It was an honor and a pleasure to moderate a discussion panel on Monday at the Health IT summit in San Diego (sponsored by the Institute for Health Technology Transformation, or iHT2—a sister organization of Healthcare Informatics under our corporate umbrella parent, the Vendome Group). The title of that discussion? “HIT & Analytics: Enabling Patient-Centered Care.”
I couldn’t have had a more distinguished and on-target panel. With me were Harris Stutman, M.D., executive director, clinical informatics, and CMIO, at MemorialCare (Long Beach, Calif.); Lori Posk, M.D., medical director for MyChart, Cleveland Clinic (Cleveland, Oh.); and Stan Huff, M.D., CMIO, Intermountain Healthcare (Salt Lake City). All three medical informaticists have been deeply and broadly involved in helping to lead their colleagues forward in a variety of important initiatives.
The question we discussed on Monday, at the Hilton Bayfront San Diego, was fundamentally this: how can and should the leaders of patient care organizations move forward to leverage data and healthcare IT to make care more “patient-centric”? It is both a good intellectual, conceptual question, and a good pragmatic one. Because, as we all agreed, there are many, many practical meanings of the concept of “patient-centered care”; and there are so many ways to try to get there.
At Intermountain Healthcare, some of the focus on patient-centeredness comes via that health system’s care management and population health management programs. At MemorialCare, a range of initiatives are moving in the same general direction. And at Cleveland Clinic, the ongoing MyChart program is bringing patients into more robust messaging and other communications with their physicians and really facilitating their participation in the organization’s Open Notes efforts.
But how to leverage healthcare IT and data and analytics to facilitate greater patient-centeredness? That really is an open question that is not an easy one to answer. Or rather, there are countless possible answers to it.
And why is that so? Well, to begin with, the broader context of all this is so complex in the current U.S. healthcare system. Our healthcare system was never set up to be patient-centric to start with. Instead, it has always been clinician-centric, and especially, physician-centric. Countless processes have focused on making physician workflows (and, let’s face it, billing) easier, while leaving patients in the lurch in so many ways. Even the hospital bills that patients receive and that are mostly paid by their health insurers (though percentage-wise, less and less, every year, as more financial responsibility is placed on patients themselves, through the adoption by their employers of high-deductible health plans), are provider-centric and not patient-centric—as anyone who’s received a hospital or medical bill can attest to.
So healthcare leaders do actually need to leverage a great deal of data and analytics in order to figure out how to make their care delivery processes and their interactions with patients, more patient-centric. Because none of this is anywhere near intuitive.
What is it that needs to be learned via analytics? Numerous things, actually: what patients want (via surveys, polls); what physicians and other clinicians want (again, via surveys, polls); what the actual processes are that physicians and other clinicians are actually engaged in, as opposed to what senior executives assume or imagine clinicians are doing; what the outcomes are from those various processes; and a series of data points emerging out of process improvement processes, for use in continuous process improvement cycles.
One always hopes that such data-driven processes will uncover data points that will help enhance patient-centric-ness in care delivery. For example, when considering offering patients direct, secure messaging with their physicians and the physicians’ practices, as well as hospitals, wouldn’t it be good to find out whether patients might be open to and welcoming of such opportunities? How about detailed analyses of the processes working to improve perioperative processes in order to make them more efficient as well as more satisfying to patients and families? How about detailed analyses of the outcomes of those processes? The possibilities are almost limitless.
And, these cycles of measurement will have to continue, as innovations take place, in order to assess how effective the innovations have been. This is particularly so, given that there is no historicity of innovation forwards patient-centeredness in U.S. healthcare.
Fortunately, organizations like Cleveland Clinic, Intermountain Healthcare, and MemorialCare, are among a cadre of leading-edge health systems nationwide, and what they’re learning from their innovations is providing insights for their peer organizations across the U.S.
This will inevitably be a series of iterative processes, both within patient care organizations, and across the U.S. healthcare system. But it was gratifying to participate in the discussion on Tuesday in San Diego, as the leaders of progressive healthcare organizations move forward, and create data and analytics that can help their peers U.S. healthcare system-wide. What the senior leaders of these organizations—and so many others—are learning, will be helpful to all of us in the next few years, as growing consumerism, shifts in federal policy and reimbursement, market competition, and other trends, converge in this area. And I look forward to data being generated, analyzed, and shared—because replicability of patient-centered care innovations is going to be key for everyone going forward.