September 4, 2015

Healthcare Innovation: What is it solving?

Kris Gösser
Kris Gösser

Datica Alumni — Former Chief Marketing Officer

Innovation in healthcare starts with the reputable intent to promote optimal quality and value of care to patients, providers, insurers, and employers. A few macro level initiatives of innovation include being able to scale the business by creating constant opportunity, shifting from a fee-for-service model, managing cost of care, and providing a framework needed to support the operational and legal backends. These innovative measures face many challenges though. The core two being: 1) Managing the total cost of care budgets by managing risk contracts and delivering the right care at the right time; and 2) Improving quality while effectively earning revenue.

Even today’s healthcare technology has challenges to effectively assist in innovation. There are intrinsic complexities of sharing data in a system of minimal interoperability, such as the limitations in progressing information through the care process. Clinical integration also becomes a matter in question when limited access to data (EHRs) is provided, the user experience for care management is incommodious, or there is inadequate access to the claims data.

With these limitations on the business and technology factions of healthcare systems, there are new call to actions (CTA) that healthcare innovation and new technologies are aiming to solve.

CTA #1: An ACO care record that advances with patients to their care destination.

Healthcare systems mandate a fully integrated health information environment that can be accessible across the comprehensive care continuum. This requires a connected ACO community that surpasses the mere needs of interoperability and necessitates a cloud-based health insurance exchange for complete data capture of the patient experience regardless of the site of care.

CTA #2: All-inclusive physician performance coverage.

Physicians and healthcare providers are immersed in patient care but cannot do it all on their own. Physicians are seeking a reporting system that can show performance metrics, high-risk patients, coding improvements, prescription status, patient rosters, gaps in care, and predictive analysis to suggest interventions.

For more information about innovation within healthcare, don’t forget to check out 7 Big Ideas in our annual Healthcare Innovation Series Report.

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