The Changing Face of Healthcare

Several significant forces in the last several years have been changing the way healthcare has and will continue to be delivered. The emergence of more unique ways to deliver care such as clinics incorporated into businesses and factories, the increased use of mid-level providers (nurse practitioners & physician assistants), the increase integration of technologies such as telemedicine and robotics and the shift from interventional reimbursement to outcomes reimbursement are just a few examples.

Compounding these are the ever-increasing costs of healthcare, the strain of funding Medicare on the U.S. economy, and the complications of insurance and healthcare payments under the affordable care act, ACA.

This has led to changes in how businesses intend to interface with the healthcare system going forward. CVS’s acquisition of Aetna will try to leverage healthcare delivery through their pharmacy structure. United Healthcare’s acquisition of DaVita hopes to leverage cost containment and resource control by directly controlling physicians. And the recently announced collaboration among Berkshire Hathaway, Amazon and J.P. Morgan Chase presents a yet unknown structure whose stated goals is improved quality and less cost. How they will implement their strategy is yet to emerge.

The decline in hospital admission over the last several decades has further led to restructuring by hospital corporations such as Tenet. Premise Health has emerged as a company placing physicians and other healthcare providers directly in corporate/business offices.

The big question then with these new ventures are how do organizations know what works financially and how do they track performance… In other words, how do you track, measure and value the relationships between cost and outcomes?

How can the analyst measure which methods(s) may generate better or best outcomes?

A simple return on investment, ROI, calculation will not provide needed nor valid insights. However, the use of cost-effectiveness analysis (CEA) would provide quite useful, valid and actionable information. CEA uses decision tree models to compare not only cost outcomes but effectiveness outcomes of various treatments on patient health and even on future healthcare usage based on various current actions. It can further be used to determine how effective a set amount of money spent on a particular treatment or method will impact outcomes (i.e. willingness to pay calculation). CEA models are flexible and can incorporate a wide variety of scenarios. As opposed to Big Data, CEA makes use of Broad Data so that comparisons of treatment modalities can be evaluated using real life outcomes. It can compare effects on a discrete problem such as a cancer tumor, or on chronic ongoing diseases such as COPD or CHF.

As the delivery of effective yet profitable, or at least cost effective, healthcare becomes more challenging, methods for evaluating treatments and programs become more necessary if not essential. Methods must be implemented to evaluate these new treatments and programs once they are in place so adjustments can be made. CEA enable organizations to both initially evaluate and subsequently monitor new methods and programs in a meaningful way.

If your objective is to provide the best decision-making for your organization and take a global view of your business, expanding your sights beyond ROI, and educating other decision-makers, Cost Effectiveness Analysis can make your organization more competitive and more profitable.

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The Use and Implementation of Health Information Systems

The contents of this article are dedicated to investigating the utilization and application of health informatics in a variety of contexts. Hence, the article will treat the subjects of health information exchange, health knowledge management, e-health systems, e-public health systems and m-health systems.

* Health information exchangesrefer to the transmission and dissemination of healthcare information electronically among organizations within a region or community. The technological development registered at the level of health informatics resulted in the capability to electronically transmit clinical data among disparate healthcare information systems without it having to suffer any alterations. The degree of exchangeability has expanded to a national level. This way clinicians can integrate their independent records, creating agile, patient-centered electronic health records that generate a new level of patient safety and information exchange.

* Health knowledge managementimplies concerted, coordinated and deliberate efforts to manage the organizational knowledge by means of processes aiming at identifying and leveraging it to accentuate the organization’s ability to compete. Such an application in the healthcare domain has led to simplifying the process of updating the general knowledge database, creating a convenient discussion environment that replaces the traditional meeting.

* E-health systemsgather the healthcare practices that are supported by electronic processes and communication. This type of system comprises a broad spectrum of services that slowly deletes the separation line between medicine and information technology. Among these services, one could include telemedicine, electronic medical record, consumer health informatics, virtual healthcare teams, health knowledge management.

* E-public health systemsembody another application of the health informatics, this time in the public domain. Its functionality has to satisfy the public health mandate of improving the health status of the community and the population at large. Through this system, community health is assessed and proper measures are taken. Collection, analysis, interpretation and communication of the results are the primary processes that are carried out within an e-public health system. Technologies employed in this type of system include geographical information systems (GIS), data mining methodology and data warehousing.

* M-health systems refer to mobile communication network technologies for healthcare that are used to ensure efficiency and to supply timely and accurate patient information to medical professionals that are sent on “field”. Since hospital environments involve mobility of medical professionals, support personnel and indispensable medical equipment, more and more wireless technologies have been adopted.

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