it is needed.

By righting the wrongs of healthcare technology, doing away with long-standing problems, and replacing them with the ideal solution- a single platform that has the power to activate healthcare data.

In with ultimate integration. We need to bring together EHRs, PHMs, payer claims, and HIEs and put it all in the palm of the providers’ hands. Whether it’s quality management or data management, it should be simple.

Even after efficiently integrating the patient data, healthcare organizations face issues maintaining uniformity across hundreds of records. Each patient’s record has to be unique and firm, allowing the providers to distinguish between even the slightest of an anomaly. The data records have to be checked rigorously to ensure that there are no broken transformations or inaccurate mappings in the patient records.

Providers are tired of wading through complicated EHRs and excel sheets. What we need now, is to seize the nanosecond and realize truly automated care delivery that helps boost the clinical outcomes.

Physicians, care coordinators, and the members of care teams have to spend too much time shuffling through spreadsheets and putting information together. This is followed by reviewing clinical records, looking for missed screenings, dropped codes, and more and since it’s a manually-extensive process, it has immense scope for errors.

Healthcare needs to reduce all these errors and leverage all the tools at their disposal to easily coordinate care for patients and improve their lives- one patient at a time. Care teams need to focus on higher-value outreach and interventions and enable efficient workflows to run routine tasks.

Healthcare in the U.S. generates enormous amounts of data every second. From clinical sources such as the EHRs to social determinants of health, any healthcare network is a host to all information that is crucial to managing population health.

However, this data, even when integrated and structured, is of little value if not analyzed accurately. Healthcare organizations need robust methodologies that can help them hone data, identify growth opportunities, and figure out the next steps as they seek to drive efficient healthcare.

It’s high time healthcare organizations were empowered to track any metrics they want, perform any analytics they need, and achieve any outcomes they deserve. They need analytics that should guide them through the blind spots in their network so that they can find and optimize the core drivers behind the performance of each measure. And all of this should be one click away- accessing data simply- and displaying it beautifully.

Healthcare providers are often forced to access bits and pieces of electronic healthcare analytics and referrals on disparate applications. It is unreasonable to expect all physicians to be focusing too much on gathering bits of information when they have their patients to look after.

Real-time care gaps. Potential coding opportunities. Patient education opportunities. Physicians want to capture all of them, the only problem is that they don’t know how. They should be able to cut through the noise in the network and close gaps in real time to deliver quality outcomes with total efficiency. Providers should be able to capture the gaps in patient care right when they need to and enhance the patient experience of care.

When was the last time when you hear patient a say that he is not interested in what happens to him during his care journey? Probably never. Healthcare is not just providing episodic care to patients, it is about building relationships with them. In a world where the quality of care directly influences the financial success of an organization, providers should look forward to aligning the needs of their patients to their treatment procedure.

In today’s age of intelligence, successful organizations do one thing right- they know the worth of their data. It is safe to conclude that the definition, as well as the scope of patient engagement, varies from provider to provider. However, organizations cannot rely on a makeshift approach for engaging patients. They not only need to have a concrete strategy, but also adequate resources and ample staff support to evaluate what works best for them and what do they need to do.

I think we can safely agree that data is of little use unless brought together. As healthcare organizations continue to embrace the power of data, they have to ensure that they are ready to tap into it to its full potential.

A data activation platform is required in healthcare to extract the full value of their data. We have to start making the full use of all the data our healthcare industry has worked so hard to collect and righting the wrongs of healthcare technology.

A data activation platform aggregates, analyzes, and activates this hard-earned data. A platform that can scale itself according to the needs of healthcare and grow as the amount of data grows. The data activation platform can open the superhighway for healthcare’s information. It can deliver insights into patient and population performance with the speed and accuracy. And does it all at the most important time— the moment of care.

To know more about how you can right the wrongs in your care network with a data activation platform, get a demo.

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This blog has originally been authored by Abhinav Shashank.