Free digital healthcare advice for C-suite

One consultant offers up a dose of reality
By Eric Wicklund
10:14 AM
CIO and docs

What's the healthcare C-suite planning for in the coming year? While everybody seems to have differing opinions, there's a consensus that 2015 will introduce a lot of changes, particularly in how providers and consumers interact.

Mark Dixon, president of the Mark Dixon Group, a Minneapolis-based consultancy for IDNs and medical suppliers, is offering "Six New Realities for the C-Suite," and it's no surprise that mHealth plays prominently in most (if not all) of them
Here's Dixon's take on the year to come to top-level healthcare executives, along with an analysis of how mobility might play into them.

1. Consumer-driven healthcare is here to stay. "Dramatic changes to healthcare insurance brought about by the Affordable Care Act mean that our patients are facing greater copays, deductibles and out-of-pocket expenses," Dixon says. "Since our patients now have more skin-in-the-game in reducing the costs of healthcare, they’re becoming even more educated about the costs of care." And how are they getting that education? They're using their smartphones and tablets to research healthcare costs and providers, asking their doctors to communicate with them more frequently, seeking more information at the point of care. And they're using apps and wearable devices to collect their own health data. They're playing an active role in their own health management, and forcing providers to adopt mHealth tools and platforms to keep up with them – or risk losing them to another provider who is using mHealth.

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2. Population health is becoming popular. "The vision of population health may not be realized yet, but we’re moving in that direction.," Dixon says. "New financial models are driving changes to how hospitals and health systems get paid – and how they deliver care. In response, providers are changing care models to deliver higher value instead of focusing on volume. These organizations are fundamentally changing care pathways for specific diseases – like diabetes, congestive heart failure, COPD and other conditions that are costly and have poor quality outcomes – by implementing proactive health management strategies to keep these patients healthier." When providers want to change how they deliver high-value care, they look to delivery networks outside the normal hospital or clinic setting. Particularly with chronic care and post-discharge patients, they want to continue a care management plan at home, so that they can keep tabs on patients and possibly intervene if a health crisis occurs. This is where home-based monitoring platform and mHealth tools come into play.

[See also: Population health is a group effort.]

3. Physician engagement becomes a priority. "Physicians direct and order the majority of the care. Without their buy-in, it’s nearly impossible to make the fundamental changes required in moving to value-based care," Dixon says. "In order to reap the benefits of new technologies and care models, C-suite leaders will not only need to continue to increase their engagement with physicians, but must also find ways to align their interests, goals and strategies with the broader healthcare organization." Here's where mHealth is working its way into the hospital. Many physicians are using smartphones and mHealth apps on their own, and it's up to the administration to support them with the necessary BYOD platform at work. They need these tools to communicate with their patients, who are demanding that their providers adopt mHealth. In addition, a health system that seeks to broaden its base by integrating telemedicine platforms (such as an eICU, telestroke or telemental health program) needs physician buy-in to succeed.

[See also: 4 ways to make BYOD work in hospitals.]

4. Consolidation is king. "Population health management requires organizations of scale to reduce costs, waste and redundancy," Dixon says. "It’s impossible for small players to survive for long in this new world of healthcare. Scale will win. Smaller healthcare organizations are getting bought out by bigger ones – and even the larger organizations are merging together to create super regional mega systems. At the same time, big players from across the market – payers, providers, vendors, etc. – are increasing collaboration and developing partnerships to leverage both size and expertise to improve care outcomes." When smaller networks join together or large health systems take in new partners, they need to make sure care delivery is coordinated across the network. If they're involved in telemedicine, they might use the spoke-and-hub model, designating one hospital as the focus point providing care through telemedicine to the network of smaller hospitals and clinics. Likewise, a large network sells itself on allowing a physician to instantly access other specialists, or in allowing a patient's entire care team to instantly communicate with each other.

5. IDNs are gaining power. "We can no longer afford the luxury of multiple-decision makers. When 500 people are making decisions independently, it leads to cost variations and waste," says Dixon. "Integrated delivery networks are responding to this, evolving from holding companies to operating companies. Instead of operating as 500 practices of one physician, IDNs are now operating as one practice of 500 physicians. This shift means decisions on capital, supply and operations will be made at a centralized level, leaving less room for local decision-making." Executives managing the entire network need to have real-time access to information on capital, supply and operations – all available by compiling data from mobile applications into a centralized dashboard. Likewise, any decisions made have to be communicated quickly to the network, and what better way to do that than through a smartphone-based messaging system?

6. Reduce spending. "Spending for healthcare still accounts for about 18 percent of our GDP, but regulatory changes and market forces are squeezing money out of the system," Dixon says. "Providers are facing reduced reimbursements from Medicare, as well as private payers. To make up for the reduced reimbursements, provider organizations are using every tool at their disposal to cut waste and variation while increasing value to patients. Providers are leveraging their new size to negotiate better pricing, increasing operational efficiencies, and engaging with physicians to develop and implement new care models that can provide quality care and lower cost."

It's been said, time and again, that mHealth reduces healthcare costs by improving outcomes and eliminating waste. Better care management, both in the health system and outside, reduces the need for costly medical interventions and ER visits. Real-time analyses of supply chain needs to help reduce waste and cut costs. Better, more efficient care means happier patients, which improves patient engagement scores for reimbursement and keeps those patients coming back. This also translates to a happier workforce, which reduces turnover.

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