- Digital Health Technology Needs to Fit into the Clinical Workflow
Survey respondents are keeping an eye on the disruptions that external market entrants like Amazon, Walmart, Google, and Apple will have on healthcare. Nearly one-third said the greatest impact of big tech and big retail will be on the current business models that now dominate in healthcare.
After business model impact, respondents said that external market entrants would have an impact on innovations in care delivery and refinement of consumer experience.
Consumer demand for better access, price/cost transparency, and convenience are all paving the way for external competitors that provide a highly refined consumer experience to enter and disrupt the market.
"Healthcare is navigating disruptions on multiple fronts, and as a consequence, payers and providers are finding themselves stretched thin as they try to address a perfect storm of change," said Change Healthcare SVP for Consulting Services David Gallegos.
"As if insurance market changes, value-based care, consumerization, and regulatory uncertainty weren't enough, this year the industry is facing a new breed of market entrants and innovators whose impact remains unknown but could be substantial. Even the largest healthcare organizations don't have the people and processes to move on all these fronts alone, yet they can't ignore these changes," Gallegos added.
Cybersecurity initiatives are not a funding priority despite the rise in breaches, with 40 percent of respondents citing sophistication of attack outpacing prevention capabilities.
The transition from volume-based to value-based care still looks to be five-plus years off, the survey found. This might indicate payers and providers are struggling in their efforts to scale complex value-based care and reimbursement models.
Obstacles to value-based care include limitations in data sharing, lack of agreement on outcome measures, and a lack of incentives for payers and providers to work together.
Regarding payer support of providers’ efforts to provide high-value care, 28 percent of respondents said that standardized data and outcome measures are lacking. Standardized measures are critical to care coordination, but payers’ and providers’ data formats usually are not interoperable.
At the same time, payers and providers believe that if they work together to develop risk-management programs, they will have the best chances of success. Other strategies cited by respondents include sharing performance data, co-development of bundled payments around episodes of care, developing application programming interfaces to improve interoperability, and sharing outcome data.
Only 11 percent of respondents said their organizations are identifying members’ communications preferences. The industry will have to do better on this and on delivering a more engaging consumer experience.
More data is being pulled from the electronic health records, where core clinical data lives. The number of respondents pulling data from health information exchanges more than doubled in just a year, from 3.8 percent in 2017 to 9.1 percent in 2018. That jump is an encouraging sign that this mode of data exchange has gained a foothold.
Rising integration of information from patient health surveys with EHR data indicates that stakeholders are focusing on individual patients, not just population health. Lagging are fundamentals like real-time data on hospital admissions and discharges. Improvement in these measures would bode well for coordination of care across providers, the survey noted.
