More Patient Demand, More Communications
Previously published on EMRandHIPAA.com
Nearly every news outlet does an annual recap about what has changed over the past 12 months. In recent years, we’ve learned we are now more connected, more aware, traveling more, doing more and so on. The role of the local family doctor being the only caregiver has also changed, giving way to more specialists, more providers and more needs. A survey by GfK Roper showed Americans over 65 saw an average of 28 doctors – and that was five years ago. There are now 8,000 of us reaching age 65 every day. By 2029, the 65+ group will comprise more than 20 percent of the population.
This is just the tip of the iceberg. Healthcare is encountering numerous problems, fueled by an aging population. For the industry to adapt, move forward, and produce better health outcomes, one particular change is critical.
Problem One: More People Seeing More Doctors
A 2014 Journal of the American Medical Association article, “Finding the Missing Link for Big Biomedical Data” (jama.2014.4228), identified there are a tremendous number of data elements which affect a patient’s health, wellness, and ultimately, their outcomes from treatment.
There are two concurrent efforts underway to manage and control this data. The first was the HITECH Act and move to digitization, management and aggregation of patient data. This push for electronic health records (EHRs) has resulted in more than 3,000 certified healthcare technology products on the market. There are 900,000 active physicians, more than 5,700 hospitals, 60,000 pharmacies and 100,000 physical therapy entities. And this doesn’t include countless caregivers, ancillary staff, labs, etc.
That said, the volume of information is staggering and will only increase.
The second effort underway is to define care needs and create communities to effectively address these. The Health Information Management System Society (HIMSS) has created the Health Story Project in an effort to understand the scope of these needs. The Office of the National Coordinator for Health Information Technology (ONC) has patient rights and wellness acts. And virtually every insurance and health system has some type of health outreach management plan.
All of these communities are empowered by access to, and utilization of, information about the patients under their care. Most importantly, it is imperative that the “left hand understand what the right hand is doing” in order to treat patients more effectively and safely, control costs, create greater efficiencies and much more.
Problem Two: So Much Information in So Many Places
“Americans are sicker” is a blanket statement that the media now seems to report daily. Obesity, chronic conditions and increased costs for healthcare are constantly in the headlines. At least one report has stated that 45 percent of all Americans suffer from at least one chronic condition. What’s more, by 2025 one half of all Americans will suffer from chronic conditions.
For many businesses and industries, there’s long been an 80/20 rule where 80% of the cost was from 20% of materials, 80% of revenue from 20% of customers, etc. For healthcare though, there are many who feel the situation with chronic care patients is much worse.
Of course, effective treatment means a need for more specialists, more providers and more information to handle those with such conditions. But that vital information is now in so many places.
Problem Three: The Communication Crisis
When I was growing up, my mother always told me to “use my words” to address conflict. Unfortunately, our healthcare crisis has an even larger and more fundamental conflict – a lack of communication. How do we deal with any of these problems if we cannot communicate?
Communication in healthcare is a multi-pronged issue. Information must be exchanged. Care, providers, resources and schedules must be coordinated. Amidst this, we cannot forget the patient, and that today as a country we are less healthy and demands have increased.
One study found patients with chronic conditions as a result of poor lifestyle choices, obesity for example, are significantly less likely to be compliant with treatment plans. The fact is, patients that have regular and interactive communication with their providers are significantly more likely to be compliant with care plans and demonstrate better outcomes.
Communication, including feedback with the patient, is critical to addressing patient compliance
A Single Solution
Communication is the foundation of coordinating the volume of care providers, specialists and services needed to address patient health, wellness and outcomes. HIPAA, HITECH, Omnibus rulings, as well as the ongoing work of the ONC and HIMSS, all support interoperability and connected healthcare. Opening the lines of communication is the first step, though with this progress, the problem of data becomes clear.
Communication exists in many forms. Healthcare is both a science of medicine and an art of care, which means various types of information must be exchanged. To achieve the “holy grail” of interoperability, obstacles for clinical information exchange must be removed. Barriers around data types and formats are a blockade to progress. Conversation, consultation, planning and discussion are as critical to the delivery of care as discrete and diagnostic data elements. Therefore, messaging must be used that is open and empowered to ALL types of data – from structured digital data to images and unstructured documents – and security is obviously imperative.
Simple communication is a conversation between providers. So, why is it, then, that many “so called” clinical messaging solutions do not support the simple process of person-to-person dialogue? A communications solution must support both “science and art.” Care coordination, facilitating provider-to-provider and provider-to-patient interaction removes barriers, simplifies and improves care delivery, and by extension, improves health and wellness.
With this in mind, the themes of “more” must be extended to healthcare to move forward. And that means more communication, more coordination and more care.