Digital Convergence: Driving Change in the Healthcare System (Part 1)

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The healthcare ecosystem is moving briskly toward a patient-centric model in response to pressures to enhance patient care and drive cost out of the system. Without question, data is at the heart of this convergence.

Our healthcare ecosystem, operating as a series of silos, captures and stores huge amounts of data from healthcare providers, pharmaceutical companies, and payers. This data should be fully analyzed and interpreted by healthcare professionals to draw meaningful conclusions that create actionable events in the form of treatment protocols. Once a protocol is selected and implemented, the results can be studied and the movement from data to information to knowledge and ultimately wisdom (the knowledge management continuum) would be in place in our healthcare system, producing better outcomes and improved patient care.

A number of factors are driving this transition to a patient-centric model. They include:

  • HITECH, part of 2009’s American Recovery and Reinvestment Act, which expanded the use of health information technology and mandated that patients have certain rights regarding their healthcare data
  • The Affordable Care Act of 2010
  • An influx of younger caregivers intent on achieving better healthcare outcomes

Although still evolving, it’s clear that this is the most significant shift in the way healthcare is delivered in the US since the advent of managed care.

So, who are the stakeholders in this historically—and, some would say, hopelessly—silo-intensive ecosystem? According to a recent report Leaving the Site Icon from The Office of the National Coordinator for Health Information Technology, stakeholders include constituencies like state and local health departments, emergency responders and public safety, hospitals, healthcare professionals, diagnostic laboratories, researchers, non-governmental human services, and advocacy and community based organizations.

That’s a lot of silos.

The migration to an environment that ensures the secure sharing of data among the stakeholders in question is fraught with complexities and contains a high level of risk. Healthcare providers and payers are realizing they must not only manage the risk associated with the converging healthcare ecosystem, but also learn to ascribe fees across all of the providers involved in an end-to-end care episode.

This can create severe technological challenges for IT systems, which we’ll explore in an upcoming post.

Post Date: 12/22/2015

Adam Nelson

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