Can outcomes get better? In 2024, the pressure grows to improve
Gaps in care experienced during care transitions remain detrimental to health outcomes, and patient safety is still a weak point for providers.
Much of the effort to improve healthcare lies in efforts to ramp up patients’ health outcomes. For decades, that’s been in the bailiwick of physicians, who have relied on their past educations, experiences or preferences. Now, with vast stores of data from electronic health records systems and advanced computing capabilities, there’s growing hope for accelerated progress.
However, even though there are years of healthcare data accumulated by healthcare organizations, it’s still a challenge to use it to improve care. That’s one of the key barriers to boosting health outcomes that lies ahead for healthcare organizations.
Other systemic issues remain as impediments to care quality, and efforts will be underway in 2024 to ameliorate shortcomings that are impacting care quality.
Closing gaps in care across various healthcare settings
While healthcare organizations have been growing in size through acquisitions and mergers during the past two decades, coordination of care for patients traversing from one care setting to another has been difficult.
The need to solve the difficulties of healthcare coordination across care settings is widely understood. In fact, at the 2023 Milken Institute Future of Health Summit, HHS Secretary Xavier Becerra and former HHS Secretary Alex Azar highlighted the importance of better care coordination to improve patient outcomes. In a story on the session, Becerra and Azar agreed that the myriad players in healthcare, from insurers to providers, need to better coordinate their efforts around the patient. “Calling it a system is an overstatement,” Azar said.
Nearly one in five Medicare patients discharged from a hospital are readmitted within 30 days, at a cost of more than $26 billion every year. That’s part of the reason behind the Community-based Care Transitions Program, which was created as part of the Affordable Care Act to test models for improving care transitions from the hospital to other settings and reducing readmissions for Medicare beneficiaries.
Managing patient care across care settings is often difficult, because continuity is hard to maintain if different records systems may be used at various care settings where patients could be transferred. The process is also complicated because of interoperability issues between different systems and challenges in promptly communicating changes in conditions to clinicians managing patient care. Experts say interoperability as crucial to achieving effective transitions of care.
Filling gaps in care has always been difficult for provider organizations because of limited standardization of order sets and the lack of visibility into changes in patient conditions in post-acute care settings. In addition, as providers increasingly turn to virtual care for patients, improving transitions in care and filling potential gaps will become even more important.
Improving the quality of medical research, baking results into care
With providers holding years of information in patients’ electronic health records, there’s great potential to slice and dice that information to provide many benefits in providing healthcare, not the least of which is finding out what works best for improving healthcare.
It’s not all that easy – much information in EHRs is contained in unformatted free text that’s included in records, and otherwise, running analytics on patient data is a developing science.
Still, growing potential to use this information to improve care is expected to grow in the coming years, which will become increasingly important as healthcare organizations trying to optimize care and reduce unnecessary costs in light of value-based care incentives.
Several initiatives are underway. As one example, Epic is continuing to work on its non-profit initiative, Epic Research, which is designed to share knowledge with clinicians and other healthcare professionals, decision-makers, researchers and other stakeholders to help solve medical and public health problems. Most studies are based on data in Cosmos, which aggregate patients’ medical information from its customers to offer a wider base of information from which to enable real-world evidence-based practice of medicine.
Other efforts look to find ways to gather data without physically putting it into one place. Called federated learning, the collaborative approach is suggested as one way to pool data for analysis by artificial intelligence. The use of AI and machine learning is expected to advance, improving research on care quality, care protocols, and drug and care regimens. Also, massive gains in computing capabilities, as evidenced by rising interest in quantum computing, is expected to increase the potential for quicker analysis of huge stores of data by researchers.
More sick people, calls for patient safety
There’s growing awareness that healthcare facilities can be dangerous places. While they increase the chances for diseases to spread, there’s also copious evidence that medical errors jeopardize patients and cost thousands of lives per year.
The problem is not new. It will be 25 years since the 1999 Institute of Medicine’s report, “To Err is Human,” which details that healthcare workers are mired in bad systems that need to be made safer. It notes that as many as 98,000 people die each year from medical errors that occur in hospitals.
Health Data Management focused on the issue in its April 2023 COVERstory package. Nearly one-quarter of all medical encounters are reported to involve some kind of patient safety issue, and a significant percentage of those result in risk to patients’ health and even death. Beyond the risk to patients, medical errors result in billions of dollars in additional costs for the nation’s healthcare system.
In part, focusing on improving patient safety (as a component of improving health outcomes) requires a cultural shift and must be a priority for senior health executives, says Justin Campbell, vice president for Galen Healthcare Solutions.
Healthcare organizations realize the threat and are renewing efforts to improve patient safety, looking to revamp processes, better equip clinicians and ease their burdens, and effectively use technological capabilities to predict and anticipate potential problems. As providers take on more risk under value-based care contracts in the coming years, it will be important to minimize errors to optimize patients’ care and reduce needless expenses.
Technology can play a role in assisting providers, giving them an extra set of eyes to preempt potential problems and safety concerns. For example, Tampa General Hospital is moving to investments in smart room technology for its vision of improving patient safety and enhancing patients’ experiences.