Examples of healthcare transformation include the digitalization of healthcare records; the use of more advanced scanners; and telemedicine. The benefits include improved public health; better workflows; and lower operating costs.
To gain an insight into these trends, Digital Journal spoke with Steve Whitehurst, who is the CEO of Health Fidelity. Health Fidelity delivers scalable risk adjustment solutions for risk-bearing organizations that participate in the U.S. healthcare schemes: Medicare Advantage, ACA, Medicaid, and Medicare ACO programs. The company uses big data analytics and natural language processing technology to extract insights from medical charts, to change the way risk is identified, quantified, and managed.
Digital Journal: What is the state of healthcare today?
Steve Whitehurst: America’s healthcare industry is in the midst of a metamorphosis; it’s struggling to shed the fee-for-service model that has outpaced other developed countries’ spend [as a percent of GDP] in order to embrace the brave new world of value-based care; a model where reimbursement is based on quality, not quantity.
The main constituents: insurers, providers, patients, vendors, and regulators are each trying to decipher how they’ll fare in this new paradigm and investors are speculating with record-breaking amounts on potential infrastructure and technology advancements to accelerate the transformation.
DJ: What are the main problems faced by providers?
Whitehurst: Providers are probably under siege the most at present; many health systems have been experiencing revenue pressure, higher costs, and margin erosion for years, so not surprisingly, consolidation, collaboration, and commercialization strategies will continue as they consider different ways to ensure financial viability.
DJ: How is healthcare being disrupted by technology?
Whitehurst: The same trends that are happening in the rest of the consumer world are impacting healthcare; data is proliferating, wearables and tracking devices are becoming more prevalent, smartphones are enabling continuous connectivity, all while the pace of innovation continues at unprecedented levels – look no further than the progress of human DNA mapping for evidence.
DJ: What are the main technologies?
Whitehurst: Exponential technologies like 3-D printing and nanotechnology, biometrics and sensors, and cognitive computing via Artificial intelligence (AI) and machine learning are paving the way for remarkable changes to the delivery, treatment, and reimbursement of care.
DJ: What does the state of healthcare look like in the three years time?
Whitehurst: In a few years, it’s no longer going to be an option for health plans and providers to not collaborate, it’s going to be a mandate that they do in order to be successful in a highly competitive healthcare landscape. How you work with your partners will become absolutely crucial to improve your outcomes and get better results for patients.