authors Cindy Sanders
More than 350 healthcare executives gathered last month for a lively panel discussion on “Shaping the New Continuum of Care.” Hosted by the Nashville Health Care Council, the featured experts represented a range of service providers along the continuum of care and included executives from start-ups to a publicly traded corporation.
Moderated by David Gruber, MD, managing director and director of research for Alvarez & Marsal Health Care Industry Group, the guest panelists were:
- Michael Burcham, founder and CEO of Narus Health,
- Paul Kusserow, president and CEO of Amedisys,
- Travis Messina, CEO of Contessa Health, and
- C. Wright Pinson, MD, CEO of Vanderbilt Health System and deputy CEO/senior associate dean for Clinical Affairs at Vanderbilt University Medical Center.
Technology and data took center stage in the discussion of how to create the most efficient system of care. Finding a way to effectively engage patients and make them active partners in their own care was also a key point.
Gruber started the day off by observing, “We live in exciting though challenging times. Unlike the recent past, the total cost of care across the continuum will matter to the bottom line.” He added there will be winners and losers as healthcare moves from a siloed approach to a more inclusive model that follows the patient.
Pinson noted, “We’ve always had the problem of fragmented care. We’ve always had the problem of communicating post-acute care.” However, he continued, the vision Vanderbilt has moving forward is to address those issues through electronic health records and billing systems to collect key data and uncover patterns. “Through our network partnerships, we are using big data to engage with patients and track results on a larger scale to provider better care,” he said. “there is also huge potential for medical breakthroughs as we create personalized care through genomics data.”
Messina concurred, noting his start-up – which manages home hospitalization programs that allow the delivery of inpatient care in the residential environment – looks to technology to improve efficiencies and allow more time to focus on patient care. “Contessa places tremendous emphasis on support services for providers, whether that be assisting with the interpretation of data or managing the patients episode of care,” he said. “By adding that level of support, providers can efficiently develop patient-specific protocols and ultimately have more time to engage with the patient.”
Kusserow also underscored the importance of data but added that data is still ‘funky’ at present. “To really do the continuum of care well, you need data,” he said. However, he continued, that data has to be shared, include predictive components and acuity levels, and be constantly monitored. “In my experience, payers are in the best position to do this because they have the most data, but the translation into coordinated execution needs work. There are opportunities for outside players from the provider side to help in this execution.”
He added that as reimbursement moves toward quality, working well with others takes on a more urgent importance. “The only way you produce quality is by having a great continuum of care,” Kusserow said. “When people sit down together across the continuum of care and focus on the patient and do the right thing for the patient, you get great outcomes.”
Sharing data to improve outcomes has been a challenge within the industry. The goal of taking knowledge gleaned from individual data and from broader population health models and turning that information into action by engaging patients in their own health management hasn’t lived up to its full potential just yet.
Burcham pointed out the average individual spends 10 to 12 hours a year with a physician and 5,000 hours on self-care. “We focus a lot of time as an industry on those 10 to 12 hours and almost no time on those 5,000 hours,” he said. “Engaging the consumer,” he continued, “is about context and presence. We must pay attention to tidal wave trends, such as social media, mobile access and generational shifts that will shape the way people will receive care in the future.”
He added that those who find a way to actively engage consumers will be poised to have the upper hand. While many of those outside players might fail, some won’t. “The things that push us to change are outside disruptors,” Burcham pointed out. At first, he said, those disruptors are annoying … and then they become competitors.