The New Year is upon us, which presents a good opportunity for healthcare providers to assess their organization's performance to date and identify areas for improvement.
We recently asked the followers of Avanza on LinkedIn to share what they thought should be the top strategic priority for healthcare providers in 2016. We received numerous insightful comments covering a wide range of issues as well as a number of followers messaging Avanza leadership directly to share their thoughts.
While all suggestions touched on important areas, here are six that we believe represent some of the best opportunities for healthcare providers in the coming year.
1. Outpatient services. While many organizations are investing resources into establishing and growing their outpatient services, as is evident in this infographic on the migration of care to outpatient settings, there remains tremendous, untapped opportunities. But this migration must be approached in a thoughtful manner. Just relocating services from the hospital to a shiny new ambulatory care center won't help organizations reduce waste, eliminate redundancies, integrate services or improve the patient experience. Care must be taken in both the facility design and developing operational expectations .
In the 2015 version of its "Impact of Change" report, Sg2 projected a 4% decline in adult inpatient discharges overall and a 19% growth in outpatient volumes over the next 10 years. Does your organization have a long-term strategy in place to capture its share of this volume? If not, make 2016 the year for establishing such a plan to do so and beginning to roll it out.
2. Collaboration. The days of healthcare organizations primarily focusing on treating the sick are numbered. The emphasis is shifting toward how to keep people healthy through population health and preventive care. To accomplish this objective, healthcare services will be delivered not only through physicians, but in collaboration with community providers and other healthcare agencies. Hospitals will need to move much of the job from within the walls of the organization where acute care is delivered to outside the hospital into the community where prevention and early intervention and treatment are based. Going where the population is already living and working as opposed to waiting for them to walk through your entrance is a new focus for hospitals.
Hospitals don't have to tackle this alone, and would be wise not to try. There are organizations in every community with missions that can align with that of the hospital. Working with other providers such as allied professionals and satellite community-based settings can create innovation that utilizes a wide range of resources and can more effectively support patient self-management and family-centered care.
Hospitals should work to identify partners with areas of expertise that will enhance the hospital's resources in the areas in which it wants to grow (e.g., physicians' groups, residency programs, public health entities, federally qualified health centers) and with specialties in areas of that intersection. Integrate collaboration with community providers into the plans for growth in all areas.
3. Patient engagement. With every year that passes, patient engagement becomes even more important. A big reason why: It is a requirement for participation in many shared savings programs (e.g., ACOs and patient-centered medical homes).
Another reason is that people who are active participants in their healthcare tend to have better outcomes and, as AHRQ notes, some preliminary studies have found that active engagement of patients can improve adherence to safety practices. With Medicare and most third-party payors no longer reimbursing for services associated with a preventable adverse event, organizations can reduce their risk by working to engage patients in their care.
There is also evidence to suggest that patient engagement can lower costs. With margins tightening and reimbursement declining, reducing costs should be a high priority for all organizations.
Finally, patients, particularly from younger generations, often expect to be active participants in their care. If an organization fails to cater to this need, patients may view the care experience as less positive, even if desired outcomes are achieved. Patient satisfaction plays a significant role in value-based care, so it must be an area that organizations make a priority.
4. Consumer-driven care. For years, "consumer driven-healthcare" was a hot topic, but there was a general consensus that it did not mean as much as the buzz would lead one to believe. If a physician recommended a certain treatment, referred a patient to a specific specialist or scheduled a procedure at a particular setting, the patient would follow the physician's guidance to a T. But that has changed, and now the true era of consumer-driven healthcare is upon us.
With healthcare consumers facing increased costs in the form of higher deductibles and copays, and with the electronic tools available to explore their healthcare options, patients are increasingly taking the initiative to research their provider's recommendations and identify possible alternatives. These may be alternative specialists and settings, and even treatment options.
Healthcare organizations can no longer assume that people will simply end up coming to them for treatment. It is imperative to stop viewing prospective patients simply as patients but rather as business consumers who have choices and are willing to make decisions that go against the recommendations of their primary care physician and specialists. Healthcare has truly become a business, and unless organizations treat patients as customers whose business must be earned day in and day out, organizations may find themselves going out of business.
5. Innovation. The "status quo" no longer works in healthcare. Organizations that have failed to respond to the rapid changes in the industry are either struggling to survive or have gone under. Organizations that cannot keep up are likely to face the same fate. Innovation must be a priority for all organizations.
Innovation can take many forms, but the objectives are generally the same: pursue and identify ways to provide higher quality, more effective care and deliver it at a reduced cost. Innovation doesn't happen in a bubble. It takes hard work, creativity and, usually, collaboration. Some attempts at innovation fail. But despite the risks, organizations must explore opportunities to bring innovation into their facilities and communities.
6. Iterative design. Iterative design is a newer concept in healthcare, but a common concept for IT startups and other new business development. Iterative design is a process through which a product or service is improved over time, with new "iterations" of the product or service coming to the market over time.
In healthcare, new services go through tests, revisions and extensive polishing before they are launched. A new service will only be provided once the desired result can be achieved the moment the service goes from development to reality. While this approach may seem practical, there is a significant problem with it: the time needed to go through this extensive process can — and often — results in the service being outdated, or close to it, by the time it actually launches.
In business development, the use of iterative design allows a company to launch a product or service with room to improve and grow. Users of the product or service benefit from the concepts included in the initial product or service launch, and can provide feedback to the developers. Developers are also able to evaluate the performance of the product or service to identify improvements to incorporate in future iterations of the product or service. As these future iterations are launched, the process repeats itself.
Another benefit of iterative design is it allows for issues that may not come to the surface until a product or service is launched to be identified and fixed before they become problems that can ruin a completed project.
Healthcare is ripe for iterative design, for those organizations willing to break away from what they find comfortable. As long as the use of iterative design does not jeopardize safety or quality, the benefits of iteration in healthcare can be substantial. Ideas that have the potential to improve some aspect of an organization's performance can be implemented and tested. Those that succeed in their objectives remain in place and are explored further and gradually improved. Those that are unsuccessful can be scrapped, with a return to the previously used process.
Over the long term, the benefits of using iterative design to bring about improvements should easily outweigh time spent on an idea that turns out to be unsuccessful, and the benefits of the new ideas that are implemented successfully and developed further will be felt for years to come.
Joan Dentler is president and CEO of Avanza Healthcare Strategies, which provides healthcare organizations with strategic guidance, with a focus on outpatient services and population health management.
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