3 Roadblocks: Operational Technology and Tomorrow’s Healthcare

August 3, 2017

While there are plenty unknowns about what lies ahead for healthcare, one thing is certain: The move to value-based care is here to stay, even if the process will be more gradual than originally projected. For any healthcare organization, transitioning to new payment models represents a significant cultural change, and technology will be integral to the transition.

As HealthTech notes, healthcare technology, including cloud computing, is creating a “valuable opportunity for deeper patient engagement by simplifying data sharing and providing easier, more flexible access to health data.” They also point out that it will play “an essential role in other initiatives to improve outcomes and the quality of patient care, such as population health, precision medicine, mobile health and interoperability.”

But before investing heavily in clinically focused initiatives, organizations preparing to move to value-based care models will need to get their operational efficiencies and data in order first. Here’s why:

One of the biggest challenges in this “new world order” is the wide range of stakeholders and variables involved in the eco-system, many with differing priorities and objectives. All have to work together seamlessly to deliver higher quality care for patients at a lower cost.

This means organizations must find the right physicians, match them to the right patients at the right time, and implement a workflow and process management system that can automatically and proactively engage patients and physicians. A healthcare technology strategy that focuses on operations and managing the provider network will be critical for managing these essential components within the world of value-based care.

Healthcare organizations will also need a clear plan to deal with the operational challenges of transitioning their business models to a value-based care ecosystem—or even to a hybrid model that continues to incorporate a degree of fee-for-service—in order for the clinically focused initiatives to be effective going forward. Having the right technology in place to enable collaboration across the entire network is key.

Add to this the need to manage and track many-to-many relationships and evaluate the effectiveness of entirely new processes, and you can see why the operational and data questions have to be resolved first. Everything else will either succeed or struggle based on that foundation.

The good news is, technology is now available or being developed to provide the path to success.

Clearing the Roadblocks with Healthcare Technology

Even though most healthcare executives publicly support the shift to value-based care, there are many barriers that can hold them back. Here are just three of a number of common roadblocks we see organizations dealing with as they make the transition:

• Data silos:

Many have already struggled to integrate data within their own systems. Value-based care models up the ante. Now they’re bringing in multiple, disparate systems and need a single source of truth for all stakeholders across the continuum. They may also need the capability to share data with external collaborators. The data integration issue can become exponentially more complex compared to what they’ve dealt with in the past.

• Communication:

Promoting open communication with all of the new stakeholders within the eco-system can be a systems issue, but in many cases, it’s more than just that; it’s a new way of thinking about your business. And even if you have the systems in place, they may not be set up to meet today’s demands, which include patient security and privacy regulations as well as active relationship management with physicians, staff, payers and employers.

• Tracking/Reporting:

Accurate, consistent and up-to-date data across the entire care continuum is essential for getting reimbursed under a value-based financial model. Again, having a single source of truth is critical. But you also have to be able to easily and efficiently identify, compile and transfer the relevant data for each payer to prove the organization is delivering value to its patients.

These kinds of barriers, along with issues related to network management, transparency/trust, and interoperability with legacy and proprietary data systems, present very real challenges for healthcare organizations, but they’re ones that have to be addressed to set the clinical initiatives up for success. Fortunately, healthcare IT is evolving rapidly to clear the path to value-based care.

As Charles Doarn, director of the Telemedicine and e-Health Program at the University of Cincinnati, says, “Our health-care system is in desperate need of reform, and technology is one tool that can help. It can be a paradigm shift in how we practice medicine.”

Want to learn more? Download our ebook: 6 Roadblocks to Success: Operational Technology for Value-based Care here.