Wednesday, January 20, 2010

A History of Our Healthcare Future

When Stage III of Meaningful Use is fully implemented in 2015, what will our healthcare system look like? Here's my future forward look at the changes in the provider, patient, payer, and researcher experience five years from now:

*Clinicians will become healthcare coordinators, working in partnership with patients to manage wellness using a shared lifetime electronic health record.

*Clinicians will produce a record that is designed to be shared with the patient, instead of just supporting the billing process.

*Hospitals will compete based on the results they achieve rather than the grandeur of their buildings. Transparency in the reporting of quality and outcomes will transform the healthcare marketplace. Patients will have a much better understanding of quality, cost, and outcomes.

*Patients will undergo fewer tests and take fewer medications because redundant and inappropriate care will be reduced. Healthcare value will improve - higher quality for less costs, since less care is often the right answer.

*Patients will have much more choice as consumers. Access to the electronic records including their genomes will enable personalized medicine - selecting the treatments that best align with their care preferences, risk taking thresholds, and physiology.

*Payers will reimburse providers for quality rather than quantity since electronic health records will document the care given and not given.

*Researchers will have access to novel data sources (with patient consent) and be able to discover which treatments are the most effective. This knowledge will be integrated into electronic health records and personal health records so that providers and patients can make the optimal care decisions. Today, there is more literature published every year than a clinician can read in a lifetime, so best current evidence is not rapidly incorporated into practice.

Change is hard, technology is easy. As we navigate the stages of meaningful use in the years ahead, be prepared for amazing shifts in workflow, process, and behavior that will accompany them. Let's hope we can tell our children the history of how we did it!

8 comments:

Anonymous said...

Great post. Thank you.

I think the key is this:

Patients will undergo fewer tests and take fewer medications because redundant and inappropriate care will be reduced. Healthcare value will improve - higher quality for less costs, since less care is often the right answer.

Prevention.

Arif Ali said...

Very interesting perspective. I would be nice if the Meaningful Use criteria could bring us to a fully electronic experience for the patient and the physician. The one thing we are not considering is the integration of PHR and the paradigm shift with patients taking more responsibility of their own care. I agree the physician will be the health-care coordinator but will most likely be with the more complex chronic conditions.
Last comment for now would be the incorporation of the medical home model into meaningful use. How would we account for the electronic data and care provided their? Would it be on the Eligible professional or on the hospital?
http://wirelessmd.blogspot.com
arif

Brian Ahier said...

Thanks John ~ You have given me a glimmer of optimism for the future :-)

reader said...

John,
Could you share your comments on the following impact of quality metrics?

With transparent quality metrics at both the PCP and hospital level will we see Doctors being averse to take up the more challenging cases. Will there not be Market pressure on doctors to keep their quality metrics competitive in order to attract customers.

With fewer tests and better outcomes the race will become one of patient volumes. What do you think?

Regards
ReaderRegular

Anonymous said...

.... and what a wonderful world this will be

dries said...

You said:

Payers will reimburse providers for quality rather than quantity since electronic health records will document the care given and not given.

Will electronic health records really impact this if we do NOT also change the how healthcare is paid for. In the Dartmouth Atlas of Health they point out that much of the variation in health costs is 'supply driven'. Physicians are rewarded for number of activities they perform. Elecronic health records will not change that.

pjmachado said...

Great post John!
We just need to align the various stakeholders incentives to pull it off!

johnh said...

Love the post...furthering pj's thoughts- how do the various stakeholder's incentives take shape?
Or should I ask, how does the marketplace drive toward (and thus create) this?.... do we wake up one day and see all EHR in the Google empire?