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.