Value-Based Reimbursements and The Times of Uncertainty
GOP leaders have recently unveiled their Affordable Care Act repeal-and-replace proposal that plans to give states more Medicaid control, cut federal Medicaid expansion and restructure how patients pay for their health insurance. The healthcare executives, on the other hand, are keen on keeping some ACA provisions intact, particularly the transition to the value-based reimbursement. So, most likely value-based care is not going anywhere even if some parts of the ACA get repealed and replaced eventually.
Whatever the outcome of the ACA repeal-and-replace is, there is one thing providers know for certain – it is not raining dollars. So doing more with less (and doing it better and faster) is a strategy for survival in the value-based care.
There are several key aspects providers can focus on to achieve positive outcomes in the value-based care – interoperability, medical automation, digitization, device convergence/integration/compatibility, and ease of use.
The industry has an urgent need to build interoperability into every HIT solution. HL7 Fast Healthcare Interoperability Resources (the FHIR standard) is being deployed by forward-thinking vendors and in in-house provider solutions.
Streamlining information exchange across platforms requires industry-wide implementation of a unified standard, and FHIR seems to have gained traction. When implementing, vendors and providers should keep in mind the resulting interfaces and data presentation should be simple.
The wealth of health data, when its fragments are consolidated from across different platforms, can be overwhelming to the detriment of the very purpose of interoperability, which is to give the physician a complete picture of the patient’s care history. Therefore, the focus on simplicity and consistency of presented data and usability of the interface is imperative for your interoperability strategy.
Medical Automation and Clinical Decision Support Tools
As is the case with industrial automation, medical automation frees up human time for the efficient patient care. Automating routine, tedious tasks within the medical field reduces human errors, cuts costs and increases the productivity of your staff.
The machine-level accuracy and reproducibility in patient monitoring, in laboratories, and pharmacies make tedious tasks of labeling, packaging, monitoring, scanning into fast, error-free routines with minimum human input. Medical automation increases positive outcomes, productivity and patient safety, decreases mortality rates and reduces costs.
An RFID-enabled medical tablet with an inbuilt barcode scanner, and equipped with medical decision support tools empowers a physician or nurse, freeing up more time to actual patient care, which is vital in value-based care. Such tool prevents drug dosage or dispensing errors, cuts down on the time-consuming research or cross-checking with different systems. Decision support programs accessible anytime, anywhere combined with the ability to scan RFID and barcodes automate the big part of the routine workflow.
It is important that all stakeholders understand medical automation is not replacing humans, but assisting them. For example, at a recent HIMSS conference, Houston Methodist Hospital held a session “Managing a Legacy Team in an EHR Transition.” Their strategy in helping the existing staff get up-to-date with the new HIT solutions is a benchmark for the industry; we suggest you read it. It consists of appointing trained team leaders to oversee the testing, deployment, troubleshooting and the transition to the new solution and keeping a close communication loop between all stakeholders. It helped the provider keep most of its medical talent, and prevent the existing staff from the otherwise inevitable anxiety of losing job to automation.
A critical point in equipping your medical staff with various automation tools is to prevent the user notification overload, which urges physicians to bypass or ignore notifications. It effectively nulls many positive outcomes of automated processes and decision support tools, so filtering and compartmentalizing notifications is a significant IT challenge for providers and vendors.
Digitization and EHR adoption is moving forward in response to the transition to the value-based care and regulatory mandates. IT productivity paradox, however, suggests that the positive effect on physician productivity and the ROI for the providers will be tangible when all the imperfections are sorted out and users are accustomed to the digitized workflow. Technology does streamlined paperless workflows, but it takes time for the vendors to simplify the usability of their EHR systems, and embed interoperability. So that caregivers, providers, and payers can all enjoy a hassle-free data exchange.
Integration, Convergence, Compatibility
When integrating new HIT solutions into your existing infrastructure, ensure device convergence and compatibility with legacy systems. Consolidating multiple devices into one and ensuring its compatibility helps you address the cost, complexity and quality issues of the value-based care. So, screen your IT vendors and choose the solution that simplifies the integration of existing systems with the new IT solutions, so that your infrastructure is optimized and future-proofed for reliable performance in the value-based care model.
Device convergence or consolidation means you are deploying one device to replace multiple devices or tools. For example, one medical tablet replaces a desktop computer, a smartphone, pen-and-paper kit, barcode scanner, pager, TV/smart blinds/bed remote control, and patient infotainment terminals. It consolidates a wealth of applications such as EHR, clinical decision support, vitals monitoring, intranet communications, nurse call button and more.
Convergence approach also addresses an important productivity roadblock – tech fatigue. With BYOD and legacy systems, a physician is equipped with a handful of devices generating dozens of notifications daily. Desktop PC, a BYOD smartphone, a medical cart laptop, information kiosk in the hallway or at patient bedside – nurses and physicians are overburdened with technology.
Additionally, having multiple computing devices in daily use chips away from your staff’s working time as nurses and doctors need to conduct daily maintenance routines. Disinfection, battery recharge, or data loss due to power outage – how often do your nurses charge their powered cart computers or laptops? How many patients does a nurse or physician contact per day, and how many hands are working with your medical computers? Are there disinfecting procedures in place for your computers and BYOD devices? Most importantly, can they withstand disinfection? Hospital-acquired infections do not help you increase patient satisfaction and succeed in value-based care.
Therefore, deploying IT solutions that guarantee full-shift uptime and address all these issues in a single, HIPAA compliant, EHR-enabled, antimicrobial build with a user-friendly, familiar Windows interface saves your resources and eliminates IT fatigue.
Innovation – Follow The Lead
By 2020, the healthcare sector will have generated 25,000 petabytes of digital medical data. So, expanding on-premise data storage is no longer feasible as cloud solutions provide cost, accessibility and efficiency advantages. 77% of health care organizations plan to rely on SaaS cloud storage providers to maintain a high infrastructure reliability.
The mobile telehealth pilots featured by some providers at HIMSS17 show the future of the value-based care is in the ubiquitous mobile technology. For example, Houston Fire Department decreases the flow of low-acuity 911 patients to EDs by providing such patients with a live video conference with a remote physician through the medical tablets used by emergency units. With the physician’s expert opinion and alternatives well-explained, the patient is more likely to choose a scheduled clinic appointment, or a taxi ride to the ED, instead of the most expensive (from the provider’s perspective) ambulance ride to the ED. Read our Key Takeaways from HIMSS17 here.
Likewise, Palmetto Health successfully implemented EHR and made the transition to digitization by deploying Windows 10 medical tablets with digitizer stylus. The key features that facilitated the implementation are familiar user interface, excellent performance, and compatibility with other medical equipment, large screen, and Dragon dictation support.
There is no one-size-fits-all HIT solution for all providers. So, knowing exactly which features of a health IT solution contribute to your value-based care system makes it easier to forge and implement a successful strategy and maintain a competitive edge. Choosing the right IT partner that understands your needs is a prerequisite for success when advancing with your value-based care.