Rather than searching for life on other planets, today we are seeking Unidentified Financial Opportunities
By Dr. John M. Ciccone, Chief Medical Officer, DSS, Inc.
Twitter: @DSSHealthIT
The rapid changes in the delivery of healthcare, and the associated technology, present both challenges and opportunities for companies engaged in the healthcare markets. The speed at which these changes are occurring is unprecedented, and will change the face of healthcare delivery worldwide.
The old paradigm of a fee-for-service model is evolving into today’s value-based system, which is intended to maximize dollars spent to achieve measurable improvement in patient outcomes. As a result, the need for new products to address these changes has never been greater.
Markets are now attempting to respond to these challenges by identifying new paradigms of care based upon innovative products, leading to the search for Unidentified Financial Opportunities (UFOs) by the healthcare industry. Ultimately, healthcare UFOs will be capable of satisfying requirements as set forth by government and third-party payers.
Healthcare providers have also seen a continuum of change in the way patients are managed, starting with the introduction of the Electronic Medical Record (EHR) in the 1960’s. While the original intent of EHRs was to better document patient interactions and track patient outcomes, these first-generation systems were unwieldy, and lacked provider-friendly workflows.
Subsequent generations of EHRs have attempted to narrow the gap between IT and provider workflows to improve efficiency and gain wider approval by providers. Practicing clinicians are starting to collaborate with software developers for product development, which has been a positive step forward.
However, today’s providers are challenged with needing to learn new technologies in a constant stream of updated products. This has led to physician burnout, early retirement and a decrease in both physician and patient satisfaction.
Although EHRs have become more user-friendly, recent governmental regulations such as mandates for additional documentation of meaningful use and changes to the electronic records format have placed more demands upon providers. These include everything from the HITECH Act under the American Recovery and Reinvestment Act to the American Recovery and Reinvestment Act to the unfettered access to patients for their complete medical records as required by the 21st Century Cures Act.
In addition, the stress upon the healthcare system by an aging population cannot be underestimated. By 2050, CMS projects that nearly 25 percent of the U.S. population will be over 65 years of age, or older. As a result, an emphasis must be redirected towards keeping the population well by identifying at risk populations for future diseases, many of which can be prevented by appropriate early lifestyle interventions such as cigarette smoking cessation, weight loss and regular exercise. The powers of lifestyle changes are further amplified through early disease detection with appropriate use of cost-effective medications.
Newer algorithms for maintaining wellness will also lessen the financial impact to the healthcare system. Population Health paradigms to direct healthcare dollars where they have the most impact, such as Remote Patient Monitoring (RPM), Hospital at Home/Virtual Care and utilization of Artificial Intelligence (AI) for data analysis, are already part of emerging technologies that present opportunity to healthcare companies and new tools for healthcare providers and systems. The next 5 years will certainly be a revolution in healthcare delivery.
Speaking of revolution, imagine a healthcare system that has unified standards of care for identification of high-risk populations based upon data analysis from EHRs – presented to a navigator who assists providers in accessing appropriate levels of the healthcare system.
Appropriate Use criteria embedded in the algorithm will also virtually eliminate unnecessary testing, thereby, providing greater access to those services at less cost, and enhance overall patient wellness.
In addition, expanding use of Virtual Care and RPM for those at risk for devastating diseases later in life will lessen the consequences of end organ disease. And, those patients with already established diseases will be better managed with RPM and Hospital at Home to eliminate or lessen the need for expensive in-patient hospitalizations.
Overall, the effects of a healthier population upon society will be profound. Quality of life as well as duration of life will be positively affected, and individual productivity will be enhanced.
Those companies that are early to recognize the need for change in healthcare delivery will be able to better profit from new and innovative products, and will also better address societal needs.
So, in many ways, UFOs are actually real, and represent undiscovered territory that will improve the efficiency and cost of healthcare delivery. They only await the innovative thinking of a new generation of healthcare pioneers who do not fear stretching the limits of imagination.
More About Dr. John M. Ciccone
Check out this Tate Chronicles episode where host Jim Tate talked to Dr. Ciccone the Chief Medical Officer at Document Storage Systems, Inc. DSS is a provider of health information technology solutions for federal, private and public healthcare organizations. DSS recently announced the launch of its Juno Health commercial division including the Juno EHR. Jim and John discuss today’s challenges for providers and health IT.