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The digital revolution in healthcare has given rise to value-based care, putting the focus on patient outcomes and cost-controls. But getting to that point is not as simple as flipping a switch. Obstacles to interoperability, security, privacy, and on-demand access to records have to first be overcome. Future Healthcare Today talked with Chris Logan, Senior Healthcare Strategist with VMware, to take a closer look at the challenges – and the opportunities – that value-based care offers.
Future Healthcare Today (FHT): What is value-based care and why is it likely to be the future for healthcare?
Chris Logan, VMware (CL): Healthcare organizations really have been managing with really tight budgets, dealing with strict regulations in this age of what we call digital transformation. The first stage that we saw take place in healthcare was a shift from this paper-based world to electronic medical records.
What became evident to healthcare providers when thinking about this digital transformation was the idea of value-based payments, or value-based care models. This is where purchasers of healthcare – so whether its the government, or your employer, or a consumer – and the payers both public and private, are now holding the healthcare delivery system accountable for both the quality and the cost of the care that’s being delivered.
Value-based care is used to promote enhanced population health management, taking care of the entire population, improving their health status. On one hand it reduces the costs of care, but really, at the end of the day, it’s focused primarily on delivering a better relationship between the patient and provider to create those better clinical outcomes.
FHT: From a consumer standpoint electronic records and online physician portals are some of the more obvious results of the kinds of things you’re talking about. But where else are providers looking to innovate as they move to this value-based model?
CL: As a consumer of healthcare services, I never go to just one place to consume a service, right? So I’m at the hospital for a procedure. I have my primary care physician for my day-to-day care and I may be going to a specialist because of a health condition that I’m suffering from or trying to recover from.
Where we’re seeing the biggest issue is the pockets of data that are out there. Sharing that data is tantamount to making sure the best outcome for the patient is achieved. Where healthcare organizations are looking to innovate and provide value is by sharing that data.
The biggest challenge here is that once we get the data into repositories, how do we make it shareable to ensure that clinicians can use it at the point of care? So what we’re seeing is organizations focusing on mobility of data access, such as streamlining how clinicians use that data, streamlining how they get into and access that data. If we have to have a clinician log into 17 different locations to get information about one patient, obviously this creates problems that are likely to result in negative patient outcomes from clinician burnout to dangerously incomplete patient medical information. So now we’re seeing healthcare organizations really start to catch up, but not just catch up but also go to the next generation of technology to meet the needs of the next generation of clinicians who are asking for these tools.
Because nobody goes and sees just one doctor anymore, the whole care team can access the same patient data and all be working towards one goal – provide the best patient outcome.
FHT: Chris, we know technology can push changes in capabilities like web- based and cloud-based access, but market needs also drive changes in technology, such as new apps and tools for telehealth. So there’s a lot happening very quickly. What are some of the challenges that providers are facing when they’re going through this digital transformation?
CL: One of the biggest challenges that I see, and one that’s become readily apparent over the past few years, are the security privacy challenges that organizations are faced with.
In the world of paper it was easy to secure the paper. You actually had to go to a department to retrieve that record and then you got the flip through that record. Sometimes you kept it sometimes you gave it back to them. While there were security issues, they were nothing to compare with a world where patient data is always right at someone’s fingertips. While the security model that we’ve followed for many years, this concept of trust but verify and putting controls around data, has really served its purpose to a point but now that’s security model needs to change.
We’ve got to stop ‘chasing bad’ and trying to find that needle in the haystack only to miss it and have to rely on our signature-based security products to let us know when something bad has already happened. Where we want to see healthcare organizations take a new approach to security is really flipping it completely upside down to ensure access to data and data availability but also ensure that it is secure and authorized.
If you think about the last two years, the biggest uptick in threats to healthcare organizations has been ransomware. Now ransomware, in and of itself, can be considered a breach of patient information but it’s really an attack on the availability of that information. When data is not available there’s a negative impact on patient care outcomes.
If I can’t have that data available to that specialist I need to go see down the road tomorrow for my follow up, I can honestly have a bad outcome for that patient. It’s also going to be much more costly for the clinicians or the health system that’s trying to provide that data.
FHT: Data privacy is just as important in healthcare as data security; that’s the point of HIPAA regulations. As with ensuring security, ensuring privacy can also have implications for data availability for clinicians. So, how much of this is the responsibility of the IT departments? And how much of that is the permission based aspect of it?
With a value-based care approach to patient care the idea of who has a seat at the table has changed. As well as patient care teams and hospital administrators, IT needs to be included in the decision making and planning process. Because we need that reliable, seamless sharing of patient information that is also compliant with myriad healthcare and health data regulations, the IT team needs to a key partner for clinicians. Largely I’m seeing clinicians in lockstep with IT and it’s helping them get exactly what they need at the point of care, but also ensuring that digital transformation isn’t creating data-driven chaos in terms of privacy and security.
Moreover, as patients take more control over their data and care, keeping the IT team front and center enables patients to have full access and visibility into their records with minimal risk. In doing so patients can make decisions about their healthcare choices based on provider rating, cost of care, and many other factors. In this sense, the IT department really is a business enabler when we talk about value-based care.
FHT: Chris, any final thoughts on where we’re heading with all of this and what providers should be looking for?
CL: Well, if I had a crystal ball, I may not be talking to you, right? But, what I want to emphasize is that healthcare organizations need to realize that the adoption of technology can’t be done just because it’s new and shiny. A lot of thought and a lot of process have to go into decision making and new technology should only be adopted when it meets the needs just in terms of business drivers but because it supports the delivery of care.
This is one of those areas where technology needs to be looked at; it needs to be really thought about and needs to be really dug into to create the best outcome possible for everybody involved. That’s the only way that organizations are going to get to a value-based care model. That’s the only way that they’re going to be able to get the cost down of how healthcare is delivered and that’s truly the only way that they’re going to be able to provide the best outcome for the patient at the other end.