Converging Trends: Shifts in Healthcare and Information Technology Align to Support Industry Transformation

Introduction

With the complexity of healthcare, innovative thinking, advanced technology, and a robust health IT infrastructure are crucial. Applications for storing, accessing, and utilizing health-related information are transforming the operations of payors, state and federal governments, life sciences organizations, and health systems.

Purpose

The ability of healthcare organizations to leverage information and telecommunications solutions—including IT shifts in mobility, social media, cloud computing, and big data analytics—is integral to enabling healthcare transformation and implementing successful strategies.

Impact of the Affordable Care Act (ACA)

The ACA has restructured how healthcare is paid for, creating a demand for big data, cloud services, and mobility in data access and capture among clinicians. It also briefly touches on social media’s role in healthcare.

Financial Incentives and ACOs

The ACA provides financial incentives to move away from the fee-for-service model by introducing Medicare Shared Savings and Accountable Care Organizations (ACOs). ACOs utilize claims data to differentiate patients with chronic and degenerative diseases.

This requires health IT (HIT) investments to:

• Perform predictive analytics for identifying patient risks.
• Support interventions to prevent costly hospitalizations and achieve shared savings targets.

Population Health Management (PHM)

The goal of PHM is to reduce emergency room visits, inpatient days, surgical procedures, and other high-cost activities. Instead of focusing on providing more services, providers aim to increase efficiency and maximize resources to improve patient care.

Preventative vs. Acute Care

The current U.S. healthcare model relies heavily on acute care, addressing patients’ needs only when their condition becomes critical. PHM shifts the focus to preventative care, keeping patients as healthy as possible and preventing chronic diseases.

Care Continuum Alliance

The Care Continuum Alliance identifies three components essential for population health improvement:

1. Leveraging primary care physicians to coordinate clinicians in care delivery.
2. Motivating patients to take personal responsibility for their care.
3. Coordinating care through wellness, disease, and chronic care management programs.

These components rely on HIT for effective communication and patient engagement.

Advances in Technology Tools

Advances in PHM technology and Electronic Health Records (EHRs) enable ACOs to:

• Improve overall patient health.
• Reduce redundant healthcare resources and costs.
• Align healthcare premiums with utilization costs.
• Drive efficiency through consumer behavior.
• Shift focus from symptom treatment to improving true patient health.
• Educate patients on health and wellness.
• Provide universal access to health information through cloud-based solutions.
• Facilitate seamless data sharing among payors, providers, hospitals, and other stakeholders.
• Deliver near-real-time aggregate patient information.
• Offer robust patient engagement tools.

Remote Monitoring and Social Media

Remote Monitoring Solutions

Cloud-based configurations enable remote monitoring by capturing biometric data such as vitals and tracking individuals’ health daily. These solutions empower patients to learn about their conditions, take preventive actions, and communicate effectively with their care teams.

Social Media in Healthcare

Networks of patients use social media to share information about conditions, treatments, and care delivery practices. Institutions mine this data to:

• Support clinical trials in real time.
• Segment populations into groups for targeted interventions.
• Enhance patient engagement and improve quality of care.

Big Data and Intelligent Systems

Big data analytics, combined with intelligent systems, allows for real-time integration and analysis of health data. This creates a collaborative health ecosystem where clinical and payer data can:

• Drive EHRs toward semantic interoperability.
• Support collaborative care across governments, health systems, and hospitals.
• Improve quality outcomes while reducing costs.

Leveraging Cloud Solutions in Health IT

To make meaningful decisions at individual and population levels, infrastructure must capture, access, and analyze exploding volumes of data across the care continuum.

Fundamental Success Factors (per Frost & Sullivan)

1. Chronic disease patient registries from multiple data sources.
2. IT tools that automate support for care teams.
3. Maximum access to shared patient data for optimized care coordination.
4. Integration of genomic and proteomic data to expand storage and data exchange capabilities.
5. Patient engagement tools that foster responsibility for health and wellness.
6. Advanced analytics and clinical decision support tools for evaluating and improving organizational performance.

Data Security in a World of Mobility

Increased accessibility demands robust data security measures to protect patients. Solutions involving cloud and mobility must incorporate advanced encryption and protection at local and global levels.

Medical Tourism Potential

Achieving global data accessibility through cloud-based solutions and Health Information Exchange (HIE) services could revolutionize healthcare. Patients could access medical information across borders, facilitating seamless care in foreign countries and different hospital systems.

Conclusion

The convergence of healthcare and information technology trends highlights the transformative potential of leveraging advanced tools and infrastructure. By prioritizing data security, patient engagement, and preventative care, the healthcare industry can achieve improved outcomes, cost efficiency, and a more connected ecosystem.