Friday, April 24, 2015

Health Care Transformation: The Big Ideas:

Hint: It’s All About Data, IT Disruption, and Consolidation

In God we trust, all others use data.

W. Edwards Deming (1900-1993) , Management Consultant

This morning I ran across “Special Report: The Transformation of Health Care Delivery.” The report appeared in and was sponsored by PriceWaterHouseCooper, the consulting powerhouse.

In essence, the report is about using IT technologies to:

Do away with “archaic “ clinical paper files.

Go digital, collect data from electronic health records.

Use data to disrupt current physician and hospital arrangements.

Transform that data into digital from to measure outcomes, improve quality, lower costs, capture more market share, increase efficiencies, raise revenues.

Consolidate health systems and physicians into larger “congruent” integrated organizations capable of increasing individual and population health and enhancing outcomes.

Transforming health delivery from individual physician and hospital practices to corporations has been going on for at least 45 years as I reported in my 1988 book And Who Shall Care for the Sick; The Corporate Transformation of Medicine in Minnesota.

What has changed is the speed of change, as facilitated by the Internet, the formation of companies like Microsoft and Google, spread of the social media through Facebook and Twitter, and the widespread adoption of electronic health records.

Almost overnight, in historical perspective, we are up to our hips, armpits, and brains with data, and the need for larger organizations to harness and deploy masses of data for achieve useful goals.

The Special Report , through an 11 member panel of editors, versed in organizational transformational matters, including 5 MDs, reaches certain conclusions, which they present in revealing bar graphs with these percentages

What’s important in carrying out the health delivery transformation are: data provided by clinical information technologies 26%, EHRs 26%, and data analytics 21%.

Types of data needed are EHRs 95%, patient demographics 91%, and 85% aggregated EHR and patient data.

The best use of the data is to improve quality 90%, to identify gaps in quality 84%, to lower costs 83%.

Types of organizations desired to gain physician buy-in through mergers, acquisitions, or partnerships 50%, to merge with other hospitals 36%, to establish new physician arrangement with health systems, 26%.

Merger objectives are to improve position in population health management 70%, to improve efficiency 65%, to improve clinical integration 61%.

To improve finances by expanding outside of hospitals, 63% , by enhancing strategic marketing 43%, by developing Accountable Care Organization or other sharing entities, and by merging services with with physicians 36%.

None of this will be easy. It will require disruptive technologies, creative destruction of existing hospital and physician organizations, and harnessing the data for useful clinical use. It will also demand a blind trust in data to provide “ evidence-based” clinical value and the partial sacrifice of one-on-one clinical autonomy

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