Dr. Paul Grundy is the Chief Transformation Officer at Innovaccer. Affectionately known as the ‘Godfather’ of the Patient-Centered Medical Home model, he is the Founding President of the Patient-Centered Primary Care Collaborative (PCPCC) and a member of the National Academy of Medicine. Prior to Innovaccer Dr. Grundy enjoyed an esteemed career at IBM, as the Chief Medical Officer of the Healthcare Life Sciences division, and the Global Director of Healthcare Transformation. Previous to IBM he was the Minister Consular for the US Department of State. Dr. Grundy is a globally respected healthcare convener, storyteller, and visionary - a "Trusted Healer.” He holds numerous international honorary titles and awards, including an honorary lifetime member of the UK National Association of Primary Care, an Ambassador for Healthcare DENMARK and the first international member of the Irish National Association of General Practice. He was the recipient of the NCQA National Quality Award in 2012, and recipient of the prestigious Barbara Starfield Primary Care Leadership Award in 2016.
There are intrinsically 3 parameters for a care delivery system to become a value-based model: delivering the right care, at the right time, and at the right price.
There are intrinsically 3 parameters for a care delivery system to become a value-based model: delivering the right care, at the right time, and at the right price. However, simple as it may sound, there are many challenges that stand in the way of delivering perfect care. These impediments end up being directly or indirectly responsible for most of the complications that our healthcare world faces.
Problems Associated With Conventional Care Systems
Patient-centered care is a relatively new concept in the healthcare space. Although concepts such as the personalized, consumer-first approach have been around for a while, going full throttle with a focus on patient needs is a new phenomenon. Traditionally, healthcare revolved mainly around providers.
This approach was successful back then, but now that value-based care has pervaded the healthcare world, the approach of healthcare stakeholders has to change. Non-personalized care models can ruin the purpose behind developing a model that focuses on wellness instead of just curing diseases.
The factors associated with healthcare remuneration does not incentivize providers to concentrate on preventative measures as much as treating the patients when they have contracted diseases. Conventional care procedures assume more importance than the personalized care models. Apart from misplaced incentives, providers have also faced a dearth of support to focus on prevention.
What’s interesting is that the healthcare sector has been more devoted to addressing the problems rather than analyzing the reasons that might have caused the problems in the first place. Organizations don’t have access to detailed insights into patient choices, and the right resources to leverage the information that can enhance the care system. Unfortunately, healthcare has stayed behind in adopting state-of-the-art technologies that can be of great assistance to care teams in improving care delivery. Many organizations are dependent on outdated information in their systems and fax machines even now.
Another attribute that has been hampering healthcare’s progress is the inability to adopt a team-based approach. Providers more often than not are absorbed into multiple menial tasks that may not boost the cause of making patients healthier. They are often caught up in intricate data files and labor-intensive tasks that do not qualify as delivering care. For instance, physicians should not have to make manual entries and care coordinators should not have to devote time to making dozens of calls to follow up with the patients.
A Fresh Perspective on Provider-Patient Dynamics
Patients demanding a consumer system, such as a care delivery model, is rising. They want to be included in the decision-making processes on top of getting personalized services. Consequently, organizations aspiring to stay at the top of the game are taking initiatives to come up with customized solutions. This prospect is promising; however, the healthcare system still has a long way to go.
Keeping in mind that patients’ needs are important but, under no circumstance should they override the decisions of care teams. They are important cogs in the healthcare wheel, and one of the primary reasons why the sector has not been making a smooth transition is due to ignoring the needs of physicians and care teams. Unavailability of supporting elements, including data insights and increasing administrative burdens on them, is impeding healthcare’s efficiency.
The Institute for Healthcare Improvement Triple Aim expanded to become the Quadruple Aim. Quadruple Aim is a relatively new term for recognizing the significance of physician engagement. To build a quality healthcare system, it is important to focus on the needs of physicians. Complete patient satisfaction can be achieved only when physicians are happy.
Amalgamating payments with performance is a great concept as long as physicians get to fulfill their objectives. We need more humane physician leaders who have an understanding of payment models and meaningful use of data.
Endowing Primary Care Providers (PCPs) With the Support of the Data Activation Technology
To build a sustainable patient-centered healthcare system, primary care will be a crucial element. PCPs and their teams should take initiatives to enhance the future health of their patients. Activating the entire healthcare data for providing physicians the right insights at the right time can substantially improve healthcare outcomes.
The biggest mischief-makers of the healthcare space are excessive utilization and high costs. PCPs are the sole stakeholders of the healthcare system that can eliminate these problems. The framework and policies necessary to achieve the objectives of patient-centered healthcare system can be put to work only by the PCPs.
I have seen organizations that have reduced their emergency department visits by monitoring at-risk population or diminished annual visits by increasing Annual Wellness Visits. I personally think that an organization’s intent matters more than anything else. When the care teams have the required resources like accurate data points in place, they can encourage more patients to visit primary care facilities.
Healthcare visionaries will agree that it is important to invest in the right technologies to boost care and quality outcomes. After identifying the cause of healthcare obstacles, they must be on a lookout for technological solutions to overcome them. Providers need insights to power clinical applications while delivering care, without searching for them elsewhere.
Need for Data Activation and Artificial Intelligence (AI)
Physicians are ready to drive healthcare change rather than being part of the problem. AI and machine learning are going to provide them with the support that they need to deliver care that patients desire.
There are so many sectors utilizing AI to improve customer experience. Healthcare, however, is falling way behind in this trend. Physicians need to go back to their electronic health records to find relevant patient details. There lies a huge opportunity for improving healthcare operations.
Leveraging the benefits of “activated data” can bring the much-needed developments that healthcare needs. Aggregating data is the key to ensuring smooth implementation of patient centered care. For instance, ideally patients with chronic illness should be informed about their care plans in real time and should receive reminders to manage their condition better. This information can also reduce the care episodes dramatically, and AI can help organizations to make this scenario come true.
To Bring a Change, We Must Act Now
Falling behind in adopting technologies that make processes easier and simpler causes organizations to leave money on the table. By not allowing their care teams to see more patients on a daily basis, owing to the lack of time, they are losing out on the opportunity to improve healthcare. The sooner they innovate, the sooner will they achieve the Quadruple Aim of Healthcare.