As healthcare agencies battle the coronavirus, another emergency is brewing to react to. The financial fallout of the pandemic will be massive and widespread and is bringing into the forefront an observable trend that has now been accelerated. Traditional healthcare providers have operated with small margins, high costs and inefficient reimbursement models as they strive to deliver premium and excellent care. With this financial challenge, the triple aim of healthcare created focus on the need to lower the per capita cost of care delivery, but progress towards this goal has been limited.
Enter the coronavirus. As nations, regions and whole economies shut down to prevent a surge of patients, overwhelming healthcare providers and resources, the number of patients who visited existing facilities for care shrunk to a minimum. The pivot was quickly made to virtual and community care, rapidly expanding technology advancements that have long been sought after but not delivered.
However, many health systems and unfortunately many rural and critical access providers, faced an inordinate burden from the financial implications of the pandemic. It becomes a simple reality, without billable patient services, there is no revenue. The future is bleak for more than 60% of the healthcare providers in the US and the balance will have to make serious changes to survive and recover.
Some of the many challenges facing healthcare in this new model will be:
- Space utilization. The physical space of care delivery will need to become highly flexible and adaptable to meet the needs of patients and their care. Being able to rapidly convert a space for testing and triage or to augment an existing area to deliver more focused and specialized care will be the expected norm. Also, now that back-office teams are working from home, traditional office space in healthcare can also be converted or reallocated.
- Overstaffed departments and teams. There is no way to sugarcoat it, but hospital workforces have been overstaffed for some time. Specialization, once thought a sure way to maintain skills, is on the way out for back office teams, specifically in IT. While the adjustments will hopefully be humane, the impact will certainly be felt.
- Reliance upon outdated practices. In the new digital world, healthcare will have to maintain key learnings from their history, but will need to be open to new and innovative ideas. Forcing a pivot to happen through existing structures and procedures will certainly push innovations to failure.
Health systems that adopt an innovative and disruptive approach to providing care will be able to take advantage of the present reality. Innovation will need to come in a few different forms:
- Financial innovation. The days of large capital expenditures, overstaffed teams and bloated maintenance contracts are over. The need to rapidly pivot to new business models will require health systems to adopt cloud consumption principles for as much of the technology stack as possible. Using advanced tools like artificial intelligence and machine learning (AI/ML) to improve operations empowers many repeatable tasks to become automated. Not only does automation free up staff time, but it also increases both stability and security for the network, provides relevant insights into patient care and better billing capture.
- Patient centricity. While care has always been about the patient, traditionally the patient has been asked to engage their care team in a monolithic structure with potentially inconvenient scheduling. Today, care can and should be delivered where the patient is, not where the hospital is.
- Real estate. With more patients being able to receive care in their home and non-clinical staff no longer needing in an office for a 40-hour work week, the health system can begin rightsizing its real estate usage. It might also involve retooling some care areas to be ready for more critical patients, while telehealth teams focus on patients who are at home who would normally have been admitted to the hospital.
Healthcare systems that can innovate rapidly will be the ones who survive and perhaps be the ones who can acquire faltering systems. This acquisition strategy will prove crucial for the rural and critical access systems that serve so many people in the US. However, caveat emptor (buyer beware). Keep in mind that the system may have failed due to lack of innovation and you as an IT leader must rectify this backlog of technical debt.
This often used quote, most often attributed to leadership thinker Peter Drucker, is “Culture eats strategy for breakfast.” While much of these new ideas have been forced upon healthcare systems, time will tell if they can do the hard and adaptive work of leading their culture to embrace and facilitate much needed technology advancements.
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