The dramatic shift to value-based reimbursement requires all providers to completely disrupt their care processes and workflows to ensure the delivery of high quality, safe care at a reasonable cost. For more than four decades these same providers thrived in an environment where providing more care easily generated higher prices and profits. In that former reimbursement model, a serious and dangerous moral hazard existed where the instinct to “do no harm” clashed mightily with a similarly powerful driver to maximize income.
Due to this shift forced by provisions of the Affordable Care Act (ACA), hospitals, clinics, physicians, and others in the healthcare marketplace find themselves scrambling to reinvent the way they provide care. Organizations that will survive under the new realities of ACA recognize the power of healthcare information technology (HIT) to assist them in reworking their business processes and clinical workflows to achieve the goal of high quality, affordable care. Effective approaches to change include leveraging recent HIT investments and the reinvigoration of legacy systems.
Health 1.0 and 2.0
Due to these dramatic changes, healthcare is emerging into Health 3.0, a natural evolution of increasing value obtained from the use of a broad swatch of HIT tools. Health 1.0, begun decades ago, encompasses the period where business and administrative systems became regular fixtures in every healthcare facility. Although many organizations planned or already deployed clinical HIT systems, the HITECH act drove the dramatic expansion of the era of Health 2.0, represented by the deployment and use of these computerized clinical systems in both acute and ambulatory care environments. All of these transactional systems produce “data exhaust” that could be collected in a data warehouse for later analysis.
The era of Health 3.0 ushers in new, disruptive uses of HIT that leverage past technology investments to obtain maximum value from newly created technologies and digital trends. This new way of using HIT offers great value in multiple areas including care collaboration, population health, and cost accounting.
Two key principles underlie Health 3.0 thinking:
- Leverage existing transactional systems to provide a data source for in-depth meaningful analysis.
- Focus on the user experience and its impact on workflow and outcomes.
Many other uses for disparate new technologies within the Health 3.0 framework exist and require exploration. Newly introduced technologies in the months ahead will offer further capabilities that also require exploitation. While the technologies developed and deployed in eras Health 1.0 and 2.0 delivered great value in the age of volume-based reimbursement, Health 3.0 offers promise that technology investments from these previous eras can be leveraged within a new user experience that delivers easy to use and compelling applications that satisfy the needs of a value-based reimbursement world. As our society embraces and further demands IT tools that are both meaningful and pleasurable, organizations that embrace the Health 3.0 framework for their HIT tools will be better positioned to thrive.
The complete article Evolving to Health 3.0 was published in Patient Safety and Quality Healthcare and can be found here.
Barry P Chaiken, MD, MPH is the chief medical information officer of Infor and adjunct professor at Boston University’s School of Management where he teaches informatics. Chaiken may be contacted at firstname.lastname@example.org.