Nearly every industry in the United States has become part of the on-demand economy, where consumers can get what they want, when they want it, and sometimes before they even realize they want it. Media, banking, grocery shopping—just about everyone has had to adapt to the Amazon effect.
Healthcare is slowly being pulled into this vortex of convenience and effectiveness. Within the last year, 71 percent of all medical practices have reported making changes to reduce patient wait times, according to a poll the Medical Group Management Association did last year. That is a good thing.
But it is not nearly enough. We are not close to getting the outcomes we say we want: better care and more satisfied patients at lower costs.
I know healthcare is a notoriously complex system with costs nearing 20 percent of our total GDP. Somehow, some way, healthcare needs to get a lot more efficient, and that means reimbursement will be tied to delivery of actual outcomes.
The frontline players—patients and physicians—will have to be bigger drivers of the change we need. Patients are going to have to demand more and doctors are going to have to deliver more on outcomes and accept that part of their compensation is going to be tied to that.
In fact, I would suggest that physicians build their data analysis and communication skills to articulate what measures and metrics actually do promote better health and better outcomes, long before those benchmarks are set for us. After all, big tech, payers, and investors are perhaps more incentivized than we are to manage costs. Healthcare is a big, juicy market to “disrupt.”
Here’s what the industry needs to keep in mind through this transition:
Focus on outcomes
In the search for quality, are physicians asking the right questions? We stuff our EHRs with data, but is it the right information and is it being used to the greatest effect? Data does not inevitably create discernment.
We need to reverse engineer the process. Let’s start with the desired end result and work backward from there to build processes and compensation models that reinforce the desired outcome, rather than what we’re doing now. My fear is that we’re waiting for someone else to do it for us. Or, perhaps more accurately, to us.
According to a 2016 MGMA poll, “Only 26 percent of physician compensation plans are tied to quality metrics.” That makes us sitting ducks in the eyes of efficiency players in the technology and logistics world.
Even as there is this disconnect, physicians are asked to manage too many metrics—4,000 data points at our last count, which doctors are forced to enter manually into EHRs after each appointment. Yet, we haven’t stepped back to ask whether or not these metrics are actually helping us to deliver the outcomes we want. I believe doctors want to influence clinical outcomes, but that’s hard to do when spending twice as much time on paperwork than with patients.