Like it or not, the Affordable Care Act has forever changed healthcare. Whereas providers and payers could previously keep patient information in separate silos, the landmark legislation now penalizes all organizations that fail to collaborate.
There is a solution, however. It's called connected care and it consists of continuous wellness, disease prevention, shared accountability, patient empowerment and remote monitoring. Powering it all are shared electronic records, mobile apps, analytics and cloud computing.
But healthcare will have to move fast if it wishes to avoid penalties by 2015. Although use of electronic records is rising, just 12% of eligible physicians were using them as of May 20121. And while accountable care organizations (or ACOs) such as the Arizona Connected Care, Accountable Care Alliance and NewHealth Collaborative have showed promising reductions in hospitalizations, costs and emergency room visits, they're still too slow when it comes to accessing cost saving or quality improvement reports.
To top it off, physician disbelief in the solution poses another problem. A recent survey of 13,500 physicians, for instance, found that 62% think ACO policies will fail to decrease cost of increase quality2.
Whatever your beliefs, there is a better way. Connected care isn't just a pipe dream. It's the future of better health. But only after healthcare providers, payers and patients accept the following six realties:
Share patient data or flounder.
Freely sharing data is the crux of connected care. But it can't be overwhelming like hospitals in the past designed it to be. And patient records should have role-based permissions to ensure the right information is presented to the appropriate physician while keeping patient data protected. Moreover, the terminology used in these records should be standardized to reduce discrepancies and patient populations must be factored when collecting data. If connected care is ever going to work, medical systems must be integrated with all providers in all care settings.
Listen to what electronic records tell you.
To do that, you'll need new-age analytics for making sense of the deluge of patient data. In connected care, analytics help hospitals aggregate clinical, administrative, socio-economic and patient-generated data to improve their understanding of processes and outcomes. Hospitals and providers can then combine this knowledge with principles of behavioral economics to gain insights into patient compliance, risk stratification and the design of appropriate interventions. But only if you listen and interpret first, instead of just "filing it away."
Automate data collection.
To transform the work culture from individual-driven to a team-driven model, care providers in an ACO will need to integrate their existing health informatics with medical processes. Doing so allows for greater automation and collaboration, freeing providers to focus on interpretation and outcomes rather than paperwork.
Educate—not only treat—patients.
Not only does ACA demand more education, increasingly informed patients do too. Consequently, health systems must adopt a fresh approach to patient education, including WebMD-style Websites and mobile apps that inform as well as provide treatment options. This ensures engagement at the beginning of the care cycle and continues as the patient moves through the care continuum with the help of electronic appointment scheduling and wearable technology for collecting and transmitting conditions.
Get in the loop.
In addition to sharing data, providers and payers must participate in the loop of information flowing from hospitals, physicians, nurses, ambulances and patients. This type of continuous feedback can empower care providers to make just-in-time interventions that result in cost reductions for the entire healthcare system. For example, a feedback loop for a heart disease patient could consist of daily weight information to trigger over the phone intervention instead of an unnecessary hospital visit.
Have a "mobile first" mindset.
Why? Because these devices alone are capable of saving $2–6 billion, according to Juniper Research. Not only that, but they improve information and engagement. Therefore, health systems must have a mobile strategy in place to address many of the above recommendations, not to mention a meaningful social strategy to engage prospective and current patients before they get sick or their conditions worsen. In light of this, several hospitals (including the Mayo Clinic) have begun using social media to not only connect with patients, but also understand what kinds of information the patient community seeks.
Again, competing in the post-reform era will require new levels of collaboration between providers to reduce cost and improve care. But it also requires mastery of social, mobile, analytics and cloud technologies to realize the kind of collaboration and accountability of connected care.