Go home, Healthcare #BPM #Healthcare

Hospitals are expensive. Beyond doctors, nurses and technicians, there are administrative, security, food services and cleaning staff. The facility’s technology appetite is a hungry beast. There is a very high cost to operating the ecosystem that makes it very attractive to move patients through and onward to their homes as rapidly as reasonably possible.

But simply sending a patient home has its drawbacks. The Centers for Medicare & Medicaid Services estimate that unnecessary readmissions are costing $17B per year, making preventing readmission a very hot issue. Appropriate healthcare too often stops at the exit door of the facility and any cost savings for moving patients through quickly can be negated by new government penalties when they are eventually readmitted.

In a post-healthcare reform world, outcomes matter more than simply fees for services. Managing a population with an increasing percentage of chronic conditions means continuous care that can’t take place only in a healthcare facility.

Beyond cost and chronicity, patients get sick in hospitals. Managing health outcomes for sick and injured people is made harder by the various infections and accidents that happen far too frequently. New rules put the cost of fixing these problems on the healthcare facility.

Home healthcare

The solution to cost, readmission, chronicity and patient safety challenges is to both send healthcare home with the patient in the form of continuous monitoring and to initiate healthcare from patients’ homes as tele-health. Both require significant shifts in communication from the traditional chart and spoken instructions between professionals to far more communication outside facility walls and with the patient’s family and other supporting players (a very ‘social’ scenario).

While the physician is actively managing the most chronically ill patients, they will be ‘listening’ by way of comprehensive device and application oriented solutions to help them manage the balance of the population.

Managed change

Healthcare moving to the home represents a significant change in processes, technologies, and revenue models. It redefines the role of healthcare information technology. This change will be difficult and potentially dangerous if not managed in a highly systematic way.

There will be a deluge of information that will require complex BPM systems to pick out relevant information and trigger timely alerts. Without these systems, patients that aren’t significantly ill will drift into chronic illnesses as the shortage of primary care physicians leads us to focus on the most ill and not the people that good preventative care could help.

If done, well, we can get ahead of chronic conditions while they are inexpensive to manage. Managed poorly, this is a cat chasing its tail and will keep healthcare spending beyond our control.

It is time for healthcare to invest in the infrastructure necessary to manage process and data in new ways that allow healthcare to take the best path.

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Categories: Data Analytics / Big Data, Healthcare, Markets, Mobility, Real-time, Social / Collaboration

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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4 Comments on “Go home, Healthcare #BPM #Healthcare”

  1. Tom Bellinson
    March 12, 2012 at 5:01 am #

    Chris, this happens to be an area with which I have some experience. Your points about technology and process are noted. Both seem to be catching up rapidly with the need. I think the biggest problem will continue to be finding professionals to do the work in the field.

    People in hospitals get around the clock nursing care. Most nurses would rather work in a hospital than drive around to different patients. Furthermore, having a dedicated nurse for one patient in their home is not cheaper than having a staff of nurses care for an even larger number of patients. When patients go home, many of them still need regular monitoring and light care throughout the day and night. The absence of this care is often what sends them back to the hospital.

    In a way, it’s like the prisoner who has been in the system so long, they can’t function on the streets. So, they get into trouble again, which causes them to be put back into the system, where they get the care they’d prefer. Breaking this cycle with technology will require some very fancy robots.

  2. Nandakumar Balasubramaniyan
    March 13, 2012 at 7:54 am #

    Hi,

    I could only relate to this. When the resources are in scarcity then it paves the way for innovation or alternate ways of thinking. I remember seeing two talks where one ‘mobile hospital’ in africa and the other one – hospital in a box. That is what came to my mind. For the benefit of other readers – here is the link for hospital in a box.

    http://www.ted.com/speakers/seyi_oyesola.html

    Best
    Nanda

  3. March 17, 2012 at 12:30 pm #

    It seems the major problem is that the gap between no healthcare and hospitals is extremely large. People go from being sick and ignoring it to suddenly landing in an emergency room.

    In some communities, there are free clinics and some drugstores are now offering medical treatment as an extension of the pharmacy. This is a good model, because of the reasons you note.

    I do think that wellness should become more comprehensive. It needs to happen everywhere—not just in a hospital.

    • March 17, 2012 at 12:50 pm #

      The real challenge is two-fold. That ‘free’ clinic isn’t actually free, it has costs which are amplified that the lack of wellness care leads to crisis intervention, the most expensive of all care paths.

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