The challenge of delivering quality healthcare at a lower cost

The pressure on costs seems to be never ending for those involved in the delivery of Healthcare to an ever-aging patient population, especially with increasing co-morbidities and therefore complexities for our clinicians to address. Often the words ‘cost reduction’ are seen as very negative and the view is often that cost reduction will lead to a decrease in the quality of care and therefore the two words quality and cost should not be seen together such as in the title of this Blog!

In the NHS 5 year forward view (1) the definition of quality in health care, includes three key aspects: ‘patient safety, clinical effectiveness and patient experience. A high quality health service exhibits all three.’ Part of the aims of the 5 year view were ‘to narrow the gap between the best and the worst, whilst raising the bar higher for everyone’.

It’s this clinical effectiveness that I’d like to focus on to address the challenge of this Blog.
Improvements from clinical effectiveness can come from many areas but as someone who has spent the past 18 years involved in enterprise IT solutions, I passionately believe that good clinical IT systems can save clinicians a tremendous amount of time, help to accurately and quickly diagnose morbidity and support the standardisation of care, all of which should lead to an increase in treatment quality which ultimately leads to a reduction in cost.

In a recent report on variations in care, the Advisory Board found that ‘High-quality hospitals deliver lower-cost care for 82% of diagnoses’ (2). The article goes on to say “Clinical leaders have long sought to improve care quality by reducing unwarranted care variation.” and the article notes that health system CEO’s and SFO’s are actively pursuing the reduction in CVR (Clinical Variation) as a necessary avenue for withstanding the cost pressures on hospital revenues.

So if delivering better quality care doesn’t necessarily mean more expense overall why isn’t everyone achieving this?
In his book, ‘Best Care at Lower Cost’, Dr Mark Smith, founder and former President and Chief Executive Officer of California HealthCare Foundation, wrote in 2013 that “about 30 percent of health spending in 2009, was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state”. Dr Smith goes on to say “Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better”.

So we have evidence that higher quality hospitals deliver lower costs and a clear call that better use of data is a critical element in the desire to deliver better care at a lower cost.

Complex enterprise IT systems, EHR’s, EMR’s and EPR’s (select the most appropriate for your organisation but you almost certainly have one) have all promised much, and I truly believe they are part of the digital healthcare solution. However, they are often seen to fail to deliver on the clinical promises that they were sold on.

They can accurately record patient data, albeit often creating a silo of data that then needs to be integrated into yet another larger silo, but clinicians complain that they aren’t intuitive to use and state that they increase the time taken to record patient information, leading to less time available to care for the patient. Often the cost of the software is far outweighed by the cost of deployment and configuration, the latter being seemingly bespoke for each hospital.

Isn’t it time for a system that doesn’t have to be taught each workflow, that gives more time to clinicians by allowing them to interact normally with their patients as part of their consultations and that supports them during that consultation with intelligent prompts?
Here at Infocare we believe so, interested? Then visit our website at www.infocarehealth.com or click here to watch a video all about it https://youtu.be/N7n0IHmHyXc

• https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
• https://www.unitedhealthgroup.com/newsroom/2018/2018-10-03-hospitals-lower-cost-care.html

Darren Ransley
VP Business Development & Product
E: darren.ransley@infocarehealth.com