Demystifying healthcare transformation Part 3 – CORE and healing healthcare

This is Part 3 of a three-part series on The coming storm in healthcare.

Healing healthcare

If healthcare were a patient itself, it would be receiving ongoing, expensive treatments from many physicians who never talk to each other. The bills would be paid by an accountant in another state who only has a fax machine. There would be shady salespeople promising miracle cures at the front door.

The numbers coming out of the National Healthcare Expenditures  (NHE) fact sheet are grim. In 2009, the last year published, NHE grew 4 percent to $2.5 trillion, or $8,086 per person, and accounted for 17.6 percent of GDP. Projected growth is 6.1 percent per year through 2019, putting the health share of of GDP at 19.3 percent in seven years. These numbers are especially alarming when you consider that this wont produce infrastructure like ports, roads and bridges that increase production capacity and create jobs but simply keep an aging population at a break-even level of health.

Plan of attack

For healthcare reform to be anything less than putting out spot fires with software ‘tanker drops’, the way of doing business needs to transform. It needs to be a coordinated attack that changes the everyday work of people and brings a new look at technology. Shortchange the process challenges and the result will be wasted time and money spent on dysfunctional automation. Software ‘cures’ that don’t support broad solutions are modern snake oil.

Healthcare Reform addressed this through CORE, a set of healthcare operating rules for interoperability. We can spend time on what CORE was meant to change, but it is essentially about reaping the benefit of all of the work done for Reform to date. For CORE to be truly successful, it needs to liberate data. CORE is meant to allow healthcare organizations to:

Improve outcomes

  • Equip medical staff with faster and more accurate access to patient records
  • Allow decision making based on data in motion, not data buried in a database
  • Ensure care plans are being followed (the 99% of the time a patient isn’t in treatment facility, office)

Reduce cost of care

  • Prevent duplicated tests and treatments
  • Proactively score patients for their risk of readmission

Reduce administrative costs

  • Automate the flow of information and take it off paper and telephone
  • Avoid the penalties of old or incorrect data

Facilitate collaboration

  • Allow quick and easy communication with the confidence that all the right people are getting the right messages
  • Make collaboration secure and reliable

Ensure compliance throughout

  • If we change everything but break HIPAA rules and disrupt revenue, we’ve accomplished nothing

What’s being described is reliant on collaboration, new levels of cooperation, new processes and new ways of applying technology. The old ways of doing business will prevent organizations from meeting the Healthcare Reform deadlines in the near term, and will create survival risk in the future as the savvy swallow up those unable to change.

If we think Reform will go away, think again, “…no matter who wins the White House this year, the U.S. healthcare system wil be reformed, and more likely transformed, in the near future…” The approach that makes sense will be the one that creates a platform for ongoing change.

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Categories: Data Analytics / Big Data, Healthcare

Author:Chris Taylor

Reimagining the way work is done through big data, analytics, and event processing. There's no end to what we can change and improve. I wear myself out...

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One Comment on “Demystifying healthcare transformation Part 3 – CORE and healing healthcare”

  1. February 14, 2012 at 11:27 am #

    Chris,
    Caught back up on this series today. Great stuff in parts 2 & 3, as well. So, it begs the question…

    What does a plan look like? If an organization wants to tackle these issues, what are the broad steps they need to undertake?

    What are the underlying system/infrasctructure items organizations like Tibco or APQC can provide healthcare organizations to help them get in line with the reform that is coming?

    – Ron

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