Follow the Human, Not the Dollar, to Transform Healthcare

In most industries, you can “follow the dollar” to identify ways to gain efficiencies and areas for innovation. In healthcare, however, following the dollar does not lead us to the best or right answers. Rather, the flow of the dollar is a symptom of a system that was developed over decades as a transactional system of record. We have to flip the typical transformation paradigm, leading with innovation and what’s best for humans, and the economics will follow.

Whether a frustrated patient who can’t access their health record or an exhausted clinician who spends more time on administrative tasks than providing care, people experience healthcare that’s inconvenient and doesn’t fully address individual needs—and, while the specifics of the challenges change region by region, it’s a global issue.

As we continue to recover from the turbulence and extraordinary challenges of the past few years, we have an opportunity to embrace the potential for tremendous growth and change. The COVID-19 pandemic taught us that not only can we tackle a crisis, but we must also innovate data for a healthier future.

To succeed, our industry must use the lessons learned over the last few years to prioritize the human experience and acknowledge the challenges that exist in today’s healthcare system. To truly build a healthier future, the dollar should follow innovation, not the other way around. But how do we do that? This requires industry collaboration on data-powered and human-centric technologies that are connected, accessible, and usable by consumers and clinicians across the continuum.

The value of collaboration versus competition

Technology absolutely can and will be an accelerator for changing the face of healthcare; however, technology alone will not solve the challenges around intelligent and secure data sharing, and resetting the attitudes and paradigms in place today. The real solutions will require many parties to come together across policy, process, standards, and cooperative agreements.

The finance, hospitality, and retail industries have come a long way in optimizing the consumer journey by integrating technologies that put consumer preferences and recommendations at the forefront of the user experience. Why is it that in healthcare, where the user experience and outcomes can have a life-or-death impact, we’ve fallen behind?

Hospitals can feel hesitant to share treatment data with other research centers, and information siloes exist even between departments within a single organization. For example, the radiology department and an outpatient physical therapy center within the same hospital system may not exchange data. Imagine the ripple effect this lack of interoperable, collaborative data may have on patient care within, between, and across organizations in different systems. Without fully understanding the whole person—medical history, medicines, surgeries or procedures, life circumstances such as income, and status—critical inputs aren’t considered during diagnosis and treatment and may ultimately result in poor patient outcomes.

With a common goal to improve the health and well-being of individuals and communities, we should focus our efforts on collaboration rather than competition. In the worst days of the pandemic, we worked together within and across industries to track, contain, understand, and treat a deadly virus that spread and evolved rapidly. Our willingness to share information and resources also helped us develop and distribute vaccines faster than anyone imagined possible. A great example of the power of collaboration in the US is the Michigan Hospital Medicine Safety Consortium, which launched a statewide database to track COVID-19 hospitalizations and identify important risk factors for severe illness just one month after Michigan’s first documented case. The result was a publicly available risk calculator that helped clinicians estimate patient risk on a case-by-case basis. Similarly, other health systems across the country also teamed up to combat the public health emergency.

Preventing complications, averting patient hospital admissions, and reducing unnecessary care saves money, too. Ultimately, Michigan’s Collaborative Quality Initiatives have saved an estimated $1.4 billion in healthcare costs. According to a study conducted by the RAND Corporation, the costs of care in Michigan are among the lowest in the country. Other states such as Illinois and Wisconsin have now adopted this approach to improve care and reduce costs in a similar way.

During a keynote presentation at Oracle CloudWorld, Oracle Chairman and Chief Technology Officer Larry Ellison emphasized improving health system connectivity, automation, and ultimately patient health outcomes is a far greater challenge than any organization can take on alone. “So, we have to build a platform, not just a healthcare application or series of healthcare applications,” he said. “We can build some of those. But we have to build an open platform where others can innovate and plug in their technology.”

By creating open solutions, such as extensible architectures and technologies that support interoperability, providers benefit from information exchange to deliver better care. Data must flow seamlessly between consumers, providers, payers, and public health organizations in a meaningful manner to ensure easy, secure, and quality access to medical records, treatment summaries, risk factors, determinants of health, and billing statements as needed. FHIR is making strides to revolutionize these critical aspects of health information exchange and interoperability.

Fostering different forms of alliances can promote an ecosystem that collectively resolves the healthcare problem. Collaboration also helps expand the customer base of collaborating organizations, and each can use the technical expertise of their partners. Competition is often seen as the best way to provide better care at lower costs. However, these examples illustrate that collaboration may be just as, if not more, effective in achieving this goal.

The critical need for digital modernization

From patient portals to mobile care team communication tools, when technology is human-centric, data-driven, and agile, it can help healthcare organizations enhance collaboration, reduce costs, and create a more compassionate, holistic, equitable, and sustainable experience.

Even with the myriad benefits of digital modernization, the upfront investment of time and money can be daunting. It’s easy to see why an enterprise may be tempted to stick with its older, established architecture. This isn’t a unique challenge to healthcare. Modernizing, let alone innovating, is a complex and ambitious decision for any organization to make. However, when an organization is reliant on legacy systems, its patients, clinicians, and payers can suffer from roadblocks such as:

• information siloes
• cybersecurity vulnerabilities
• limited collaboration
• inhibited innovation, and
• a lack of data-driven informed decision-making

The decision to evolve systems of record is not an if, but a when. Many health organizations are on the brink of these decisions as they evaluate technology that’s fragile and out of support, workforces that are scarce on talent for outdated skills, and need to attract, retain, and serve their patient populations differently. Our goal is to work toward the future with the least impact on existing health system operations.

The tri-modal approach to healthcare transformation

As we strive to put humans at the center of care, how can we be innovative and efficient while also addressing practical cost concerns?

Many healthcare organizations operate bi-modally, with tension existing between the systems of record—a single source of truth that’s historically legacy and hard to change—and systems of engagement—applications that are more customer-centric and easier to change.

In contrast, tri-modal strategies allow organizations to integrate and enhance their internal processes (systems of record) and people-centered digital offerings (systems of engagement) while elevating systems of intelligence that include AI.

With a tri-modal approach to improving health, we have the potential to:

• Leverage technology to securely store, process, and analyze large volumes of data to break down siloes and synthesize the information available on the cloud
• Enhance interoperability and gain actionable insights that identify patterns, guide treatment plans, and improve care delivery
• Connect end-to-end processes that support front- and back-office operations, revenue management and billing, health insurance operations, clinical trials, research, regulatory compliance, and public health management systems.

Dissatisfied patients and burdened clinicians don't have to be the norm in healthcare.

Through collaboration and human-centric technology, we have an incredible opportunity to improve health and wellness for individuals and communities. By choosing to prioritize what’s best for people rather than following the dollar, healthcare can be streamlined, transparent, and data driven. Combined brainpower and technologies have greater potential to impact change than individual players; this tenet is true whether in financial services, education, or healthcare. We can empower innovation that disrupts the status quo and enables affordable, efficient, and optimized care for all.

With our full suite of integrated clinical and business applications, Oracle Health driving innovation beyond the electronic health record. We’re committed to partnering across the ecosystem with care providers, major technology system vendors, independent software vendors, researchers, pharmaceutical companies, governments, and global organizations. Together, we’ll leverage infrastructure, cloud-enabled capabilities, modern user experiences, and systems of intelligence to help improve healthcare globally.