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.
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?
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?