While the U.S. spends far more money on healthcare than other developed countries, it ranks the lowest in the effectiveness of its healthcare system. A study comparing the U.S. health system to those of the 10 highest-income countries showed that the U.S. ranked last or almost-last in four of the five performance measures: Access, administrative efficiency, equity, and healthcare outcomes. In the remaining category, care process, the U.S. ranked fifth. These scores reflect a dire need for healthcare reform within the U.S.
Although the Affordable Care Act established payment incentives for value-based care, the adoption of these quality-emphasizing payment models has been slow. In today’s landscape, research by the Health Care Payment Learning & Action Network showed that 43% of US healthcare spending is basic fee-for-service, 28% is fee-for-service-based with links of payments to quality and value, and 29% of spending is alternative payment models (APMs) that promote value-based care through shared savings, shared risk, and bundled payments.
Under value-based care, the entire ecosystem of technology ultimately needs to become patient-centric. Metrics for patient satisfaction, health outcomes, and quality of care need to be infused throughout the continuum of care, from pre-registration to post-appointment or discharge. Many of the payment incentives aligned with value-based care necessitate patient interactions outside the hospital walls as a supplement to in-person care, such as virtual appointments. Real-time access to patient health or wellness data, including medication adherence, exercise levels, and more can help providers identify appropriate times to provide extra support for patients between appointments to drive better health outcomes. In all facets of patient care, data needs to be shared for holistic analysis.
Data interoperability
Data integration constitutes one of the most challenging and costly parts of IT implementation. Even after successful data migration efforts, many systems remain disparate, making it difficult or even impossible to share data or conduct analytics across systems or departments. These inefficiencies lead to high operational costs for maintaining many vendors, wasted employee time, and limited capability to access value-based performance metrics.
Data interoperability has become a priority as industry-wide standards like FHIR (Fast Healthcare Interoperability Resources) and HL7 have emerged to facilitate data transfer not only within hospital systems but across them, too. Microsoft’s Dynamics 365 Healthcare Accelerator supports interoperability through a FHIR and HIPAA-compliant data model that builds healthcare-specific entities directly into Microsoft Dynamics 365 for Customer Engagement.
The Dynamics 365 platform provides centralized data storage in Azure, giving healthcare organizations an opportunity to leverage cross-functional metrics to balance performance across clinical, operational, and financial teams and understand how these key business areas impact each other. These insights help providers identify the best mix of payment models for their organizations and support healthcare providers in delivering on the Triple Aim, a framework for healthcare improvement defined as:
- Improving the patient experience of care (including quality and satisfaction);
- Improving the health of populations; and
- Reducing the per capita cost of health care.
Patient relationship management
From pre-patient care to clinical experiences to post-care, patient relationship management solutions enable healthcare delivery organizations to exceed their patients’ expectations for engaging service while helping hospital employees to prioritize tasks and deliver efficient care. Engaged patients are more likely to maintain healthy habits, manage their chronic conditions, and exhibit satisfaction and loyalty. By providing proactive care, healthcare systems satisfy patient demands for personalization while reducing costs of care, boosting operational efficiency, and improving health outcomes for the populations they serve in the short-term and long-term.
In addition to catering to the needs of their patients, healthcare organizations must also improve the experiences of their staff members. Manual processes and an excess of IT systems bog down doctors and nurses with exhausting administrative work that also takes away valuable face-to-face time from patients. Automating certain post-visit events like experience surveys and care plan reminders through a variety of channels – including email, text, mobile app, chatbot, or phone call – reduces toil for staff members and makes sure patients stay engaged with their health and their providers’ brand.
With more connected patients and happier workers, healthcare organizations can realize improved patient experience, lower staff and patient turnover, and lower costs. Third-party solutions can provide patient scheduling and engagement, complete with HL7 and FHIR standard EMR integrations that make clinical data actionable in Dynamics 365.
Operations
Although hospital operations are often considered an entirely different realm than patient care, the efficiency and accuracy of these processes impact patient experience and quality of care. Thus, part of the transition to value-based care and performance-based payments necessitates improvements in hospital operations with patients at the center.
Materials management metrics, for example, need to include the Total Cost of Care, a number that reflects the end-to-end care, including costs incurred through readmissions within 30 days or hospital-induced infections. Intersectional analyses on patient data and operational expenses can reveal powerful insights into cost and quality tradeoffs and points of improvement. Furthermore, process improvements such as automated supply requisitions and PAR replenishment across departments and PAR locations yields effective just-in-time inventory.
Similar efficiency boosts can apply to non-surgical procurement as well. Many nurses want to order supplies such as surgical masks or stethoscopes in a simple click-and-choose method; they are not interested in which contracts are in place within their organizations. Providing them with an Amazon-style shopping experience for contracted or non-contracted items can save employees time and energy on fulfilling basic supply needs. Options to save orders, set up recurring shipments, or mark favorite products creates an increasingly simple ordering workflow.
With intelligent solutions built around Dynamics 365, providers can also leverage workforce management capabilities such as elastic demand management of acuity levels to prevent employee overscheduling and fatigue. Optimizing shift scheduling to prioritize employee preferences leads to better patient experience and health outcomes.
Holistic, value-based analytics
Data interoperability across the full spectrum of business operations is essential to the success of healthcare providers in the era of value-based care. Shared operational, clinical, and financial performance data enables analyses that can help providers optimize physician reimbursement, embrace new service lines, and increase patient satisfaction and quality of care. With better understanding of how different departments of the hospital impact patient outcomes, healthcare providers can make informed decisions on which areas to improve and which payment mixes to target.
