In this special Speaker Series, Becker's Healthcare caught up with Justin Brueck, assistant vice president of NorthShore University HealthSystem in Evanston, Ill.
Mr. Brueck will speak on a panel during the Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference titled "Advanced Primary Care: Making Genetic Medicine a Reality," at 1:45 p.m. Wednesday, Sept. 19. Learn more about the event and register to attend in Chicago.
Question: In the past 12 months, how have you adapted to new patient experience expectations in the age of consumerism?
Justin Brueck: As the healthcare landscape continues to evolve, an increasing number of patients are accessing their genomic information. The FDA has also outlined a path for direct-to-consumer companies to provide health-related genetic testing. This trend is likely to continue, and as a health system, we are exploring ways to better engage patients and to access genomic information in a more proactive manner. Part of this effort has been offering patients the "healthy gene panel" and pharmacogenomics testing through the Genetic and Wellness Assessment tool. This approach goes beyond purely reactive testing based on a diagnosis or a family history, and moves toward a more proactive approach which answers the question, "What changes in my DNA might be important to my health?"
In the fields of personalized medicine and digital health, many nontraditional and disruptive entrants are emerging. Some companies are heavily invested in developing consumer-oriented services as this represents a significant departure from healthcare's traditional engagement with patients. As a result, NorthShore has focused on providing patients with more choices and access 'on their terms' with its Immediate Care expansion, a new functionality around wait time estimates, and "Expect Me," a feature that allows patients to put themselves in a virtual line before they arrive at their provider's office. We have also implemented new ways for patients to interact with providers via e-visit functionality and sending messages to providers via NorthShore's app. At NorthShore, we foresee continued development of such technologies. However, it remains to be seen whether payers will accept these technologies and begin reimbursing for the services.
Q: What do you see as the most vulnerable part of a hospital's business?
JB: The most vulnerable part of a hospital's business is effectively managing and rationalizing services across high-cost, fixed assets as care shifts from inpatient to outpatient settings. As we know, healthcare services have historically been centralized in large facilities like hospital campuses. However, due to [emerging] technology, as well as a change in consumer preferences, patients are willing and able to receive the same types of treatments in much lower-cost settings, [including outpatient surgery centers instead of hospital [operating rooms], immediate care settings instead of emergency rooms, drugstores or telemedicine instead of traditional brick-and-mortar primary care offices.
Q: What is the biggest barrier to price transparency in the healthcare industry?
JB: One of the biggest barriers in price transparency is that many health system contracts have payer confidentiality provisions, which makes it difficult to discuss such matters. Additionally, we must remember that 'price' does not necessarily reflect 'out-of-pocket' cost — and out-of-pocket costs are typically what patients are interested in when they are seeking transparency. As a result of wide deductible ranges, coupled with in-network and out-of-network requirements, it is almost impossible for a layperson to compare apples to apples. For example, a 'list price' for surgery may be less at hospital A than hospital B. However, if hospital A is out-of-network or has less-preferred contracts with the patient's insurer, hospital B's more expensive list price may ultimately result in less out-of-pocket cost to the patient. This complexity and information disparity further creates barriers.