Integrated Deliveries with the Patient First Approach
Vasanth Srinivas, Vice President - Healthcare and Lifesciences, Atos, talks to our host Pranjal Sharma, about how the patient-first approach is becoming a crucial factor in the design of integrated healthcare systems.
Irrespective of how complex it may sound, "integrated deliveries with the patient-first approach" ensure that, no matter what happens in the healthcare system, the patient is put first. Let us understand the essentiality and necessity of harboring a patient-first approach in the modern healthcare world.
Understanding Integrated Delivery Systems
When it comes to healthcare, it is a three-legged stool. We must consider access to care, quality, and cost of care. Healthcare costs are very high in some countries, despite people having access to better systems and quality. People in some industrialized countries produce higher-quality results at a lower cost.
The reason behind high costs is the availability of health systems that differ from the payer's organizations, such as health insurance companies or government schemes. Moreover, fragmented systems like nursing homes are built entirely differently. Hospitals are constructed in completely different ways. Eventually, they need to reconcile everything with payers or insurance companies, leading to a tug of war between them until the introduction of the "Accountable Care Act" in 2010, bringing accountability between multiple stakeholders on the same page. It further resulted in the creation of "Accountable Care Organizations" - a contract between payer and provider that focuses on the outcome of the patient or the improvement in the delta and the population of a particular geography or member base where the consequences could be improved. This also created incentives based on ACOs or accountable care organizations to come together.
To sum it up, an integrated delivery system or IDS (also known as an integrated delivery network or IDN) is a health system with the goal of logical integration of the delivery (provision) of health care as opposed to a fragmented system or a disorganized lack of system.
Digitizing All Aspects of Healthcare
With the help of these integrated delivery systems, we are eventually trying to build a digital layer that will provide for telehealth, decentralized clinical trials (in the case of pharmaceutical companies), and the digital layer that can provide machine learning capability to understand population trends. This leads to a crucial factor that will affect the quality of care: care management. We are eventually attempting to build a digital layer that will provide for telehealth, decentralized clinical trials (in the case of pharmaceutical companies), and a digital layer that can provide machine learning capability to understand population trends with the help of these integrated delivery systems. This leads to a crucial factor that will affect the quality of care: care management.
Currently, several large health systems are entirely revamping their digital areas. They are their application base and are moving towards a vertical stack approach by taking those and transforming those applications to lend themselves to the new digital layer.
There is something known as interoperable between payer and provide which needs to increase. While all these ideas existed before, it was not pervasive. It was probably 3-4% and now we expect this to go up. And what it means is that, for example, if I walk into a hospital, let's say, if I have a surgery and fighting a staying the hospital at the point of inception or find a walk in, I should get my insurance data validated. And I walk in, I get the surgery done, and then eventually when I walk out, when the discharge happens, all the systems from the payer and provider should be talking to each other to ensure that I'm completely done. And then the bill comes out and then it gets paid by payer and then I walk out with my own obligation to be paid."
- Vasanth
Simplifying the Process via Integration of Healthcare Providers
Although integrating healthcare service providers with a payment system, insurance companies, banks, or the patient's and consumer's accounts can be more extensive and more interconnected, it is also more complex.
Payment systems are one area where problems are frequently discovered because they are coded. Interoperability must be strengthened once the hospital codes all payments required by healthcare insurance providers.
The exchange of data on electronic health records (EHR) between the hospital and the payer will accelerate the entire process. As a result, the payment experience and process are less stressful.
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