It's been a while since I wrote the first blog post and I told you that I would post something each month. Well...life happens! I'm also not great about talking about my personal or professional life. Instead of writing about my daily, monthly, or yearly highlights and downfalls, I just continue to live them out and do my best work. Ok, enough of explaining my procrastination. In August 2023, I moved into a new role at the university as Associate Dean of Health Sciences. I had been the founding PA program/department director for the past 10.5 years and it was time to hand the reigns over to a senior faculty member who has built the program alongside myself and a few other great people. In my new role, I plan to support all undergraduate and graduate healthcare programs in our college as well as provide ongoing support to the Dean and upper level administration. So far, things have been going well and I am excited to work with a greater number of hardworking individuals to assist in sustaining their wonderful work. Ok- there's a short update on the new position.
Now onto a few areas that I am passionate about on the research and policy side of healthcare. As we know, healthcare is evolving in ways that continue to be inconsistent, fragmented, and dollar-focused which presents challenges to providers, patients, hospitals, health plans, and other stakeholders in our messy U.S healthcare system. Why is it that we provide care on a fee-for-service arrangement (as the majority) and continue to see health outcomes that are inferior to many other globalized as well as some developing countries? Continuing down the traditional fee-for-service path creates not only provides incentives for providers to enter heavy procedurally oriented specialities but also doesn't allow for accountability of patient outcomes. But...is this the best model? We have gotten a lot further in the past 10 years at least talking about value-based reimbursement and value-based care but there are many issues preventing the full adoption of this model in the U.S. Can providers and hospitals still be paid on a fee-for-service basis and provide better care to patients? The answer is yes, with the appropriate mindset, resources, and long-term vision for what a hospital should look like in the future. Back in the 4th century AD when the notion of a "hospital" came into existence, it was a place for extremely sick people to go prior to their passing. Hospitals now have only a small percentage of these types of patients and the rest are there for maybe a more milder course of illness or at least for a defined period of time. Why are hospitals now treated like a hotel? Why do we admit patients for social reasons? Why is the hospital admission the default when we need further testing? Don't get me wrong, the U.S. has some of the best hospitals and health systems in the world and we have so many great people who dedicate their lives to taking care of the sick and injured but, is there something better? Is there a better way to take care of patients? Can we achieve better outcomes without significantly changing the ways in which providers are compensated or exploring compensation models that actually result in a greater quality of care?
The future of healthcare is outside the walls of the hospital. It is a digitally integrated platform that allows for real-time communication and data dissemination between patients, providers, health plans, and other entities. We now have the ability to keep people healthy so they don't need the emergency department or the hospital admission. Here is a brief list of strategies that can move U.S. health systems to become more sustainable, patient-focused, and technology enhanced:
Hospital investment in the community surrounding education and nutrition. The hospital has many resources including purchasing power, human capital, and expertise to assist with supporting people in the community and partnering with other non-profit agencies with a common goal in mind- educating for the future and maintaining a healthy lifestyle.
Digital workflow integrations to allow for greater communication with patients before they step into the hospital or clinic. Providers can recognize problems early and prevent exacerbation of the illness, avoiding an ER visit or hospitalization. Equipping patients with the appropriate resources or devices to aid achieving a healthy body and mind.
Care coordination. This is a key factor in achieving quality healthcare outcomes. When examining the Patient-Centered Medical Home (PCMH) model, there are many factors taken into consideration. Based on some of my prior research, care coordination and communication were the only statistically significant factors that enhanced access and quality of care in patients who sought care within or outside of a PCHM model.
Telemedicine. Patients love having access to a provider. In addition to digital workflows, patients can now see their provider from the comfort of their home. This model removes any transportation barriers for the patient and potentially other financial constraints that would traditionally impede their ability to see a provider in person.
As hospitals become more technology driven and as we continue to educate a new era of tech-savvy providers, our list of resources is potentially unlimited. Patients also have greater access to devices and programs that can help keep them healthy and provide a greater sense of empowerment. The traditional hospital today will soon be something of the past. If we continue to enhance our technology, connecting providers with patients, we will see large gains in access and quality of care that we provide. ER visits and hospital admissions will fall as patients will receive care in alternative ways which are cheaper, more accessible, and patient-centered.
