With a clear vision to deliver the qualitative CARE characterised with availability, accessibility, and affordability parameters, now, the industry is looking at How to adapt to the changing needs of patients and remain fiscally stable? The industry is transforming strategically from volume to value based services. The program centric and physician centric approach is getting shifted to Patient centric approach which will help to create a relation among practitioners, patients, and their families to align decisions with patient wants, needs, and preferences. To enable on-demand interaction, IT and AI technologies are looking into improving the experience of patients.
Healthcare administrators are responsible for the overall management of a hospital, starting from managing finances and handling the daily operations. Here, the priorities keep on changing constantly. Improving Care management would help hospitals to improve their financial performance if they strengthen customer loyalty, build reputation and brand, and boost utilisation of hospital services through increased referrals to family and friends. Research has shown that hospitals with excellent Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient ratings have a net margin of 4.7 per cent, on average, as compared to just 1.8 per cent of hospital with low ratings.
Today, the consumer has to spend out of pocket expenses on healthcare; hence he is seeking value during health purchases. In this context, value is the cost relationship between expense and quality, which most healthcare consumers equate with service and positive experience. Hospitals that respond to this are poised to thrive in this era of healthcare consumerism.
The most important factors that hospitals need to consider are based on quality metrics. Measuring the factors contributing to quality metrics helps in addressing the gaps in the care system. Those gaps can directly assist lay systems and processes in order. Taking this into consideration, the quality metrics include:
1. Patient safety
2. Treatment effectiveness
3. Patient centricity
4. Timeliness
5. Efficiency
6. Equity measures
Patient safety intends to elude harmful factors from the care system. It can be calculated considering the patient mortality rate segmented by type of illness and treatment provided. Further more, it can also be measured by calculating the percentage of successful and failed surgeries with complications and postoperative infections or by rate of disease recurrence during hospital stay.
Effectiveness can be calculated based on the percentage of patient referrals the hospital receives for specific health conditions like stroke, pneumonia, organ replacement, or prevention of surgical infection.
Patient centricity can be studied from the patient’s journey starting from admission and the care that they receive from the hospital till they get discharged. Also, the provision of care instruction during discharge can be measured in certain health cases.
Timeline measure is directly the timeliness of care and service that is provided by the staff of the hospitals.
Efficiency measure is dependent on utilisation of hospital services which can be measured by studying hospital discharge rate.
Equity measure is dependent on hospital’s capacity to provide quality of care and the facilities provided. It depends on certification of the hospital, use of advanced technologies, percentage of physicians, physician to patient ratio, nurse to patient ratio, no. of beds and types of services provided at the hospital.
Access to health services is defined by availability of Healthcare Professionals (HCPs), ease of admission into the hospital and a healthcare provider with whom the patient can communicate comfortably. There are various barriers that impact health services, including high cost of care, inadequate or no insurance coverage, lack of availability of services, lack of ulturally competent care. Improving healthcare services includes accessibility to advance healthcare ervices and use of evidence-based preventive services.
Clinical preventive services promote the effectiveness of a hospital by promoting the prevention of illness with healthy behaviours, creating awareness amongst society, and identifying risk factors, especially for lifestyle diseases before occurrence of illness. This includes screening for hypertension, diabetes, or colorectal cancer. In addition to primary healthcare and preventive services, emergency medical services are also essential. This is the field where Uber is tweeting in. A noteworthy development has been observed in recent years which has made emergency medical services accessible.
Creating an appropriate management team for quality improvement and ensuring that they have the right tools to support them is critical and essential. Identifying the gaps in care and then implementing strategies to overcome it with proper tracking system is a need of today’s care management. Electronic Health Records (EHR) interoperability is one of the methods to address the care gap that exists among healthcare providers. Recently a report “Closing Gaps in Care through Health Data Exchange” figured out that “HCPs are incapable of efficiently recognising patient needs according to evidence-based guidelines in a timely manner.”
Given the challenges that range from rising malpractice costs to physician turnover, medical practices must maximise resources and remain profitable. Satisfied patients are easier and more rewarding to care for, they also employ less physician and staff time and are more compliant. If we think strategically then reducing the length of patients’ visits and wait time can reduce treatment costs and increase patient volume. In addition, many hospitals are also realising the need of building financially sound operating models to face diminishing margins due to price controls on drugs, consumables, and medical devices.
In 1960 airports deployed new traffic control systems that allowed them to changeover from scheduling a few hundred flights to managing thousands in a day, with improved safety and efficiency in the process. For healthcare, 2018 was the period of transformation because of digitisation across the industry. Medium and large size hospitals are implementing their own NASA-style command centres designed in a way to serve as a central mission control across the hospital’s functions and services. The objective is to address the questions of capacity, safety, quality, and wait-time issues that have afflicted the system.
Digital healthcare innovations play a major role in providing primary healthcare by means of mobile health, wireless health, connected health, etc. Technology is providing a way forward to tackle the increasing demand of qualitative care with better diagnostic tools and customised therapeutics. Three developments are providing healthcare organisations insights from countless data sources:
In the era of digitisation and big data, cognitive computing in healthcare is bridging the gap between care providers and patients. It is turning the enormous scattered fragmented healthcare data into insights that convey the need of personalised medicine. In simple terms, cognitive computing, inclusive of machine learning, neural networks, deep learning, etc. is a set of common techniques to deal with plethora of fragmented data.
Interoperable EHRs associated with artificial intelligence (AI) will enable us to improvise processes and efficient decision making that will boostquality.
Interoperability is an ornate word for the ability of healthcare technology in the field of IT systems and software applications to enable communication, exchange of data, and use the information to communicate and share data across wide area. The main objective of medical interoperability is to ensure that doctors, surgeons, and other medical providers have the information on fingertips that they need in order to provide appropriate care.
With rising awareness of data management and EHRs, healthcare organisations have different EHR platforms. One can imagine how tedious it would be to connect the data to provide efficient care. It was observed from a research that:
• 36 per cent of medical record administrators reported that they have EHR interoperability issues when they exchange patient health records with other providers.
• 25 per cent of charted physicians indicated that they still cannot exploit meaningful patient information received electronically from external sources as shared data is in silos.
Looking ahead, medical interoperability can provide healthcare organisations certain tools or initiatives as they work toward improved interoperability options.
Development of the IoT in healthcare, also known as Internet of Medical Things (IoMT), is a boon to remote areas where availability and accessibility is an issue. It has enabled systems to furnish services that will provide clinical monitoring, chronic disease management, preventive care, and fitness monitoring. It is characterised by cost advantage, improved efficiency, and bridging the gap and focusing on quality patient care.
Two factors can be considered while promoting quality in health systems. In a developing nation like India, optimisation of resources and expanding the services to enable availability, accessibility, and affordability is essential; whereas in developed nations where health systems are already streamlined, maintaining the quality standards of healthcare delivery internally and between healthcare systems is crucial.
Application of lean management systems in healthcare leads to improving efficiency, customer and employee satisfaction. It also helps to analyse the gaps and to assess the suitability of other activities that add customer value in an optimal way. This leads to the development of efficient and effective practices with patient-centric mindset.
References:
https://ehrintelligence.com/news/4-key-areasto-watch-in-healthcare-interoperability
https://rockhealth.com/reports/predictiveanalytics/
https://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf
