Over the last five years, value-based healthcare (VBHC) has become more and more popular among medical institutions, and eventually this new approach became a state priority in Europe and the USA. The Deloitte Global Healthcare Outlook highlights using new care delivery models to improve access and affordability as one of the forefront issues in healthcare today.
In value-based healthcare, service providers get paid not for the scope of services, but for the outcome of the treatment which means patients obtain a more effective cure, while doctors do everything they can to prevent illness and relieve chronic diseases.
Implementation of this new approach is impossible without a unified system containing all data about a particular patient’s diseases, allergies and medical tests – an electronic health record system. EHR systems allow specialists to work together to provide better treatment, as well as offer a great number of hidden benefits and features, which we will reveal through the course of this article.
Value Based Care as a Current Priority in the Healthcare Industry
The United Kingdom’s National Health Service launched the NHS RightCare programme, which was designed to improve treatment outcomes and deliver a financially sustainable health system nationwide. To simplify the model’s implementation, the King's Health Partners’ Academic Health Science Centre developed a system of patient-centred metrics based on outcomes for diabetes, Parkinson’s disease and chronic obstructive pulmonary disease.
The Canadian Foundation for Healthcare Improvement held a webinar dedicated to the VBHC approach for health system leaders, healthcare providers, patient organizations and government officials. The webinar revealed the key foundations of this novel model, it’s current implementation, and how it will be spread across Canada.
In the USA, Aetna, a health care insurance provider, currently spends around 53% of the total disbursement on value-based providers. This is predicted to rise to 75% in the next year. For this reason, we can assert that VBHC is not a utopian healthcare approach, but a real model that works.
What does VBHC mean for patients and hospitals?
It is clear the value-based model is significantly different to the previous (old) volume-based one, so we need more details to reveal the benefits of VBHC for both patients and healthcare services providers.
Imagine, your neighbour James has got a kidney disease. Even though James gets medication and treatment procedures from the local clinic, his health remains the same. His insurance company has paid part of the treatment costs for six months already.
If his insurance company worked using the VBHC model, as Aetna does, the situation would be different. A nurse care manager would work closely with James to educate him about his disease and specific ways to improve his health. A dietitian mobile application would help James to keep a kidney-friendly diet, and his health improves. With his symptoms under control, the care team would work with James to get him on the kidney transplant waiting list. After the operation, he is able to return work and feels confident that his health has thoroughly improved.
To provide such a level of services, health care institutions have a lot to do. There are several challenges for them during the transition from the volume-based to value-based model:
- Value-based payments
The Healthcare Financial Management Association presented several payment models for value-based reimbursement; one of them fits the value-based care approach the best. Patient-centred medical practices use electronic medical records and central data repositories to facilitate care coordination activities, and require physicians to follow a limited set of evidence-based care guidelines. To cover the costs, providers can often negotiate a fee-for-service (FFS) rate increase or a per-member-per-month payment on top of the standard FFS payments.
- Identification of service quality indicators
Even though companies like King's Health Partners determine patient-centred healthcare outcomes metrics for various diseases, the entire system still isn’t ready. Almost every individual diagnosis requires distinctive health indexes, while provided cure services have to be controlled using appropriate quality indicators. Therefore, most healthcare institutions suffer from the absence of a thorough indicators system.
- Providing the tech environment
The implementation of value-based care is impossible without specialised software and an effective team. On the one hand, management has to perform a tremendous amount of work to form teams that will be responsible for each patient’s recovery. On the other hand, such care can’t be delivered if tools such as an electronic health record system are not put in place.
These challenges are not easy to resolve, but healthcare service providers can’t shy away from the VBHC trend, as it has become a state priority in many countries. The full transition to value-based software is just a matter of time.
EHR Software Solutions Role in the Client-Centric Healthcare Approach
Medical institutions can’t provide a high level of service without crucial patient data, so the availability of healthcare records is critical. Allied Market Research reveal that the global EHR market will reach $33,294 million by 2023, which confirms the key role of electronic records in healthcare.
According to a recent Healthcare Information and Management Systems Society survey, 71% of healthcare organizations determine their #1 IT priority as getting more value out of their EHR. The system is used at every stage of treatment, starting from diagnostics and ending with a determination of treatment results.
In terms of value-based healthcare, electronic healthcare records are even more topical. As payment for healthcare services is calculated based on outcomes, health indicators are the only way to estimate treatment effectiveness. There are many benefits in using an electronic record system.
Benefits that encourage healthcare service providers to incorporate EHR systems
During the last year, almost nine out of ten physicians used an EHR - not necessarily a system, but at least organised digital data. The workflow of providers with an EHR has become more efficient thanks to tools such as alerts and reminders. The system identifies required lab tests and warns personnel about critical lab values, errors, or preventive care necessities.
All parties benefit from direct communication, which leads to enhanced overall patient care because patients stand as active collaborators in their own health care management. Permanent access to patient data allows doctors to obtain benefits critical for business.
Easy access to patient data
Not only will different doctors have access to the patient’s data, but different clinics. All the information about a person's diagnosis, health indexes, allergies, and previous treatment are stored in one place. This fact enables medics to diagnose more precisely and cure in the right way, which leads to faster recovery. This data is also used for education by first-year doctors, who spend 43% of their time interacting with EHR.
Advanced technologies enable team-based care, where primary care physicians, specialists, nurses, and technicians work together in the best interest of the particular patient. All team members have permanent access to the patient’s health data, which positively influences the entire cure process. Moreover, different healthcare institutions can access EHR system data, so the likelihood of double tests or procedures taking place is slim.
According to the statistics provided by Ponemon Institute, US hospitals lose a total of $8.3 billion annually due to inefficient communications between doctors and patients - EHR can partially reduce these losses. Precise data decreases misunderstandings and helps doctors to determine the correct treatment, avoiding unnecessary prescriptions. Moreover, electronic healthcare record system s automate several time-consuming, paper-driven and labour-intensive tasks, so that employees perform more work in comparison to medical staff who process data manually.
Now it is clear why most healthcare institutions in the USA, Canada and UK spend the lion's share of investments to acquire an electronic healthcare record system. When we talk about complicated software system development, we also talk about the huge responsibility and possible pitfalls. Let's learn more about medical EHR software to know where to start.
EHR Software Requirements
As with any big and complex system, EHR has a lot of nuances to consider, starting with the choice between cloud-based or in-premises software and ending with providing mobile app integration. We will dig into electronic healthcare record system development to emphasize the key features and the ways to implement them.
First of all, the system has extensive managerial functionality, including both patient and staff management features. All together, they constitute a hands-on tool to assign clinical tasks to staff, schedule patients, and manage their treatment and medication, etc. The system automatically generates and records patient-specific instructions based on the guidelines, protocols and care plans for a particular diagnosis.
Second, the EHR system offers prompt support. In cases where some critical health indexes occur, it warns personnel to take extra actions. Accurate specimen collection, drug interaction and dosing are also controlled by an electronic healthcare record system to present alerts for deviations. With EHR system reminders, doctors won’t miss preventive and wellness activities due to excessive patient numbers.
Third, in order to ensure patients follow their prescriptions, the EHR system provides communication between a provider, patients and their families. Another advantage of such interaction is it facilitates the education of patients about the disease, its threats and treatment. If a patient receives services from a few providers, the system also provides inter-provider and pharmacy communication.
Finally, healthcare data should be stored and exchanged in a secure way, so several security safeguards should be implemented. Health information is protected with the following features:
- access control;
- entity authentication;
- audit trails;
- data encryption;
- firewall protection;
- virus checking
Even though there is a list of essential EHR system features, the functionality can be broadened with custom features to meet distinct business needs. Decisions about integration with other systems, cloud incorporation and mobile opportunities are among these variables.
Cloud-Based vs On-Premises: What to Choose
The database of the system can be placed inside the healthcare institution or in the cloud. Both options have their pros and cons for different needs.
A Black Book Rankings survey reveals the increasing of cloud based on EHR systems, stating that, presently, 82% of small and solo medical practices use cloud computing to implement and maintain their electronic records. The USA National Centre of Biotechnology Information characterises cloud computing as a cheap, safe, scalable, and interoperable solution. It is good for interinstitutional use as it allows faster data transfer, has the ability to search and explore info by keywords, and wide security opportunities.
Significant health IT market participants like Epic, Cerner, MEDITECH, and others primarily offer on-premises EHR systems, as they are the most reliable option. Offline access, full control of data storage, safe data storage and wider abilities for custom development are appropriate for big institutions who can afford more expensive development and server maintenance. Moreover, the possibility that somebody could hack the system is lower in this case. However, cloud-based solutions are going to reach the same level of safety soon.
Mobile capabilities as a way to enhance your EHR
The growing popularity of mobile app usage in the healthcare industry affects electronic healthcare record system. Applications such as health indicator trackers collect a vast amount of data about patients and their behaviour. You may be surprised by the fact that only 8% of organisations capture all the data gathered by mobile devices into their EHR, while almost all the entities use the system. We are sure mobile integration is an excellent opportunity to obtain a competitive advantage.
Coordination between distinct institutions like medical centres, clinics, and physician’s practices can be improved, particularly for patients with chronic diseases. The nutrition and physical activity data captured by mobile apps and stored in an EHR are useful for the adjustment and maintenance of shared care plans, as well as symptom and medication management. As a result of improved cooperation, readmission rates decrease, and treatment outcomes improve. Better outcomes mean higher income, according to value-based healthcare approach.
It is necessary to learn about EHR's major architectural components to understand how it works. The architecture includes a user interface, clinical decision support system (CDSS), terminology services and record services.
All applications contain a user interface (UI) as a fundamental component; it is used in EHR systems to enter and display health records. Through the UI, medical staff input data like medication or observed finding to the CDSS, while in turn, UI displays alerts, advisories, and clinical guidelines.
The primary role of the CDSS is to execute the decision support logic. It interacts with each of other major components within the EHR. The clinical decision support system uses two or more patient data items and generates care advice. Therefore, healthcare professionals receive consistent informational support to aid in decision making.
Record services are needed to manage patient health records, providing services such as entering data, as well as searching for and retrieving health records. It also allows clinicians to query and extract data from healthcare records, and communicate and exchange files with other apps. Record services interact with CDSS and UI.
Terminology services interact with CDSS and manage terminology resources. They request concepts, reference and relationship sets, and install or update SNOMED CT from release files.
Through the UI, users interact with record services by entering, storing, and searching data. The user interface also sends inputs to the CDSS and receives guidelines and alerts on its behalf. To generate recommendations, the clinical decision support system uses UI inputs and data from record and terminology services.
Value-based healthcare is becoming more and more typical among care services providers, so that decision makers can’t ignore this trend. In fact, they can use it to be closer to patient needs and grab additional market share. On the way towards the implementation of this new approach, medical institutions have to resolve several challenges, and one of the most challenging is incorporating software into the processes.
EHR systems are a key tool for healthcare entities that are striving to rise treatment outcomes, increase customer satisfaction, and save the costs. The limitless potential of the system is worth considerable investment, as it is compatible with other software, has wide functionality and can digitalise of the majority of day to day paperwork. Complex electronic healthcare record systems are not easy to implement correctly, but if you find an experienced vendor, the positive result is imminent.
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