4 min read.Updated: 10 Aug 2020, 11:02 AM ISTSachin K. Gupta
Driving patient behaviour change can only be done if we make significant investments in collecting, curating, processing, leveraging data
Care delivery systems looking to make meaningful impact through data face a number of challenges, the most critical one is collecting data from various sources
Prevention is better than cure. There couldn’t be a better time to apply this adage to the healthcare delivery system than now. The care delivery system globally has been built primarily around large health systems, hospitals and facilities to deal with specific acute care episodes, procedures and emergencies. This approach has served to increase the total cost of care because it focuses on treatment of diagnosed conditions and not on the overall health of the population.
Healthcare systems across the globe have started to recognize the importance of taking care of an individual early in the care continuum, especially to manage chronic conditions. Coordinating care across the care continuum is a key challenge and moving to proactive care requires effectively stratifying the population, understanding the potential disease risks and engaging patients at the right place and the right time. As the covid pandemic accelerates the move to virtual/remote care, it opens up the possibility of engaging the patients in their living rooms, moving beyond the exam room. Driving patient behaviour change can only be done if we make significant investments in collecting, curating, processing and leveraging data. This includes all manifests of data related to a patient: their past medical, family and social history (PMFSH), their interactions with the healthcare ecosystem and financial data related to care delivery.
Care delivery systems and physician enterprises looking to make a meaningful impact through data face a number of challenges, the most critical one is collecting data from various sources and across care settings because of lack of interoperability and lack of digitization. Another key challenge is to curate and process it into discrete data which is difficult given that a lot of data is in physical form or images. Other challenges include storage, security, ownership and making it available in the form of actionable insights.
All key stakeholders in the care delivery system suffer because of lack of the right data at the right time. For patients it affects safety because social or medical history is not recorded / available in electronic form, which could lead to clinical errors. Physicians spend more time reordering tests or searching for results, which could lead to delays or errors in medical judgement due to lack of all information related to the patient. For the broader Healthcare system, it increases the overall cost of care with duplicate testing and repeat diagnosing. These are the manifestations of ‘avoidable suffering’ as described by Dr. Thomas H. Lee and Deirdre E. Mylod in their essay in HBR in 2013. The ‘avoidable suffering’ that comes from the dysfunction of the Healthcare system and how we have become used to it instead of fixing it.
Through the history of the medical profession, it has been the physician’s role to gather patient data to determine the right treatment path. In the past, this information was documented only to a small degree, focused on the immediate needs of the patient. However, with increasing administrative and clinical complexity, Physicians need support and tools to ensure that they have the precise insights and data needed to make the right clinical decisions.
Taking away their burden to collect, curate, stratify and tabulate patient data is critical so they can focus on caring and curing for the patients. We often ignore that a physician’s job involves a significant amount of emotional labour, the term coined by Dr. Hochschild, referring to the emotional requirements of a job. A physician is expected to build trust with the patient and their family quickly, so they follow their professional advice. A physician is expected to make life and death decisions objectively, while leaving aside personal gain, exhaustion or trauma. This needs tremendous mental and emotional energy, which today is wasted because of lack of a strong foundation built on data.
Healthcare enterprises need to make that journey from digitization of all data where it is stored in an electronic form, to digitalization of data such that it is stored, classified and available in the right discrete structures to leverage advanced data science tools to enable Digital Transformation of how care is delivered.
In this journey, it is important to keep into account the needs of all stakeholders in the care delivery system. However, the most important factor is to ensure that all processes are designed around the most important relationship in healthcare - the patient-physician relationship. Physicians are at the centre of driving change and improvement in a care delivery system. Helping them restore the primacy of the patient-physician relationship by giving them the right data at the right time to drive proactive care instead of reactive care is the only path to deliver a radically different and significantly more efficient healthcare ecosystem.