Enabling health care delivery in the community

One of the aims and consequences of health care payment reform is pushing care to lower cost settings. More and more, we hear this means treating patients in outpatient settings or in their homes.

So, it is with great interest that I attended the Massachusetts Technology Leadership Council's seminar  on How Technology is Enabling Dynamic Community Care Teams.  My goal was to learn more about:

  • the kinds of care providers are delivering at patients' homes and in the community,
  • why pundits view home and community-based care as essential to improving health outcomes and minimizing costs
  • which technologies contribute to delivering these results and why

Care delivered in the community

As it turns out, the patients most likely to receive care in the community are those that are well, recuperating, or have a chronic condition.  For these individuals, the key to getting better is ensuring that their care progresses according to plan.

Usually, a health care provider develops the plan upon examining the patient in a clinical setting.  The community-based care centers around:

  • ensuring patient compliance,
  • monitoring specific measures to ensure that patient is achieving desirable outcomes, and
  • alerting providers to either problems or unanticipated delays in recovery.

Why community-based care is cost-effective

Community care is cost-effective because its administration doesn't depend on the technical or human resources available only in higher-cost inpatient or outpatient settings. Instead, providers can address patients'  needs with a combination of media, remote monitoring, and lower cost community care providers.

Technology can aid in delivering media and remote monitoring, and sometimes reduce the number of visits lower-cost community care providers need to make to the home.  This means that patients can receive care where they prefer to get it: in a familiar setting and among friends and family.

It's all about the relationship

Perhaps the greatest surprise of today's technology conference is that the importance of human relationships took center stage.  According to keynote speaker, Rick Siegrist, CIO at Press Ganey, patients' satisfaction  and health outcomes depend most on the emotional connection with the caregiver.

As the speakers explained, patient engagement matters more than anything else.  Patients need to understand their care plan.  They have more control over their recovery than anyone.

Some need a personally meaningful goal to motivate them to act.  As one speaker said most patients are more interested in attending an upcoming family event, such as a wedding, than improving the level of a medical statistic.

Patients  need confidence that they can manage the disease process.  And according to another speaker, there needs to be a sustained connection, so that patients can interact with their health care providers when needed.

Technology is great when it works

As the speakers noted, technology can help providers deliver the right information at the right time without requiring a separate home care visit.   And, equally important, technology helps strengthen connections between the patient and the care team by facilitating the exchange of information each party finds valuable.

Technology also helps enforce clinical protocols.  For example, it can prompt providers to get answers to important health status questions they might otherwise forget to ask.

Desired improvements

Nevertheless, both panel and audience members expressed frustration with technology gaps and complexity.  At present, much of the technology is still hard to use. Moreover, it floods caregivers with data-rather than presenting just the information they need, the way they need it.  There is also a need for industry standards.

For technology to be truly useful, caregivers  need filtering, the ability to customize content and presentation by user, and full integration with their own and others' systems.   Regulation will drive some of these changes.  As one panelist said, "Look for future releases."

 

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