Health 2.0: Providers must reinvent themselves to achieve quadruple aim
SANTA CLARA – At the Health 2.0 Provider Symposium on Monday, one physician leader opened the morning by taking a trip back in time, to 1999.
It was a year of red pills (The Matrix, where Neo gulped down a tablet that showed him the true nature of reality) and blue pills (Viagra, which earned Pfizer $281 million that year, boosting its profits by 14%).
It was a year of a technology panic that wasn't (Y2K) and of the first major warnings about a different sort of emergency: the Institute of Medicine's landmark '99 report, "To Err is Human: Building a Safer Health System," which shocked the world by showing 44,000-98,000 people die each year as a result of avoidable medical errors.
In the two decades since, a lot has changed in healthcare as the industry has worked in earnest to achieve the Triple Aim: improving quality and safety while also lowering costs and boosting patient experience, according to Dr. Albert Chan, chief of digital patient experience at Sutter Health.
But too much has also stayed the same, he said. The digital revolution put into motion by widespread adoption of electronic health records has been a major innovation, and has helped improve patient safety when the technology is effectively deployed. (Chan, who graduated from medical school in 1999, said he decided to specialize in clinical informatics for that very reason.)
But today, too many physicians feel like technology is "part of the problem," he said. No wonder, given that docs have to spend three hours of "desktop medicine" for every hour spent with patients.
That's why the Triple Aim has since become the Quadruple Aim, with the key component of provider experience now added to the equation, something Chan said is invaluable to the effective and efficient care delivery.
That sort of willingness to innovate and rethink existing care processes will be essential if healthcare wants to make good on its promise to patients and physicians alike.
Interpreting data in new and novel ways will be key for shaping our solutions going forward. Twenty years after that agenda-setting IOM report, the marching orders for the years ahead are to think more creatively and humanely about how information and technology are put to work, said Chan.
"Interpreting data in new and novel ways will be key for shaping our solutions going forward," said Chan.
Crucially, he added, "we can't do it alone. We have to have partnerships."
There's "tremendous interest, investment and opportunity" in digital health funding, he said. But it's imperative to stay focused on the big goal.
"It's the patients who matter in this case," said Chan. "They access data much more than us."
He offered a success story from Sutter Health by way of example. "We have 2.2 million patients enrolled in our portal," he said. Every year more than a million of them book appointments and make payments online.
Building from that deep patient engagement, then, Sutter launched a new program of text intervention – reaching out to their patients to remind them of their appointments.
The result? No-shows dropped by as much as 19%. Even better, with the opportunity to more efficiently fill cancelled appointment slots with patients from a waitlist, Sutter patients were able to see their primary care docs 14 days sooner, on average, and specialists 22 days sooner.
It was a simple innovation, scaled quickly, said Chan. And it had big results.
At Sutter, he said, "if we can't scale it we won't do it."
Innovation pilots are all well and good, he explained, but unless they're scalable to the wider enterprise, they're just a waste of resources.
"We have tremendous work to do," said Chan. "Prioritization is key. Scale is key."