The progression of unplanned care: Past, present and an interoperable future

Roger Davis, President & CEO, T-System -

The unplanned care market has experienced exponential growth over the last five years. It's estimated there are now more than 500 freestanding emergency centers (FSEC) in the U.S., and approximately 9,300 walk-in, stand-alone urgent care centers with 50 to 100 new clinics opening every year.

"Retailization" of healthcare growth is inevitable, and patients will continue to shop and seek care at sites that offer such conveniences.

Today, there are fewer hospital-based emergency departments, but the volume of patients they're seeing is increasing. The increased capacity with less departments is accelerating these alternate care sites, such as FSECs and urgent care centers. Since the inception of the ACA, this environment has grown dramatically due to the convenience and access these organizations provide.

As the CEO of a healthcare IT company celebrating its 20th anniversary, one thing is clear: the past five years will look significantly different from the next five. These entities will continue to see an influx of patients seeking convenient access, and the unplanned care market will experience an increase in care settings. It's important to understand how these organizations influence and shape the care continuum and how technology plays a critical role.

An Evolution: Industry & Regulatory
The industry has certainly undergone drastic changes over the past five years alone, fueled by regulatory efforts such as Meaningful Use and ICD-10. Today a new focus from the CMS is shifting the conversation from simply mandating the use of technology to demanding better outcomes as a result of technology use. A key component of this? Interoperability.

The responsibility is on us – and all vendors – to ensure our technology is helping create a more interoperable system that supports and helps providers meet their goals. Interoperability is the driving force behind a better healthcare system – a system that enables the right data to be available at the moment of care, exactly when needed. We need and encourage each of our customers to hold us – and other technology solutions providers – accountable for upholding promises to quickly develop and deliver real world technology solutions that drive interoperability so providers can focus on what's best for the patient.

Data Access & Flow Fuel an Interoperable System
To ensure technology is helping create a more interoperable system, vendors have a responsibility to make a commitment to open APIs and foster an environment of openness and free flow of data. This decision is helping providers access and share data at the moment of care for improved clinical outcomes. Real-time capabilities of moving data between applications will optimize both the provider's capability as well as the patient outcomes.

As more patients seek unplanned care through retail clinics, urgent care centers, emergency departments, and FSECs, interoperability is a critical component to ensure care is captured consistently and appropriately during each touch point as patient-consumers journey through the healthcare system. However, there is an increased need for real-time interoperability, where data about the patient – including labs from previous visits, prescribed medication and medical history, among others – is immediately available at the point of care. This is a relationship between applications that goes beyond interfacing and moves toward the ability of applications to play with one another over a standard repeatable framework regardless of technology vendors. In the unplanned care space, there is a greater sensitivity to time due to severity of conditions, and information made available in real-time is a critical component of delivering quality care.

Patient Needs Remain at the Forefront
In the unplanned care environment, overall experience and satisfaction are critical to a successful model. Historically, the left without being seen rate has plagued these organizations. Long wait times ultimately lead to frustration and dissatisfaction. As patients continue to seek care at these settings, they will develop expectations for efficient and seamless care delivery setting expectations for future encounters.

Technology plays a key role in a patient's experience with the healthcare system. It must meet the needs of not only the providers to seamlessly deliver care, but also the patients as they continue to make decisions tied to their health. At the end of the day, the patient is – and must remain – at the heart of every decision to drive improved clinical outcomes and lower costs.

There's no doubt the industry will continue to evolve and regulatory rulings will create new demands – of both providers and technology partners. Interoperability will facilitate the exchange of data in real-time for improved outcomes and better connect the care continuum. The public's desire for immediate and convenient access to care will remain the driving the force behind the growth of the unplanned healthcare market.

Over the next five years, delivery of emergency medicine through unplanned care settings will be challenging, yet exciting. Change is inevitable, but it will push each of us to disrupt the status quo, go beyond boundaries and deliver unprecedented care to the individuals who need it – at the exact moment it is needed. Interoperability is – and will continue to be – an imperative for improving healthcare and making it work the way it should. And at the end of the day, patients come first and technology must support that notion.

Roger Davis is president and chief executive officer at T-System, where he is expanding the company's 20-year legacy as a disruptive innovator in emergency medicine. With more than 30 years of experience in healthcare, Davis has a record of success and knowledge in a broad range of areas, including business process reengineering, performance enhancement, physician practice management, compliance and privacy and business development. www.tsystem.com

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