Healthcare organizations are unique beasts. Like other industries, they too, are separated by different participating groups- payers, health systems, accountable care organizations, pharmaceutical companies, and biotech companies- to name a few. But unlike other industries, they have patients, strict data management, specific billing requirements, and several compliance-oriented rules that make healthcare operations complicated.
Traditionally, you’d think that all these different groups with varied needs are going to need different solutions and technologies. Many healthcare organizations are still logging into multiple systems for EHR, billing, and practice management. And there are hundreds, if not thousands, of different solutions available for each of these groups!
Why does healthcare need a unified platform
Healthcare has been a little behind other fields in adopting technology. It took several government incentives and penalties to adopt EHRs- a basic functionality, now that you look at it. The objective here is different, though. In this era, the organizations are driven by the need to make healthcare efficient, it’s time our technology reflected the same.
Quality is the most important factor in healthcare at this juncture. Gone are the days of on-premise, purpose-built IT environments where every user had a different set of credential for different systems. It’s time we got rid of the hassle of training people, integrating a new system with the existing ones, get new data servers, formulate back up, and accelerate implementation to keep their processes running smoothly.
Most healthcare leaders recognize the inefficiencies disparate systems cause them. In a 2014 survey of independent providers and leaders, 89% of them admitted that they had to upgrade their billing and collections system just to maintain a positive cash flow and remain profitable. Plus, it’s not just a question of efficient processes. Another report suggests that right integration can save the healthcare industry as much as $300 million every year.
Plugging the gaps with a single platform that empowers efficient care
At Innovaccer, we looked at the challenge of disparate systems closely. We realized that the difference lies in the needs of the end user and their applications, but there’s no reason why a unified common technology platform can’t work for all these groups. Broadly speaking, there could be four stages of setting up a technology that drives healthcare efficiency:
Healthcare is still dynamic and having seen technology trends first-hand, we realized that all healthcare organizations regardless of their scale will need to address these stages at some point. The needs and requirements may differ for every end user, but an underlying common foundation will be needed- one that can deliver secure, accurate, and efficient operations.
Driving the change with an outcomes-driven platform
Consider an example- a provider network with over 100,000 attributed lives in a value-based contract with a payer. You’d think they would require two different sets of applications. The payer would require structured data that allows them to have a holistic view of the population, and the provider would require something that pulls out the care gaps for every patient. Although when you look at it, the data they both need are quite similar- EHRs, claims data, ADT feeds, ambulatory data- to begin with.
Where we begin to see the difference is how both these groups leverage their data. The provider may want to understand how their patients traverse in and out of the network to ensure the patients get the best care and remain within the network. The payer, on the other hand, would want to ensure the patients are being referred to the best providers within the network. Looking at it closely, these two scenarios are the two sides of the same coin. Both these organizations want to manage their network efficiently, albeit for different reasons.
A single platform that can incorporate multiple data sources and deliver clean, structured datasets and can grow as the amount and types of data increase can cater to their needs. Then, they could leverage analytics to learn about their network utilization and identify care gaps. Similarly, payers can learn about the growth opportunities in their network and tap into them.
Delivering simplified operations
As we get closer to the part where the end user would directly interact with the technology solution, it’s important that we create action-oriented applications. These applications should support an efficient system of delivering data along with a broad range of clinical and operational insights. It’s important to realize that these applications should address the biggest challenge of all- making the entire experience of managing care hassle-free. The frontline teams are generally required to interact directly with data-driven insights and utilize them to deliver better clinical and operational processes- so this process has to be quick, efficient, and simple.
On a unified platform that pulls data from multiple sources, all contributing to a single, holistic patient record, a specific application for providers can be built that allows them to access actionable insights at the point of care. They can identify the gaps in care, coding gaps, and keep a track of due measures or screenings. Similarly, on a higher level, the organization leaders can simply view their dashboards to understand network trends and patterns and learn what areas should they focus on to achieve their cost and quality goals.
The road ahead
Healthcare may have been behind other industries in adopting technology- but the evolution has been incredibly quick. Healthcare organizations are looking for every possible way to deliver the best patient experience and spend their dollars efficiently. As we head towards a future where quality in healthcare would be driven by data transparency, it’s time we streamlined our efforts. A successful healthcare organization should rely not only on advanced technology, but on the synergy of tools, skilled people, and a culture that promotes interoperability- and what better than a unified, integrated platform to start with!
To learn how the you can drive an efficient healthcare with a unified platform, get a demo.