Big Data

How are Spreadsheets Killing Care Management and What Do We Need to Do?

Abhinav Shashank
Tue 21 August 2018

In 1913, Henry Ford opened new doors to a whole other world in the automobile industry with one of the first forms of automation. Not the Model T, Ford’s real innovation was the moving assembly line, which changed work forever.

Before 1913, car making consisted of workers putting together entire cars at one station. The assembly line reduced the number of workers laboring over a car and cut down the time to make a car from 12 hours to a little over two hours. And since began the dawn of a new world as we know it- where building things didn’t take long, finding information was easy, and the return on investment was much higher than the old days.

Source: The History of the Model T,

For a sector looking to reduce costs and improve efficiency by saving time, healthcare has a number of opportunities where automation can be an important part- especially areas dominated by papers and bundles of records such as care coordination. Much like Ford in 1913, moving care coordination from a paper-based system to an efficient and automated one has been a dream for long, and the efforts have been anything but seamless.

The long spreadsheets and overwhelming data

Healthcare is literally sitting on a goldmine of data. Only the challenge is that 80% of this data is unstructured, distributed across physicians’ hand-written notes, prescriptions, and such. Putting all this information together is necessary to create a picture of the patient, but finding it, integrating it, and analyzing it is a challenge.

Physicians, health coaches, care coordinators, and the members of care teams spend too much time shuffling through spreadsheets and putting information together. This is followed by reviewing their records, looking for missed screenings, dropped codes, and more.

Additionally, providers have to update information back into their EHRs and spreadsheets. Information such as patient’s response to follow-ups, their upcoming appointments, the results of their previous screenings, and more have to be updated- something which takes almost half of a physician’s time.

These operations are crucial, but they are taking up too much of a provider’s time. The explosion of data systems in healthcare has rendered physicians scouring for useful patient information from all corners. Agreed, attesting to reporting requirements, or navigating various platforms to find anything that could potentially improve patient care is necessary, but it has to be better.

Why has transforming care management been a challenge?

One of the biggest challenges has been bringing providers together. Coordinated care is only possible when the entire care team is on the same page. The healthcare that we’re looking at currently is an assortment of services which are mostly fragmented across different avenues. There’s hardly any actual coordination between providers- especially across different practices due to the existing lack of interoperability.

Apart from this, end-to-end care coordination faces several barriers such as:

  • Overwhelming information and workflows
  • Challenges with integrating and managing data
  • Fragmented contact with patients once they are discharged
  • Poor communication among healthcare practices

Behind the technology, there needs to be cohesiveness. While automation can never replace physicians or the essence of a human-centered sector, we can’t automate any process as long as there are gaps that patients might fall through.

A change in expectations

The reason why I emphasize the need for automation in care management is the number of opportunities the field has.

Consider an example. According to a study in the American Journal of Managed Care, it takes a nurse about three minutes to prepare for a phone call after reviewing a patient’s chart and the call itself takes around five to six minutes.

Combining this with the Bureau of Labor Statistics, the researchers concluded that the average per-minute salary of a nurse is 51 cents. Considering the number of patients in a practice around 4800 and each two-minute preparation before call takes $1.44 per patient, $6,900 go into preparing for calls alone. For patients who report no improvement, the cost of an additional five minutes of assessment time was estimated to be $2.57.

True, the value these processes add to the healthcare chain is much more than a dollar equivalent, but we can’t overlook the fact that a considerable amount of time goes into merely preparing for and scheduling the call. If the nurses are provided with information at their fingertips, the time that goes into reviewing patient details could be reduced. If the calls are scheduled automatically, and so are the consultations, the process can be even more streamlined.

Today, providers, nurses, health coaches, and care teams have to shuffle through a ton of paperwork where information is directed ‘at’ them. They spend too much time putting together the fragments, understanding the underlying patterns, following up with patients, and updating all of that in the EHR. And eventually, some of them burn out. Automating these process to simplify their daily workload could be a start.

Six things you didn’t even know you could automate in care management

Automation in healthcare is currently at a very macro level. Most of the considerations are around how automation combined with machine learning can simplify operations such as stratifying patient population or run predictive analytics to identify episodes before their onsets. However, there are some operations that can be automated to guide you into an intelligent healthcare:

  • Patient outreach: All outreach campaigns such as text messages reminding of upcoming appointments, follow-up calls, snail mails can be automated to save time and reach out to a larger breadth of patients.  
  • Patient onboarding and scheduling: Automation can be helpful in reducing paperwork and organizing records to manage appointments, schedule referrals, design patient flow, and help them navigate the care continuum.  
  • Smoother task handoffs and transitions: Providers can also get quick access to details such as other members of care teams and automate their work queues to collaborate with the care team and ensure smoother task handoffs.  
  • Daily agenda and care gaps: Automation can also help physicians synchronize their daily calendars with upcoming appointments to an extent where they can even review the number of care gaps that need to be addressed against every patient.  
  • Notifications and updates: Physicians and care team members can also allow push notifications and updates to be delivered on their phone or email to keep them informed of their patients’ health and network performance in real time.

The road ahead

For the Ford Motor Company, the assembly line was great. For the workers, it took a little while to get used to the changes that were enforced. But the assembly line is regarded as one of the earliest forms of automation that helped create the reality of work in the 20th century. In the same way, automation should be blended into the current workflows to make care delivery processes much more efficient. Automation is already transforming the world as we know it- and it’s poised to take healthcare by storm. It’s time healthcare rode the wave of change.


To know more on how you can automate your care management processes with a unified healthcare data platform, get a demo.

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