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Rx for burnout: value based care, smartphones and EMRs?

February 26, 2021
Business Affairs
From the January/February issue of HealthCare Business News magazine

By Jeff Fallon

Three changes have transformed U.S. healthcare since 2005. The burnout and headaches for providers still persist. But I’m bullish on what’s ahead. Stick with me to hear why all this will be worth it in the end.

Individually, each rocked healthcare and caused significant provider burnout due to new documentation requirements; large software costs and steep learning curves; patient satisfaction scores and new patient expectations for shared decision making. Each change pushed more providers into retirement or alternative roles to avoid the new burdens.

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Despite this, I’m excited about the future because of the convergence of these changes. They’re foundational to a world in which provider workload can actually decrease while quality and cost improve. Let me explain.

1. The 2005 Deficit Reduction Act formally started the march to healthcare’s value-based financial future when Congress directed CMS to develop new payment models that shifted away from Fee For Service to Value-Based Purchasing (VBP) to bend the cost curve to something more economically sustainable. After much innovation and new ideas tried, we’re well short of CMS’ aspirations for the percentage of care funded under value-based schemes. But this genie is out of the bottle and VBP’s future as the dominant model is a question of when, not if.

2. Apple kicked off the smartphone age with the first iPhone in 2007. Now nearly 4 billion people carry smartphones. They’ve revolutionized nearly everything for half of humanity and healthcare won’t escape this. 1.2 million terabytes of web-based information available in a handheld supercomputer enable us all to be instantly “informed” about everything. Certainly, information is not knowledge, and knowledge is not wisdom, but this limitless fountain of information democratizes even dense clinical research and theoretically elevates our collective clinical IQ. Challenging though newly-opinionated patients may be, data shows that those who are engaged will equal better outcomes. And surely we all want the option to make our own choices about what’s right for us when that time comes. When patients become active information seekers, physicians and nurses can now reasonably expect those in their care to take some responsibility for their health choices and the smart device is the tool through which they can efficiently share their guidance.

3. The Affordable Care Act of 2010 invested $35B for providers to adopt digital health technologies. The resulting EMR focus shrunk clinician face time with patients as providers turned to face computer screens. Implementing the EMR was arduous but important work for provider staff. Now the EMR is data plumbing under the healthcare kitchen counter that enables fantastic digital health appliances on top of the counter to plug into that data source to deliver new value that improves quality and reduces cost.

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