Predictive, preventive, pesonalised and participatory are the 4Ps of next-generation healthcare. This approach shifts the emphasis from reactive to preventative and from disease to wellness. This article talks about the role information plays in enabling this advancement.
In the global economy, healthcare challenges and issues rise to the top, irrespective of the country or region. The lack of medical availability to significant numbers of citizens, escalating costs, and growing influence by governments, further exacerbated by the desire for consumer control and access, has created a serious crisis.
According to the Frost and Sullivan Asia-Pacific Healthcare Outlook 2012-2015, the healthcare sector in Asia Pacific (APAC) is growing quickly, spurred further by an increased spending on health, the liberalisation of investment policies, growing medical tourism activity, and high adoption of new technologies. Accounting for over 60 per cent of the world's total population, this region alone presents significant growth opportunities to meet the increasing needs of a rapidly growing and ageing population. In 2011, the APAC healthcare market held 27.5 per cent of global healthcare market share and by 2015, this is expected to grow to 33.1 per cent.
Due to the sheer opportunity in the healthcare industry, there is no question that we need to collectively move forward to innovate and transform how we manage our health.
What is the vision for next-generation healthcare? This fundamental question can be answered with four words-predictive, preventive, personalised, and participatory. Known as P4 medicine, this approach shifts the emphasis in healthcare from reaction to prevention and from disease to wellness. P4 medicine promises to improve outcomes, reduce costs, and empower patients to take a more active and informed role in their care. The opportunity for reduced medical errors and improved patient safety is another key element that will encourage the adoption of IT systems for next-generation healthcare.
Information is the key to realising the potential of P4 medicine – whether flowing from healthcare providers to pharmaceutical organisations for the development of more personalised therapies, exchanged between providers to improve care coordination, delivered to the point of care for more informed decisions, or communicated directly to patients to enable them to assume a more active role in their personal health.
Our journey toward the next generation of healthcare requires the rethinking of the overarching technology, interoperability, processes, and people that will need to be in place to support it. The first critical step in this journey is to focus on the fuel that will propel us and subsequently pave the path to innovation-liquid data.
The amount of data that today’s healthcare systems are gathering is staggering. However, sheer volume does little to advance care if it remains isolated. We have many of the systems and foundational elements in place to generate the raw data needed to move forward – such as Electronic Health Records (EHRs), clinical information systems, and Computerised Physician Order Entry (CPOE) systems. The critical data from these systems, however, remains largely frozen. Our data must become liquid to provide the most benefit for healthcare patients and practitioners.
Simply put, liquid data is information that can flow to where it is needed in a form that can be easily accessed, is semantically interoperable, and ultimately actionable. It requires trusted and secure access and exchange, and drives the ability to recombine data at a secondary level to drive new insights.
On the road to personalised medicine and improved population health, our next milestones as an industry will be supported by the ability to better assess performance and outcomes, clinical effectiveness, and comparative effectiveness. Liquid data is essential in achieving each of these goals, but while it may sound simple enough, we have, and continue to face some hefty roadblocks along the way – including competition amongst those providing and consuming healthcare information that has led to data lock-in.
To get liquid, the healthcare industry as a whole must strongly consider four foundational tenets when evaluating solutions:
A key enabling technology to achieve the liquidity needed in our healthcare data is interoperative information exchange that will aggregate and normalise data from core transactional systems, and seamlessly enable healthcare providers and researchers to act on it.
Oracle is on the front lines of helping healthcare organisations achieve this important goal, offering complete, standards-based solutions to facilitate integration and automate processes across multiple systems in the healthcare enterprise.
For example, Oracle Health Information Exchange provides a suite of extensible, open, standards-based solutions built upon a reliable technology infrastructure for the secure exchange of electronic health information. These solutions help to empower healthcare entities globally to reduce costs, enhance revenues, and most importantly, improve patient care. The Oracle Healthcare Master Person Index provides a single point of reference to information about a patient, clinician, payer or other healthcare entity within and across healthcare organisations, ensuring the availability of unified, trusted data from many systems that reference the entity with different identifiers or names.
Liquid data is essential, but cannot alone transform healthcare. To gain actionable insight and drive transformation, we require powerful software applications for both physicians and patients. Liquid data must be engaging, useable, interactive, and provide clear direction to the physician and patient. Further, if health IT is to become the next ‘participant’ in healthcare, it must be intelligent enough to be an ‘advocate’ in helping patients reach their health goals while driving personalised care around the clock.
Increasingly sophisticated decision support systems and analytical applications are emerging and will be fundamental to realising P4 medicine. We are seeing the emergence of next-generational clinical decision support systems that guide decisions at the point of care, as well as analytical applications that enable providers to better evaluate outcomes as well as facility operations.
For example, Oracle Enterprise Healthcare Analytics helps healthcare organisations gain expanded clinical and business intelligence through an integrated picture of clinical, financial, administrative and research information across the enterprise. This holistic view can truly help ‘close the loop’ in healthcare intelligence, allowing for the right clinical information and best treatment practices to be placed at the point of care ensuring the best decision by the doctor and patient when needed most.
Applications will also be essential to fostering greater patient engagement. Integrated or ‘accountable’ care is gaining momentum, but will only succeed if consumers can play a more active role in their care. Personal Health Records (PHRs), which enable patients to have access to information related to their care, will help set the stage for increased engagement and collaboration in a more efficient and streamlined manner. Initial adoption remains slow, but as we develop more technologies to bring personal information together and integrate it into a provider’s workflow, consumer empowerment will increase as they gain the capability and knowledge to positively affect their care.
To be truly beneficial long term, however, technology must deliver information to the physician, and ultimately the patient, in a proactive, timely, and secure manner through preferred communication channels.
We find ourselves at an exciting time in the history of modern medicine, as we look forward to what the next generation of healthcare will bring. Building the right infrastructure to support data collection, integration, and transformation is essential to enable new insights and accelerate our journey toward highly effective and efficient personalised care.
Marc Perlmanis Global Vice President for Oracle's healthcare and life sciences responsible for driving strategy and industry solutions across the organisation. He leads the Healthcare Customer Industry Strategy Council and serves as executive lead with some of the top healthcare and life science companies. With more than 30 years in the healthcare industry, he brings deep global experience.