Population health insights

A digital platform for value-based care management

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Mar 04, 2019

It is becoming clear that the traditional approaches to care management, including efforts to close gaps in care, are not sufficient to deliver value-based healthcare. Efforts are fragmented and driven by what healthcare organizations have established as appropriate, and not based on what a patient needs and when they need it. IDC research has shown a need for continuous care driven by intelligence and insight that reduces the friction between payers and providers and delivers value that consumers and physicians are seeking. New digital platforms for value-based care management can provide the insights to guide stakeholders to the most appropriate action, the workflow and devices to manage care across the continuum of care settings and acuity, and the digital communication tools to support patients on their healthcare journey. The adoption of value-based healthcare, the pressure to manage cost and improve quality as well as the availability of technology holds promise to ease the burden for all stakeholders.

 

Care management has historically been focused on a sub-set of patients with chronic conditions, with efforts including identifying patients in need of routine preventive screenings and providing generalized care plans to help patients manage their condition.  With the increased availability and adoption of technology, particularly remote devices and sensors in combination with mobile devices, it is possible to extend care management across a broader population that represents the full spectrum of acuity — from prevention to care of unstable and frail patients. Whether driven by cost management or quality improvements, healthcare organizations must broaden their care management strategies to increase the use of technology to manage patients, regardless of acuity, where and when they need care — a true patient centered approach to care.

Magnitude of the problem

The current fragmented care management efforts often result in patient non-compliance to medication regimens, care plan instructions, and even seeking care when it is needed. The financial and clinical impact of non-compliance is significant:
  • The isolation between office visits often results in poor medication adherence, which was reported to cost the health industry $100-$289 billion a year1.
  • Further, the lack of continuity leads to non-adherence to chronic disease care plans. Not only does the health of patients suffer but the direct cost of non-adherence to care plans comes at an annual cost of $100 billion per year.2
  • Missed appointments cost the National Health Service in the UK £1 billion in 20173; a simple reminder of an upcoming appointment could reduce that expense.

The direct cost of non-adherence to care plans comes at an annual cost of $100 billion per year.

A central source of curated data is the lynch pin for success

While it is tempting to take a short-cut when it comes to assembling patient data and rely on the most accessible source because it will solve today’s problem, it is not a long-term solution. Healthcare organizations must create and execute a strategy to build an integrated patient-level data resource that is the "single source of truth" for care management. The data source becomes the hub or core of care management with use case applications relying on and contributing data to the central repository. Creating separate data sources for each use case application is duplicative and creates a data management nightmare.

Parting thoughts

Effective value-based care management must go beyond managing chronic conditions in the ambulatory setting and address the needs of patients across the continuum of care settings and acuity spectrum with convenient, continuous and personalized care. Current strategies are fragmented and limited in scope, causing inefficiency and frustration for care managers and physicians, less than optimal outcomes for patients, limited ROI for payers and lost revenue for delivery systems. The creation of a digital platform for value-based care management requires an architecture that can accept and transmit data to and from multiple settings of care, provide insights for decision making and help guide patients through their healthcare journey.

 

For more details on how technology can improve care management costs and outcomes, as well as Philips’ role in this important market, I invite you to download the IDC whitepaper, "A Digital Platform for Value-based Care Management."

About the author

Cynthia Burghard
Cynthia Burghard, 
Research Director, IDC Health Insights
Cynthia Burghard is a research director with IDC Health Insights where she is responsible for the value-based healthcare practice. A key focus of her research includes the use of cognitive/AI technologies to advance digital transformation in healthcare. Areas of research include analytics, population health management and proactive patient engagement including patient personal assistants.

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