David Williams is the Vice President and General Manager of Conduent Healthcare Provider Solutions.
The way that providers and patients in the U.S. healthcare system have interacted for far too long could be characterized as the "catch and release" paradigm: Patients get sick, they're treated and then they're discharged with instructions to follow a specific care plan.
The problem is; this doesn't work. Right now, roughly 20% of Medicare beneficiaries are readmitted within 30 days of discharge, costing the American public roughly $15 billion per year. The findings of other studies have been even less sanguine — for instance, 22% of patients admitted to general medicine services either die, are readmitted, or visit an emergency room within 30 days of discharge.
Change is in order. It will mean embracing the power of new technologies generally, and digital interactions specifically, to proactively engage with patients and transform the practice of healthcare. Indeed, such an approach is already being adopted by hospitals as they develop best practices for reducing readmissions.
That's only one example. Fueled by technology and powered by digital interactions, the future of healthcare is proactive and has two points of emphasis: on one hand, providing more effective care and treatment for patients; on the other, preventing scenarios that cause people to enter hospitals and treatment centers in the first place.
Let's look at three areas where this new proactive paradigm is transforming the U.S. healthcare system.
Proactive preventive care and chronic disease management
When it comes to chronic diseases, there’s tremendous potential for more proactive approaches, particularly around wellness and preventive measures. Positively influencing and shaping behaviors results in improved health outcomes and reduced costs for everyone. The central idea is that proactively engaging with patients is an effective way of motivating them to undertake critical actions — actions that are linked to better health outcomes — which they wouldn't ordinarily undertake otherwise.
That could have a dramatic impact on costs. Right now, chronic diseases are responsible for nearly 75 percent of aggregate healthcare spending in the U.S. — roughly $5,300 per person annually.
A good example of this is the treatment of Type 2 diabetes. Let's imagine a patient is diagnosed with this type of diabetes, which can be effectively treated and managed by diet alone. As part of the diagnosis, the doctor provides the patient with a care plan — a series of recommendations to follow, for instance, foods to eat (and foods to avoid), exams (say, an A1C test) to sign up for, follow-up appointments to book and so on. This is proactive chronic disease management in action. When the patient follows the doctor’s orders, his or her health is likely to improve, the disease is managed and, ideally, that patient’s healthcare costs go down.
Proactive post-discharge care coordination
Post-discharge care coordination has a lot of overlap with preventive care and chronic disease management — these areas are intimately linked. For example, if a patient is admitted to undergo a medical procedure, and that patient has high blood pressure, this preexisting condition informs every aspect of post-discharge care.
Under a proactive paradigm, every phase of post-discharge care can be tracked and followed-up on to ensure the best possible health outcome for the patient. That doesn't just mean text or phone call reminders to pick up your prescription, but robust resources and support that inform and empower patients after discharge.
To implement such an approach will require more effective coordination across every stage of care management –– between payers, providers, community resources and other stakeholders. With proper communication channels in place, and the right technology platforms to support them, lingering siloes will be out of the way and the patient experience will become more individualized, immediate and intelligent at every step of the way
Proactive insights into community health
You might say identifying more efficient paths to better patient outcomes is the Holy Grail for hospitals, health systems, physician practices, public health departments, community-based health improvement collaboratives and pretty much every other stakeholder in the U.S. healthcare ecosystem.
But understanding risk factors within specific communities — and uncovering which levers within a community will actually drive results — requires going beyond clearly defined population health management approaches, where the focus is all about individuals, and developing evidence-based programs that also consider the needs of specific populations and geographies.
For example, today with diabetes management, it’s possible to leverage digital interactions across channels to generate a wealth of data points — from risk factors to motivations, and everything in between. This data can show how to most effectively engage with patients. It can be analyzed to uncover previously unforeseen pain points and see precisely where care plans were breaking down.
Using this data, strategic interventions can be introduced, leveraging the channels and touch points that make the most sense for reaching and engaging with noncompliant patients in the targetehttps://www.conduent.com/solution/healthcare-provider-solutions/health-outcomes/d area.
What's next for proactive health?
Patients are becoming more involved and invested in wellness. Some of that is self-directed — for instance, in the proliferation and popularity of wearables — and some of that reflects levers and other tools payers are beginning to use to motivate healthy behaviors. To overcome resistance to proactive engagement, it's important to take the right approach and strategy when developing new programs.
The future of health requires fundamentally new approaches to healthcare management at all levels, from how hospitals address Medicare and Medicaid readmission penalties to the ways that population health needs are strategically identified and improved in communities. A strategic partner with expertise in digital interactions and organizational transformation can help you identify and address these challenges — putting your organization at the forefront of proactive patient care.
About the Author
David is the Vice President & General Manager of Conduent Healthcare Provider Solutions.More Content by David Williams