There and Back Again: Charting the Way to a New Destination in Healthcare IT

The COVID-19 pandemic has put most travel on hold, forcing would-be explorers to get their adventure fix through virtual tours of exotic places.

Nepal, Fiji, and Botswana are certainly attractive destinations. But for healthcare IT pioneers, there is somewhere even more exciting to go: a place where we can leverage intelligent technologies to deliver appropriate, comprehensive care for everyone anywhere it’s needed.

By focusing on a handful of critical pain points in patient care, including prior authorizations, social determinants of health (SDOHs), knowledge delivery, and the expanded use of telehealth, we can encourage greater adherence to create a holistic, patient-centered ecosystem.

This is our new destination in healthcare IT. We know we can get there, because we are seeing it done by some of the most exciting, innovative leaders in the field. All we need to do in order to join them is book our ticket and work together along the way.

Visualizing the future of seamless, patient-focused healthcare

 Healthcare has experienced any number of bumps in the road during its transition to a digitally native industry. Workflow challenges continue to plague providers a decade after EMR adoption. Meanwhile, challenging reimbursement reforms and the need to keep pace with changing consumer demands have left many organizations feeling like they’re spinning their wheels.

It’s easy to lose sight of the ultimate goal when providers are getting bogged down in the details of wrestling with workflows, meeting quality measures, and fielding complaints from frustrated staff and patients.

But there is an ultimate goal, and it is achievable.

It’s safe to say that patients and their families shouldn’t need a degree in healthcare administration to get access to necessary treatments and understand their financial responsibilities. My brothers and I are our mother’s Care Navigators. We shouldn’t have to become experts in care coordination just to stay on top of her health information and adhere to their recommended care plans, but we are.

Instead, ideal care delivery incorporates a proactive, personalized relationship between the patient and their provider. Patients should have access to care whenever and wherever they need it, through telehealth, texting, or in-person, in-home consultations – and providers should have access to predictive, actionable insights that make those interactions efficient and fulfilling for all parties.

Those insights should include clinical and non-clinical factors that illuminate each individual’s challenges and opportunities to improve or stay well. They should be surfaced to providers, patients, and care navigators in a way that reduces cognitive burdens and encourages shared decision-making, providing true value to patients, caregivers, providers, and the health system as a whole.

As healthcare IT professionals, we need to provide patients and providers with a new generation of technologies that can connect everyone with everything they need to make timely, fully informed decisions about health and wellness.  We do this in other parts of our lives. Health should be as good if not better.

Removing health IT roadblocks during the journey

If we concentrate our efforts to break down barriers in a few strategically important areas, we can stop wasting resources and get back on our way to where we want to be.

One key area of focus is prior authorizations. Prior authorizations may be necessary in many circumstances for controlling spending and maintaining adherence to evidence-based medicine, but they are also a perennial thorn in the side of healthcare organizations across the care continuum. Why? The knowledge is out there. This is a function of a lack of shared knowledge or opinion on medical appropriateness.

In a 2020 survey by the American Medical Association, 94 percent of participants said prior authorizations can lead to care delays. Physicians describe the burdens associated with prior authorizations as “very high,” commenting that they spend an average of 16 hours per week simply working through the paperwork.

Using intelligent, automated technologies to reinvent the prior authorization process could save providers significant time and money, not to mention avoiding other negative outcomes, such as treatment abandonment, hospitalizations, and serious adverse events as reported by survey participants.

Second, we can continue to expand the use of telehealth and other remote care strategies to keep patients connected with their integrated care teams.

COVID-19 has been a catalyst for telehealth adoption, jumpstarting a 3,000 percent increase in telehealth use in a variety of settings, including primary care and behavioral health. We need to continue this trend to make sure that every patient can connect with a provider at their convenience.

But we cannot let telehealth grow into yet another fragmented silo of information. Integrating telehealth-related information into the comprehensive medical record will be key, especially when patients use commercial telehealth services unaffiliated with their main care team.

Last, but certainly not least, we must explore additional avenues for prioritizing the social determinants of health.

Despite the established wisdom that SDOH can account for up to 80 percent of outcomes, we still have staggering gaps in our ability to identify and address non-clinical issues. Just collecting complete data on individual and community challenges is hard to do. And the art of finding meaning in these patterns and correlating the results to effective interventions is still in its infancy.

As we develop our population health management capabilities, we must consider how to connect these emerging insights to the many potential points of care. If we can widely deploy systems that automatically analyze patients for SDOH-related concerns and recommend contextually appropriate, specific actions to providers, we can start to provide more comprehensive care while helping patients improve adherence.

 Riding a wave of knowledge to our new destination

 By making a concerted effort to attack these three areas of concern, we can reinvigorate our progress toward a seamless, comprehensive, patient-centered healthcare delivery ecosystem.

Doing so will require us to be thoughtful and innovative in our use of data, information, and knowledge. When we invest in new infrastructure, we must avoid the pitfalls of data fragmentation, prioritize value for patients, caregivers, providers, and staff, and create knowledge-driven experiences that reduce burdens across all stakeholders.

The technology to do so is here now. A number of leading-edge organizations are already leveraging digital tools in creative, successful ways to dramatically improve experiences and outcomes. We are excited to share their stories with you over the next few months so you can be inspired by what’s possible right now – and in the future.

With real-world perspectives from colleagues and peers leading the way, we will be able to see exactly what it takes to reach the new destination of healthcare IT and why it’s absolutely worth making the crucial journey.