What Would New Care Delivery Models Look Like If Created Today?


This tweet has been on my mind the last month. I’m sure that many in the trenches probably think that this type of thinking is a pipe dream and not worthy of discussion. While it’s true that we can’t go back and change the past, this type of thinking may predict where we need to go in the future.

I and many others have long talked about the way EHR software was built to maximize billing and then meaningful use. The focus of the EHR was not on how to improve patient care, but was really built around how the organization could manage it’s billing and make more money. So, we shouldn’t be too surprised that the EHR systems we have today aren’t these amazing systems that dramatically improve the care we provide.

With that said, there’s a sea change happening in health care when it comes to how organizations are being reimbursed based on value. Might I suggest that an organization that wants to be ready for this change in reimbursement might want to take the time to think about what care models would look like if they were created from scratch today without the overhead of the past.

I’m not the only one thinking about this. Check out this tweet from Linda Stotsky that quotes Rasu Shrestha, MD, MBA.


In the article that’s linked to in that tweet Rasu describes the real challenge of rethinking our care models:

What does it truly mean to have a patient-centered approach to care? As a clinician, I can tell you confidently that most of my colleagues tend to get defensive amid talk of the need to adopt a patient-centric approach to care. “Of course, we’re focused on the patient!” seems to be the most common reaction. Many simply assume that because care is essentially imparted onto a patient, everything we do, naturally, is patient-centric

Then he offers this frank comment:

But where is the patient in all of this? Is a system designed to help document our attempts to cure the patient, and help bill for the associated services, really the best we can do? Perhaps the problem is bigger than just the EMR. Perhaps our frequently paternalistic, and often heroic, approaches to care have been cherished, celebrated and incentivized for far too long. Perhaps we need to rethink care in a big way.

I agree with Rasu. He also quotes Ellen Stoval, survivor or three bouts of cancer who says, “We have been chasing the cure, rather than the care.” I’m actually optimistic that these changes are happening. We’re going to see a drastically improved health care system. It’s going to take time, but most changes do. What’s most exciting is that if we navigate these shifts properly, then doctors will finally get to practice medicine the way they imagined medicine. Instead of churning patients to meet revenue, they could actually spend more time caring for patients. That’s something worth aspiring towards.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • The model will likely not change much until the insurance and payment model changes. Perhaps mandated health savings accounts — something like the Chilean model. Those old enough may remember how care-free (and cheap) health care was before third-party insurance became the norm.

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