Andrey Ostrovsky, MD, a physician and social entrepreneur from Harvard Medical School, Boston Children's Hospital and Boston Medical Center is Co-Founder and CEO at Care at Hand and a Healthcare Transformer at StartUp Health. He'll offer Health Care in Transition attendees strategic insight on how using innovative, disruptive technology can improve health and reduce readmissions for vulnerable populations. He spoke with reporter Liz Seegert about his upcoming workshop.
HCTR: Our "Healthcare in Transition" seminar is coming up next week and you are one of the featured speakers. Your session is titled, "Patient Facing Technologies Improve Quality of Life, Patient Independence, Readmissions." What can attendees can look forward to taking home from your presentation?
AO: I'd really like to hone in on changing reimbursement structure - transitions from fee for service to quality outcomes. There's no roadmap, no one has shared the recipe for "here's how organizations in the post-acute care space can follow the following steps, throw in the following spices and ingredients, swirl it around, take it out of the oven and here you have a viable business model, a nice pattern of care delivery that feeds into the new model but uses existing machinery of post-acute care."
A lot of organizations I speak with don't understand how to transform their current processes into value based care delivery. I want to show at least one recipe that seems to be working and we're starting to produce an OK-tasting product in all of this and show how it can work for care transitions. I think it's very timely, because I think care transitions are just on the cusp of becoming this "sexy new thing."
HCTR: Can you persuade people that change is sexy?
AO: Care transition is a manageable and more digestible morsel of system redesign. It does not require an ACO, it does not require an entire state to adopt a Health Information Exchange or some technology product. Care transitions are something that small organizations can implement using certain evidence-based processes. A lot of this has been done in controlled environments so far, and there are huge gaps between theory and practice, and building a business case; so I'll share some of the crosswalks of what are some of the best practices of care transitions.
There is a role for technology to insert itself and make those best practices limitations in the real world actually viable and scalable — from the perspective of the triple aim, and from the perspective of home care providers, community based organizations and other players. I want to make sure that there is actually a solid business case to move away from fee for service.
HCTR: Why do some home care companies seem fearful — or at least quite reluctant — to embrace technology in this new model?
AO: If the precedent for technology is EMRs, and some – not all – of the billing and payroll software, they should be very afraid. As a physician who is painfully suffering through using an EMR, I know most EMRs are the opposite of patient-centered, the opposite of a well-designed user experience. The EMR companies really never had an incentive to design well. And that's a problem for patients, because providers are frustrated and things fall through the cracks.
HCTR: So what's different now? Why aren't they kicking and screaming if past experiences have been so poor?
AO: Good point. In a world of very small margins, not just home care, but all of post-acute care has to find ways to be more cost-conscious. There are a lot of technologies that are a little duplicative, basically going after the billing/payroll/reporting plank, and that's fine, because it does solve problems for the customers.
The role of technology, I think, is to disrupt, but in a productive way that ultimately redefines the patient's experience. Those are big aspirations but, on the flip side, those huge changes actually come with very gentle implementation. So instead of having a behemoth billing/payroll system or giant EMR, which is disruptive in a bad way because it takes years of planning and implementing and causes headaches and slows things down, and ultimately imprisons you in a giant silo, we need to ask, "what's the best way for the provider to work?" What's the best way for the patient to interact with their own information? The [existing] design is more about whether salespeople can get their foot in the door.
HCTR: Is it up to the tech community to do things differently?
AO: It should be the responsibility of the technology community to solve problems. Thinking a little ahead for their sake - what are the implications of what we do, not tomorrow, but the day after tomorrow? Or next week, or in two years? If we put ourselves in our customers' shoes, thinking about their needs now and two years from now and their pain points now and two years from now, and if that's the prism through which we design, that process would redefine a lot of the technology that's being created today.
We took that approach at my company, and we had these grand ideas and we do one thing, one tiny thing. We focus on one user. If you're a non-clinical person, out in the community, that's it. We don't want to have a billion different features for a billion different users. We want to hone in on just one specific problem, and really execute on that. I think this ultimately benefits providers in the post-acute care space and ultimately give providers better options to choose from.
HCTR: What's the bottom line message you want next week's seminar attendees to take back home?
AO: I would implore providers to take the risk of investing in businesses processes and technology for the sake of aligning care with the new financial incentives coming down the pike. So somehow – by scaring them or inspiring them – I want to show them that the tools and expertise that can help people do this are already there. If I can get a few folks to convert from the old-school, fee for service mindset, and start to make effective pitches to hospitals about reducing 30-day readmissions or to ACOs about helping them thrive under a Medicare shared savings system, then I will have given them something valuable.
"Healthcare in Transition" runs Sunday, April 13 through Tuesday, April 15 at the DoubleTree Paradise Valley in Scottsdale, AZ. Register at http://RowanResources.com/THRIVE.
©2014 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org