How changing healthcare pathways upend operating models, culture and information exchange

Globally, healthcare is undergoing a fundamental, multi-factorial change that is shaking up traditional operating models, culture and behavior across the health continuum.

From developed markets to developing markets, the patient has become more complex. There’s a rise in chronic, life-threatening conditions, as well as more awareness of conditions not previously widely known, such as atrial fibrillation. More and more people are becoming burdened with chronic disease.

A second shift is in how patients access care. Healthcare providers worry about how they can manage the patient flow to the right resources. They are looking at ways to provide their patients with care in the most convenient way. Developing countries face constraints because of their infrastructure networks, such as roads and places that deliver healthcare — meaning that a need exists to find new ways for people to access care.

And, in many developed countries, some procedures that were once performed in acute-care settings are now conducted in community settings or even in the home. A prime example is breast cancer, with some patients being asked to administer their own post-chemotherapy injections at home, assisted by a spouse or caregiver, rather than having to deal with the time-consuming and stressful process of going to a hospital every week.

Furthermore, the complexity of illnesses, particularly with patients over 60 who typically are dealing with several serious conditions, requires more complex multidisciplinary teams — primary care physicians, acute care, community care and even family. This changes the way resources are used and by whom.

All of these factors must be considered in terms not only of delivering transformational care, but also ensuring that costs are managed according to the appropriate setting. If we take the breast cancer example, having injections administered at home not only reduces stress for the patient but also the cost of bringing a patient in and needing to interact with many different people at a hospital.

Staying connected

At the same time, however, the larger healthcare environment is not set up to manage as one continuum of care. For example, the incentives for hospitals are not designed to encourage patients to be cared for in a community or home setting. That will require a shift in thinking and in the overall culture of healthcare.

Instrumental to having a true continuum of care is the ability to connect the multiple data systems that exist across numerous healthcare and community settings. Integrating the data from these myriad systems is essential if we are to create a seamless patient journey.

Again, let’s return to the breast cancer example. When a patient has injections administered at home, it’s essential that vital information about that process, such as temperature, is sent back to the hospital, typically in the form of a text. That data needs to be integrated into the patient’s record to provide the insights clinicians need to determine a course of action. For example, if the patient’s temperature is elevated or lower than normal, it might be a signal that an infection is present and the patient should come into the hospital. This is really where the value of big data lies — not in the data itself, but in the actionable insights a connected health technology solution can provide.

People power

On the other end of the spectrum from the data and analytics is the human element. First, some care providers believe they may not need a system to guide them and prefer to rely entirely on their training, judgment and experience. Then, some patients are not accustomed to playing a more active role in their healthcare, so simple things such as lack of access to the internet or unfamiliarity with IT can be a barrier.

But those attitudes are shifting, and increasingly clinicians and patients are becoming forces for change. In so many areas, clinicians are taking the lead in healthcare decision making, rather than leaving those decisions to policy makers.

It was oncologists who drove the new practice of encouraging patients to administer their injections from home to make those patients more comfortable. Another example is that of diabetes, where 90 to 95 percent of treatment is now carried out at home — such as the way a patient manages his or her diet and fitness, as well as managing insulin levels. This change was again precipitated by clinicians. In fact, the role of the chief clinical information officer is becoming as powerful as that of the chief information officer.

Patients are also becoming key decision makers as people generally become more educated about healthcare treatments and outcomes, and as clinicians encourage their patients to embrace that learning.

In this dynamic new environment, how information is shared across the continuum and how it enables actionable insights will become more and more critical. Modern healthcare and social care operating models require open, connected healthcare solutions that improve the flow of information.

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