Two major issues are amplifying the existing stress on IT budgets for healthcare providers: A rapidly growing gap in the physician-to-patient ratio and limited access to digestible healthcare information for patients.
The roadblocks stemming from both scenarios are numerous and interwoven. And while the natural reaction — a search for tools that will help — is promising, it can also be a pitfall.
Ultimately, the list of IT projects in need of funding is long, and the reality is scary: Only the top two or three actually see the dollars they need behind them. Coveted are the investments that marry core values with long term goals.
For healthcare organizations, there are three principles that need to be considered when allocating resources for new projects: How they'll help physicians, what they'll do for patients and how they integrate with long term initiatives, specifically, electronic health records.
1. Urgency regarding physician capacity
Tools developed to improve physician efficiency — mostly apps or gadgets — generally save a few seconds every day, but they're not designed, by nature, to have an impact significant enough to counter the growing burden on physicians from a sheer volume perspective, and completely ignore adherence issues — described by physicians as the number one barrier to improved care.
Rather than investing in physician-centric innovations, more substantial gains will come from flipping priorities to consider, first and foremost, IT investments that give patients the ability to keep themselves healthy.
Case-in-point: In a recent study, the highest level of engaged and activated patients had healthcare costs that were 8-to-21 percent lower than those patients with the lowest rates of activation.
The current (and projected) shortage of physicians increases the urgency for technology that empowers and engages patients. In the U.S. there's just one licensed physician for every 370 people, and the expanded scope shows an even more dire outlook. In fact, the American Medical Association has predicted a physician shortage of 150,000 physicians over the next 15 years, and the Patient Protection and Affordable Care Act will increase the number of insured Americans seeking healthcare by more than 26 million. These figures add to the nearly 70 million aging Baby Boomers set to collide with an under-staffed industry over the next few years.
Innovation won't come from investing millions to save seconds. We must engage patients and empower individuals to take responsibility, and control, for their own personal health management.
2. Putting patient engagement first to lower costs
Improving patient engagement and increasing adherence is critical — both for an individual's health and for the health of the medical industry.
Low patient engagement costs billions of dollars every year and comes in many forms. Medication non-adherence results in approximately 140 million unfilled prescriptions — valued at $2.8 billion annually, and the overall cost of poor adherence is close to $310 billion annually representing approximately 14 percent of total healthcare costs. Further, the cost of low health literacy ranges from $106 to $238 billion every year.
By taking an active and empowered role in the management of their personal health, patients are more likely to understand diagnoses, follow medication adherence, schedule follow-up appointments and avoid re-admittance — all actions that will help to cut out unnecessary healthcare costs related to non-adherence.
But patients need tools to be empowered. And this starts with access to guideline-driven information to help develop, implement, monitor and track a personal plan for improved health. Building a personalized bridge between patients and the most relevant health resources, and facilitating a much stronger therapeutic alliance between them and their healthcare team is the next frontier for meaningful and effective patient empowerment.
This is a scenario where IT investments become exponentially more valuable.
Rather than continue to cultivate an ecosystem that reinforces a patient's reliance on physician care with every question, virtual health assistants, for example, offer a path to self-management, available for 24/7 guidance and able to answer all of a patient's questions — even those that may feel embarrassing or unworthy of direct physician attention.
For example, A 2011 study conducted by Dr. Timothy Bickmore found that patients had more favorable outcomes after interacting with a computer simulated nurse than a live physician. Specifically, patient engagement and satisfaction was higher; patients more accurately reported their health information to the virtual character and preferred the virtual character because they didn't feel rushed or talked down to. On top of that, one month after discharge those patients were more likely to know their diagnoses and make follow-up appointments with their doctors. These machine-to-patient conversations paved the path to more effective patient engagement and a better result, one month after their hospital stay.
It's clear that patients want more personal, relevant and timely access to healthcare, but taxed hospital staffs can only deliver so much one-on-one care and attention, particularly after patients leave the hospital.
Virtual health assistants, fueled by similar technology as that used in Dr. Bickmore's 2011 study, are able to create a more engaged environment with guideline-driven information to enable better medication adherence and personal monitoring — without adding to the burden and cost of live-help.
3. Long-term goals meet current initiatives
In 2013, hospitals are allotting 8 percent of its operating budget for healthcare IT. And for the vast majority (62 percent), EHR spending will tally up the largest expense, according to a survey by Morgan Stanley.
As the industry navigates implementation, an eye toward the future has to focus on meaningful use, specifically on improving outcomes, and eventually evolving to collect and transport the most relevant patient-generated health data from the patient to the EHR. Integrating VHAs can have huge implications for the effective use of EHRs, and the unified, richer experience it allows between physician and patient.
To be effective in the current and changing healthcare landscape, VHAs can:
- Provide ongoing collection of patient-generated health data
- Track and monitor a variety of inputs
- Proactively engage the patient through their smartphone
- Facilitate interventions tailored specifically to a given patient in real time.
By interpreting EHR input and remote monitoring devices combined with patient input, VHAs are able to provide an extremely high level of real-time context and engagement, proving an invaluable resource for physicians.
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