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5 ways Healthcare is changing for better
In last couple of years, there has been tectonic shift under the surface in healt...
According to McKinsey (http://healthcare.mckinsey.com/sites/default/files/the-trillion-dollar-prize.pdf), This
single chan...
insurance) to minimize out of pocket expenses. But in the future, more of the data about the cost and patient
experience w...
analytics and automation on back office and routine services as any savings with cost innovation will have
a direct impact...
more of similar treatment options will arrive in future in more rapid pace.
4. Telemedicine:Telemedicine or telehealth is ...
Please put your comments on any other major trend which I may have missed or put your thoughts in any of
them.
Disclaimer:...
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5 ways healthcare is changing for better

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Here are major trends which are shaping future of healthcare.

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5 ways healthcare is changing for better

  1. 1. 5 ways Healthcare is changing for better In last couple of years, there has been tectonic shift under the surface in healthcare world moving towards consumerism, value based pricing, telehealth and so on. Real impact of this shift is still getting shapes, but we can feel some of remarkable changes today in a way different stakeholders do business in healthcare. We will be able to see more transformative changes in the future. Transferring of financial risk to patient induced by high deductible plans and outcome based pricing gaining momentum, are acting as catalysts in this journey of changes. All of these factors give more incentive to patient to get engaged actively in any decision, more motivation to providers to assume more share in patient's health outcome and to deliver best experience at the lowest cost. Here are major trends as we can see emerging :- 1. Outcome based pricing: Today in healthcare, the monetary and human resources is inaptly utilized due to misaligned incentive model. Current "Fee for Service" payment model often rewards failure while not rewarding success. For example, many hospitals earn additional income from needless re-admissions or complications out of hospital induced infections. Same way in physician's world, a failed procedure is being paid for with same amount compared with a successful one. This will also open a floodgate of new opportunity in robotics and automation on back office and routine services.
  2. 2. According to McKinsey (http://healthcare.mckinsey.com/sites/default/files/the-trillion-dollar-prize.pdf), This single change from "Fee for Service" to "outcome based payment " model can save up to one trillion in next decade at the same time improve patient health. It is predicted that more than 50% of total healthcare payment will come from this category by 2018. This shift will trigger more innovation in saving cost and better outcome. This will also address some of the core cost issues, which we are facing today(misuse of resources, unnecessary procedures, not adopting automation/ robotics for routine jobs). We should not be surprised to see someday hospital registration area looking like a airport check-in lounge with all self service kiosks and a few attendants around with a robot guiding patients to the exam room. 2.Personalized Medicine: As a broader trend, personalized medicines are slowly becoming mainstream. Right from treating cancer for those tumors with specific genetic characteristics to treating certain cystic fibrosis patients with a specific genetic mutation, or creating a bioresorbable tracheal splint for treating a critically-ill infant using three-dimensional (3D) printing are all examples of innovation in personal and individualized medicine. As cost for genomic testing is going down and more and more diseases are linked to genetic profiles, more of similar treatment options will arrive in future in more rapid pace. 3. Price transparency and quality bench marking: Outcome based pricing model along with increased patient involvement and consumerism will also sets off in an era of bench marking providers based real patient experience and cost. Patients are demanding to have a reasonably accurate estimate before actual delivery of services, at the same time providers also have huge incentive to obtain some commitment from patient for payment through contracted financing or secure future payment on credit card (very similar to what we do at car rental check-in). So, accurate estimate for the service(and formal financial contract with patient) will become mainstream for most inpatient and any outpatient scenarios. Currently patient has less of an say in choosing the providers as he/she has to go with in-network(providers who are contracted with his/her
  3. 3. insurance) to minimize out of pocket expenses. But in the future, more of the data about the cost and patient experience will be out and patient will have a say in choosing provider and options. More and more social media based marketing will become mainstream to attract more patients( note that I am not referring to service line here). Providers has to align their services to service one whole patient rather than service patients for different line of business (lab, out patient, in-patient etc). This will be a major shift as different departments have to utilize systems which are connected to all information of the patient. 4. Telemedicine: Telemedicine or telehealth is the delivery of health-related services and information via telecommunications technologies. Now this will be the way care will be delivered in this century. Hospitals and other providers have to be ready to embrace this new mode of care delivery to address specific access to specialized care and reduce cost at the same time. Combined with the outcome based pricing, this will play nicely in overall savings on the provider side. This also provide opportunity to migrate towards digital health. With the new era of mobility and millennial's addiction to mobile devices, this should reduce cost, improve patient engagement and patient experience at the same time address issue of access to care with this surge of patient population. 