In the words of George Halvorson, CEO of Kaiser Permanente, “"We are on the cusp of the golden age of healthcare delivery,” He went on to explain that the toolkit to improve patient care, "is getting better every day. We have better technology, better connectivity, better databases, and better science. We have better opportunities to interact with patients to help them improve their health.”
How? Well, we could give patients more instructions on what to do once out of the hospital, we could coordinate the transition to home and rehab facilities. We could have the hospital take charge of care once patients have left the hospital. And we could punish those hospitals with high readmission rates by lowering their Medicare payments.
You can use big data to measure these problems, which are well known, but measurement does not necessarily change the realities and dynamics on the ground.
“The findings suggest governments and health insurers across the world may be wasting billions of dollars on doctor incentive schemes but getting no improvement in patient care, researchers who conducted the study said.”
“Researchers from Britain, the United States and Canada assessed the impact of incentivised targets on quality of care and health outcomes in around 470,000 British patients with hypertension and found that they had no impact on rates of heart attacks, kidney failure, stroke or death.”
Measurements of hemoglobin A1C and body mass indices could serve as signposts of improvement , and teams of primary physicians, dieticians, nurses, and others visiting homes or in telephone contact could improve outcomes. But diabetes and obesity are only two clinical conditions and account for a fraction of chronic diseases requiring improvement.
Studies to date have shown only modest improvement when doctors are paid for improvement. Maybe with big databases , studies of population health, closer interaction with patients based on information technologies, these numbers will improve.