Old-school healthcare providers were more concerned with the number of patients than with the effectiveness of the care they gave. The emerging paradigm of value-based care—ensuring quality, not quantity, of care—is replacing that system. The old model paid doctors and services depending on the volume of the care they provided. Quality care has arrived, bringing with it a huge transition that calls for integrated thinking, technology expertise, and tools to ensure quality care.
The healthcare shift
Systems for providing health services differ greatly between countries. Some are state-funded and coordinated—like in the UK and Canada—and some are governed by private companies, like in the US.
In the States, if someone gets sick, either they or their insurance companies will have to pay for their treatment. The US government does fund two kinds of health plans, though: Medicare and Medicaid. They specifically serve the elderly, disabled, poor, and young. In these cases the patient, their insurance, or the government (or a combination) pays the medical institution for the service provided.
The traditional fee-for-service (FFS) model in the US used to incentivize providers for volume of services given. The new shift to value-based care (VBC) is changing this. The goal of VBC is to improve the overall quality of health services. Now, the incentives offered are based on the quality and outcomes of the service. This shift in the system has turned technology into a key aspect for care providers. It is becoming more important than ever to track process adherence, performance, and outcomes.
However, the new model doesn’t come without challenges; that’s why health service providers need to rethink their business strategy. To provide quality service, first they must automate and integrate several of their business processes and applications. This allows them to implement a metric system on such processes. That way, organizations can detect improvement opportunities early and solve them as quickly as possible.
How technology could change the landscape
With technology like Artificial Intelligence (AI) and Big Data, we can define and monitor patient health indicators: physiological indicators, success of treatments, mortality measures, etc. Many forthcoming medical technologies, like telemetry, can enable providers to meet higher quality standards. This is especially the case with the combination of AI and patient-centered services.
Abandoning individual treatments and monitoring devices in favor of a patient-centered platform can better help providers track patient evolution. In turn, this helps achieve better results. Patient-centered platforms combine data across disparate data sources, creating a 360-degree, holistic view of the patient’s health. On top of that, they enable providers to leverage combined data from both monitoring and tracking systems. This process presents actionable insights in a format that’s easy-to-understand. This way, it fits seamlessly into their daily activities and facilitates better decision making processes.
We are already seeing providers focus their efforts in certain areas. Improving their discharge processes is one of them. Another is working on prediction systems to reduce readmission and allow for a more efficient discharge process. The industry is also focusing more investment on trainings and education systems. The goal here is to ensure that personnel follow the right procedures and can know how to provide excellent service.
But further implementations of technology have yet to enter into the world of health services. Technological advances have always gone hand-in-hand with medical developments. However, at this point it’s up to the industry to anticipate the coming changes and adapt accordingly. With focus shifting towards value over volume, the healthcare industry requires metrics and reports to track progress. Checking off the number of clients served is no longer enough.