5. Improved patient experience- Last but not the least, patients are demanding greater control over their care (The most important stake holder finally have a say for obvious reason as compared to current model where they mostly do not have any say, everything is decided either by doctor or insurance). Provisions in the Affordable Care Act now link performance related to patient experience metrics to reimbursement. For the first time, health care organizations—and eventually individual providers—will be paid partly based on how they are rated by patients. Now Medicare and some of the insurance carrier are enforcing this payment model. But in future, any provider has to excel in this area in order to survive in business and attract new patients. Patient experience design has to consider every interactions with patient with any department of the health systems or provider office (including reminders, follow-up calls along with interactions with any staff during care delivery). For each interaction, expectation has to be set explicitly and provider staffs have to strive to exceed that. DIn last couple of years, there has been tectonic shift under the surface in healthcare world moving towards consumerism, value based pricing, telehealth and so on. Real impact of this shift is still getting shapes, but we can feel some of remarkable changes today in a way different stakeholders do business in healthcare. We will be able to see more transformative changes in the future. Certain events like increased financial responsibility to patient and outcome based pricing, are acting as catalysts in this journey of changes. All of these factors give more incentive to patient to get engaged actively in any decision, provide more motivation to providers to assume more stake in improving patient health and to deliver best experience at the lowest cost. Here are major trends as we can see emerging :- 1. Outcome based pricing: Today in healthcare, the monetary and human resources is inaptly utilized due to misaligned incentive model. Current "Fee for Service" payment model often rewards failure while not rewarding success. For example, many hospitals earn additional income from needless re-admissions or complications out of hospital induced infections. Same way in physician's world, a failed procedure is paid with same amount as a successful one. This new model will also open a floodgate for new opportunities in robotics , predictive
  4. 4. analytics and automation on back office and routine services as any savings with cost innovation will have a direct impact to provider bottom line and ability to attract more business. According to McKinsey (http://healthcare.mckinsey.com/sites/default/files/the-trillion-dollar-prize.pdf), This single change from "Fee for Service" to "outcome based payment " model can "save up to one trillion in next decade at the same time improve patient health". It is predicted that more than 50% of total healthcare payment will come from this category by 2018. This shift will trigger more innovation in saving cost and better outcome. This will also address some of the core cost issues, which we are facing today(misuse of resources, unnecessary procedures, not adopting automation/ robotics for routine jobs). We should not be surprised to see someday hospital registration area looking like a airport check-in lounge with all self service kiosks and a few attendants around with a robot guiding patients to the exam room. 2. Price transparency and quality bench marking:Outcome based pricing model along with increased patient involvement and consumerism will also sets off in an era of bench marking providers based real patient experience and cost. Patients are demanding a reasonably accurate estimate before actual delivery of services, at the same time providers also have huge incentive to obtain some commitment from patient for payment through contracted financing or secure future payment on credit card (very similar to what we do at car rental check-in). So, accurate estimate for the service(and formal financial contract with patient) will become mainstream for most inpatient and any outpatient scenarios. Currently patient has less of an say in choosing the providers as he/she has to go with in-network(providers who are contracted with his/her insurance) to minimize out of pocket expenses. But in the future, more of the data about the cost and patient experience will be out and patient will have a say in choosing provider and options. More and more social media based marketing will become mainstream to attract more patients( note that I am not referring to service line here). Providers has to align their services to service one whole patient rather than service patients for different line of business (lab, out patient, in- patient etc). This will be a major shift as different departments have to utilize systems which are connected to all information of the patient. 3. Personalized Medicine: As a broader trend, personalized medicines are slowly becoming mainstream. Right from treating cancer for those tumors with specific genetic characteristics to treating certain cystic fibrosis patients with a specific genetic mutation, or creating a bioresorbable tracheal splint for treating a critically-ill infant using three-dimensional (3D) printing are all examples of innovation in personal and individualized medicine. As cost for genomic testing is going down and more and more diseases are linked to genetic profiles,
  5. 5. more of similar treatment options will arrive in future in more rapid pace. 4. Telemedicine:Telemedicine or telehealth is the delivery of health-related services and information via telecommunications technologies. Now this will be the way care will be delivered in this century. Hospitals and other providers have to be ready to embrace this new mode of care delivery to address specific access to specialized care and reduce cost at the same time. Combined with the outcome based pricing, this will play nicely in overall savings on the provider side. This also provide opportunity to migrate towards digital health. With the new era of mobility and millennial's addiction to mobile devices, this should reduce cost, improve patient engagement and patient experience at the same time address issue of access to care with this surge of patient population. 5. Improved patient experience- Last but not the least, patients are demanding greater control over their care (The most important stake holder finally have a say for obvious reason as compared to current model where they mostly do not have any say, everything is decided either by doctoror insurance). Provisions in the Affordable Care Act now link performance related to patient experience metrics to reimbursement. For the first time, health care organizations—and eventually individual providers—will be paid partly based on how they are rated by patients. Now Medicare and some of the insurance carrier are enforcing this payment model. But in future, any provider has to excel in this area in order to survive in business and attract new patients. Patient experience design has to consider every interactions with patient with any department of the health systems or provider office (including reminders, follow-up calls along with interactions with any staff during care delivery). For each interaction, expectation has to be set explicitly and provider staffs have to strive to exceed that.
  6. 6. Please put your comments on any other major trend which I may have missed or put your thoughts in any of them. Disclaimer: Any opinion expressed in this post is my personal point view and does not represent the views of my employer or any other organization I might be associated with.. References: http://www.fda.gov/downloads/ScienceResearch/SpecialTopics/PersonalizedMedicine/UCM372421.pdf. http://healthcare.mckinsey.com/sites/default/files/the-trillion-dollar-prize.pdf isclaimer: Any opinion expressed in this post is my personal point view and does not represent the views of my employer or any other organization I might be associated with References: http://www.fda.gov/downloads/ScienceResearch/SpecialTopics/PersonalizedMedicine/UCM372421.pdf. http://healthcare.mckinsey.com/sites/default/files/the-trillion-dollar-prize.pdf

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