Embracing the health ecosystem

Despite significant intervention and investment over the past several decades, the U.S. healthcare system continues to be challenged by unrelenting rising costs and stagnant quality. 

Of course, exceptional health systems and hospitals across the country provide world-class care and life-changing research. But in the aggregate, the healthcare delivery system is fundamentally flawed.  

For far too long, the U.S. healthcare system has operated within a disjointed framework where fragmented services and siloed systems have given way to rising costs, patient dissatisfaction, provider frustration, and, overall, flatlining quality.

For years, thoughtful, intelligent people have tried everything to break healthcare’s Gordian Knot: providing high-quality and accessible care that is affordable for providers, payers, employers, and patients. Despite this work, the U.S. continues to fall further behind in several key healthcare measures, according to the Commonwealth Fund.

Life expectancy in the U.S. is the lowest of the world’s 11 high-income countries. The U.S. also ranked last in quality, access to care, administrative efficiency, equity and health outcomes. At the same time, spending on healthcare continues to increase each year.    

And so, we must rebuild and make a dramatic change. Specifically, we must move from a linear system of care driven by the immediate need for service to a virtuous cycle of coordinated care where the patient’s complete care experience is proactively managed across all parts of the health care ecosystem. 

Care coordination is an approach where we take a 360-degree, consumer-friendly approach to patient-centered care. We service the medical and non-medical needs that impact the health of the individual. Armed with technology and the appropriate communication tools across care settings, care coordination allows providers to anticipate patient needs and potential red flags.  

Under the old system, the approach to care and the patient is both transactional and reactive. Interactions with patients center around taking care of immediate health issues, and the patient “advances” in the care continuum as it relates to their need for follow-up treatment.

At Tampa General Hospital, we have begun to invest, plan and implement care coordination across the ambulatory, acute, and post-acute settings.  

In the ambulatory setting, we have developed a robust nurse navigator program at one of our main outpatient facilities — the Tampa General Diagnostic Center in Sun City, Fla. This multi-purpose facility was specifically designed to support patients without existing connections to local care providers, allowing them to walk into the facility (without an appointment) to receive a diagnostic work-up. 

From there, a nurse navigator coordinates all needed follow-up medical care and helps access support services.    

In our inpatient acute hospital setting, we have leveraged CareComm, our hospital command center, which we launched in partnership with GE Health Care. CareComm uses predictive analytics and artificial intelligence applications to help optimize minute-to-minute patient care operations and care coordination with real-time, actionable information. An example of this work is in our effort to combat and manage sepsis — a leading cause of U.S. inpatient hospital deaths and hospital readmittance.

In 2022, we began working with the CareComm sepsis tile — a diagnostic dashboard comprised of technological innovation that focuses both on the early detection of patients at risk for sepsis and subsequent monitoring of management protocols for patients that acquire the disease.   

Since we started focusing on this alignment work, average sepsis mortality dropped to 7.645 percent, and in the fourth quarter of FY 2022, and since the sepsis tile went live, we have seen the average sepsis mortality decrease to 6.190 percent — significantly lower than the national average of 24 percent.   

Our next step in coordinating care across our system is to move beyond the traditional call center to leverage technology into an integrated experience center. The retail industry has done this quite effectively with customer relationship management systems (CRMs), and we must also do it. 

When thinking about businesses that have been wildly successful in terms of customer experience, a handful come to mind — American Express, Apple and Amazon. I would argue that Apple's success is not with its products but with the experience ecosystem it has created for users and creators.  

And so, taking a page out of the Apple playbook, now is the time to reimagine and retool health systems across the country into health ecosystems. We must embrace the fact that we are in the care coordination business.  

But we cannot do this alone. We must partner with venture capital and private equity to help propel our work forward. And we call on the state and the federal government to join us by making substantive changes to health policy that will facilitate and incentivize innovation so that change is not only meaningful but sustainable. Only then can we revolutionize how we care for everyone and make a real and lasting impact on the health of this country and its citizens.

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