Five Keys to Healing the Healthcare Industry from Within

During her keynote at HIMSS19, Premier’s CEO Susan DeVore shared her personal story about why she feels we all have a higher calling to heal the U.S. healthcare system as a whole.

Susan then discussed Premier’s vision for smarter, more responsive healthcare that is consumer-centered and provider-led, and has data that flows seamlessly, is analyzed effectively and gets leveraged to guide decision making at the point of care. Getting there means taking a big step forward from our current environment to confront and overcome a number of challenges holding back progress.

HIMSS19 was full of discussions around how to put patients at the center, but in order to do that, the industry needs to address where un-curated data is fueling fragmentation, duplicative practices, quality gaps and clinician burnout. The following are five critical steps to move forward when it comes to the flow of information and data.

1. Transform Data Overload into Actionable Data

For years, the buzzwords that defined the future of healthcare were “Big Data.” But now that it’s here, the sheer volume of it all is overwhelming. We have data on costs, quality, claims, supplies, the workforce, outcomes, lab, imaging, billing, scheduling… and now genomic and patient-reported data, and much more.

We have to make this landslide of data useful. In other words, Big Data needs to be made into Small Data – actionable data.

Providers must be empowered with the capability to isolate the information that is relevant to a care decision at a specific moment in time and take action.

2. Move from Actionable Data to Informed Clinicians

Physicians need a total performance architecture to evaluate their cost and quality outcomes, pinpoint opportunity areas, and serve data up in an actionable format—no matter where the patient turns to receive care.

For providers who have one foot in the fee-for-service world, where everything is measured in terms of access, volume and productivity, and the other in the value-based care world, where quality, utilization, prevention, costs and outcomes are key, reconciling these two paradigms can be daunting.

The solution is to create a common management platform guided by a standard measure set that satisfies the need for cross-continuum performance data. If partner organizations invest in measure tracking and reporting infrastructure for physicians, administrative tasks can be handled somewhere else—and doctors can focus on caring for their patients.

3. Support Informed Clinicians with a Robust Infrastructure

There’s a growing trend in the industry where health systems are bypassing traditional, third-party payers altogether and contracting directly with employers to manage their employee populations (GM and Walmart have both experimented successfully with these models).

It makes sense—employers can customize plans and standardize to high-value providers that deliver predictable outcomes, and employees pay a lower price. For providers, it offers a reputational boost and an expanded community footprint—while also cutting out the middleman standing between patients, care decisions and payment.

But industry players who want to jump on this bandwagon must invest in the infrastructure to support it—i.e., significant IT and data assets, including claims analytics to measure network utilization, standardized ways to evaluate health and wellness, and performance measures, predictive analytics, and care management tools to help manage employees with high-cost, chronic diseases.

4. Build on Robust Infrastructure with Innovative Apps

A new medical journal article, scientific study or research publication is released every 26 seconds. If a physician read and retained two of these articles every single night, at the end of a year, they’d be about 1,000 years behind the current evidence.

Clinicians need better ways to access up-to-date information on medical advancements and evidence-based standards at the point of making care decisions.

Apps that achieve this are on the market today, but haven’t been widely adopted. The industry must determine how to create a robust marketplace for adoption – with the appropriate incentives.

5. Unlock Liquid, Interoperable Information to Improve the Health of Populations

Last but not least, the most urgent challenge to address in the world of health IT is how to make data liquid, so that information can be accessed by any system at any time, without walls or silos.

The current system – in which claims data lives with insurers, supply data lives within an ERP, finances are managed by software, and so on – is the equivalent of an email system that only allows messages to be sent to people in your company, or a cell phone that only allows calls to your immediate family.

The insights we heard at HIMSS19 and the new rules that came out that week from the Office of the National Coordinator give us hope. We must enable the flow of information so that providers can do their jobs and patients can get the care they need.

At Premier, we believe that individual healthcare organizations can perform better than they expected, and that our system can perform better than anyone thought possible. And while it’s easy to feel discouraged by the enormity of change, we must choose to continue working on behalf of the people who are counting on us – for the patients, mothers and fathers, children and grandchildren, who deserve a brighter future.