Adapting to Value-Based Care Means Updating Dated Hospital Technology

"It's been a long, a long time comin, but I know-oh-oo-oh, change gon' come, oh-ooh—oh yes it will" - Sam Cooke

We can all agree, healthcare is changing. The shift away from fee-for-service reimbursements towards value-based care is fundamentally altering the ways in which care providers and hospitals operate. Hospitals are having to rethink processes and systems that had become old hat and rewrite how things are done. Two main factors are leading this shift:

1. Changes in Reimbursement

At the core, the ripple effect of the regulations imposed by CMS, like MACRA, APMs, and ACA, echo throughout hospital systems nationwide. The emphasis on patient satisfaction, value-based business, and strategic partnerships through initiatives like gainsharing, alter the fundamental ways hospitals must execute for success.

2. Mass Industry Consolidation

Large health systems like Dignity and CHI or RegionalCare and Capella are consolidating as a means to lower costs and execute on value-based care requirements. Consolidation improves efficiency, caseload, market share, and reimbursement potential, but also impacts how a successful hospital system operates. A consolidation forces the reexamination of a multitude of operational factors, with IT systems management, overhead, and data-sharing being a notable obstacle.

Pair these main factors with increased patient volumes and overwhelming caseloads for providers that are burdensome to hospital systems and it becomes clear that adaptation is not just a requirement for success, but for survival.

Health Systems Must Keep Up with Change

To adapt with the times hospitals must employ changes at all levels of their business in order to comply with mandated regulations, earn value-based reimbursements, fulfill shifting patient expectations, and meet strategic goals. To do this, it’s imperative that health systems streamline their practices to keep up with the constant change. A major part of this streamlining is thinking outside of the traditional, physical IT network and adopting lighter, comprehensive solutions that meet demand and can be easily iterated upon to solve new challenges.

Despite knowing that faster solutions exist, many health systems are locked into costly, bulky IT infrastructure and IT departments are tasked with building solutions on dated infrastructure that takes several months or years to roll-out. With a factory-line of healthcare reform pumping out each year, if one looks closely, it is obvious why the pace of yesteryear no longer supports adaptation for success.

6 Reasons Why Shedding the Weight of Old IT Systems is Imperative

It’s imperative that health systems shed the weight of their old, slow and costly IT systems by bringing in cutting-edge solutions from newer and more nimble vendors. Maintaining or investing in bulky, traditional systems to solve modern challenges in healthcare is rife with failure.

  • It takes too long to get started—The planning and implementation of traditional IT infrastructure takes months (or years) to deploy. When it comes to meeting game-changing shifts of contemporary healthcare, bulky, large systems can’t keep up. By the time a solution is rolled out and ready to be turned on, there’s a good chance it’s already outdated.
  • Large IT Systems are Inflexible—Historically, hospitals operate on massive IT systems. As a rule of thumb, the bigger the system, the less flexible and all-encompassing the solution. If a system “touches every corner” it takes much longer to run a risk analysis for security leaks, to recover from a compromised system, to make workflow adjustments etc. It’s not adaptable.
  • Large IT Systems are security threats—If a system touches every hospital function, it is going to be vulnerable to security breaches. The greater the surface area of the system, the more opportunity there is for an attacker to gain access. Additionally, if a breach occurs, the time to recover takes much longer. This creates unintended obstacles for care providers to treat patients.
  • Contracting is Way More Difficult—Since the systems are so complex, the cost to implement takes a long time and an enormous price tag. It can take many months or years for massive solution to come to life. For example, in 2016 Mayo Clinic has invested more than $1B in a single EHR from EPIC that will take 5 years to roll out. In this timeframe, inevitably some of the original contractors working the implementation will have moved on, leaving new people to carry out the rollout. Inherited IT integration is never a good thing.
  • Training Staff is Costly and Time-Consuming— Training staff on how to properly use these complex systems takes years (if ever). The learning curve is great. For the Mayo Clinic / EPIC rollout, 45,000 Mayo Clinic employees will need to be trained to use the new system. In most cases, making these systems functional requires ongoing consulting services from the vendor of the solution, in addition to regular maintenance like hardware upgrades and replacements and the implementation investment (such data center leasing, hardware procurement, installation, testing, etc.)
  • Lose with Patients—As patients become more like consumers, being slow to adapt to their behavioral shifts fails everyone. As patient expectation shift, the desire for more convenient, engaging, interactive healthcare from their providers is becoming more heavily weighted when selecting a provider. Denying greater interaction and engagement may not only be hurting your health system, but is stifling industry growth, and keeping patients passive about their health. The longer it takes to roll out a solution, the longer it takes to help the patients who benefit from what that solution solves for.

We know that the rapidity and constance of change to our nation’s healthcare system is not likely to let up anytime soon. Health systems have an immense responsibility and challenge to adapt their infrastructure to be successful in this transforming landscape. Thankfully, modern technology is within reach.

In Part 2 of this article, we will cover how working with smaller vendors can solve for the changes needed by health systems.

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Hi, I'm Grace. I write all things surgery for the PeerWell blog. You may remember me from such titles as: "Diabetes & Joint Replacement 101" & "Sex After a Joint Replacement".

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