Healthcare’s Triple Aim: Beyond the Four Walls of Hospitals

Abhinav Shashank
Wed 21 Jun 2017
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Ask an average person walking down the streets what do they think of healthcare. The answers will range from exceedingly costly to mediocre quality of care. Maybe some would hope for a ground-breaking innovation or a vaccine for an incurable disease. But everyone, whether patients or physicians, nurses or executives, would agree on encouraging the push towards value-based care and making healthcare more than just an in-and-out operation in a brick-and-mortar structure.

Driven by the Triple Aim of Healthcare

Ever since the Institute for Health Improvement (IHI) coined the Triple Aim of healthcare and labeled it as ‘a framework for optimizing health system performance,’ providers of every health system, large or small, are working towards finding the perfect balance between driving better clinical outcomes and containing costs. The advent and appeal are so significant, that if you look at the recent emerging healthcare payment models, it’s clear how the goals of the model and the Triple Aim align themselves perfectly. The Triple Aim is more than a notion, a cure- it’s the idea of how we need to focus on keeping people healthy rather than treating the sick.

“The health care system has focused on treating people after they become sick instead of keeping them healthy in the first place.” -United States Centers for Disease Control and Prevention

The skyrocketing cost of care

The rising cost of healthcare in the U.S. is projected to continue at a rate of 5.8 percent from 2015, and even after spending over $9000 per capita, the out-of-pocket expenditure on healthcare in the US is second highest (over $1000) among all the countries right after Switzerland.

There have been transformations, but they have been retained within the four walls of health systems. We often talk about what goes inside the hospital wall that a stark separation has come into existence. The healthcare in the U.S. is a little shy of $3 trillion, and the hospitals of New York alone spent more than $6 billion on construction by 2015. As cutting down expenses is a priority, providers need to push the physical boundaries and deliver care that goes beyond four walls.

Diminishing lines with technology

It’s no secret that technology has had a major impact on us and has become a part of our everyday lives. From emails and phone calls to news and social media, the virtual distance has become almost non-existent. In fact, almost 77 percent of Americans own a smartphone, and 78 percent own a computer. Forget about running to a video store every time you wanted to watch a movie; technology has enabled us to download and watch it on TV, computer, or even on a phone. Because of these technologies, everything, right from how we work to how to we socialize, has changed. Appreciable? Yes!

Yet, the most significant aspect of our lives- our health- has been more or less unaffected by what is termed as a ‘digital revolution.’ True, there have been remarkable developments in the field of medicine, and all 6 billion letters of a person’s genome sequence can be determined today, but we are hardly as engaged in the matters of our health as we are in other aspects of our lives.

Changing the landscape with technology

It has only been a little over than a decade since technology was extended into healthcare. Be it determining blood pressure round the clock or implementing precision medicine, healthcare has experienced an explosion of innovations. However, technology doesn’t have to be complex- the matter of improving outcomes with technology is simple one, with these:

  • Big data: The advent of big data has opened up the doors of possibilities wide. A huge amount of data, collected from all spheres- EHRs, claims, lab tests, immunizations, flat files- can not only be ingested but predictively analyzed well in time to give a clear picture of the immediate future.
  • Mobility: Imagine if just like everything, health care could also be delivered on the go? With innovation like wearable technology and remote monitoring, health of any patient can be tracked at any time and care would be accessible on the fly- anywhere.
  • Internet: The internet has magically transformed the world and has the potential to take healthcare by storm too. The opportunities are endless- from leveraging the internet to create awareness and provide educational material to improving communication between patient and caregivers and push notifications.
  • Cloud services: When speaking of eliminating virtual distance, one can’t leave out cloud services. Cloud has been remarkable in healthcare- the applications can be easily scaled up or down, they can store immense amount of data and offer the capabilities to analyze, store, and share data between patients and providers in a secure and cost-efficient environment.

Achieving the Triple Aim

 Health IT can significantly close in on several gaps and helps providers create a strategic roadmap to achieving the Triple Aim- with focus on delivering quality, improving access, increasing efficiency, and reducing waste.

  • Better population health: With strong analytical solutions, providers can stratify their population, find patients with complex needs, obtain all relevant information and develop a tailor-made care plan for patients in an ecosystem of population health where patients are treated as individuals, and not an aggregate of a population.
  • Improved patient experience: Patient experience can be improved by having technology make healthcare as indispensable as any other aspect of care- through follow-ups, ensuring medication adherence, conducting wellness visits and making patient experience more than just a regulatory requirement.
  • Reduced cost: Analytics can help in more than one ways. Providers can analyze and deep dive into their expenditure and learn about overhead cost drivers, redundancies in the system and procedures that don’t justify their costs.

Bringing the continuum of care to a full circle

The full-scale shift from fee-for-service to value-based care that healthcare is underway, requires a clear focus on every stage of the care continuum. Right from the first step of gathering data and analyzing it to use these data-driven insights to create the most efficient care process, providers need to have a well-defined workflow. Along with that, providers need to gather insights not just from clinical and claims data, but also from socioeconomic and behavioral sources to know all the specifics.

The bottom line is that hospitals, regardless of their infrastructure have to change the way physicians deliver, and patients perceive care. More than that, it has to be realized that the infrastructure of a health system does little to improve its overall outcomes- the key is care management. To truly improve all aspects of care beyond boundaries, providers must leverage data to their benefit and bridge gaps and aim to transform care, with physical boundaries being the least of all challenges.


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Tags: Accountable Care, Healthcare, Integration
Abhinav Shashank
Healthcare’s Triple Aim: Beyond the Four Walls of Hospitals

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