In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject. Oriana Beaudet is a nurse and vice president of healthcare transformation and clinical leader at Array Architects (Philadelphia). Here, she shares her thoughts on employer-driven healthcare initiatives, artificial intelligence, and the changing role of healthcare professionals.
1. Employer driven health outcomes
Employers are tired of paying for the high cost of care and have started searching for ways to lower costs while improving quality. A Kaiser Family Foundation survey reveals the average cost of health insurance increased 5 percent over the last year, with family insurance coverage averaging $19,500—$14,000 of which was a direct cost to employers. The solution to this cost burden is unclear, but employer-sponsored wellness initiatives have had mixed results. For that reason, the next iteration of employer-driven transformation is the creation of businesses like Haven Healthcareformed by Amazon, Berkshire Hathaway, and JPMorgan Chase to bring together the resources and capabilities of the three companies to create better outcomes, greater satisfaction, and lower costs for employees and families. Walmart, which employs more than 1.5 million people nationwide, has created Centers of Excellence to manage cancer care, orthopedic injuries, and heart surgeries, and has built partnerships with large health systems nationwide to ensure that employees are seeing the best providers possible. This push will create new opportunities for healthcare systems practicing at the highest levels.
2. Artificial intelligence
Increasingly, companies are investing in artificial intelligence (AI) to power everything from voice assistants to translation apps. As it becomes more mainstream, there are enormous opportunities for AI across healthcare. The large-scale datasets owned by healthcare organizations are a huge opportunity for a technology-driven transformation across the industry in areas like precision medicine, population health, financial and operational modeling, and future policy creation. The development of AI will need to include ethical frameworks during the design of this technology to ensure its accuracy. Although the healthcare industry will have unique barriers to implementing AI due to siloed data caused by interoperability between systems and incomplete datasets across electronic health records, the need to build AI’s healthcare capacity is critical for large-scale population health improvements.
3. Reimbursement, policy, and public health
Hospitals across the country are experiencing increasing market competition and stricter requirements for reimbursement. This is requiring health systems to focus on future trends across intersecting industries and health policies impacting the revenue cycle. As criteria for inpatient admission becomes more stringent, increasingly complex care cases are being pushed to lower-cost care settings like ambulatory facilities. Accordingly, Centers for Medicare and Medicaid Services’ new payment model, Primary Care First, will increase reimbursement to health systems as they increase the amount of risk they’re able to manage, focusing financial rewards on “improved health outcomes.” These changes will require robust frameworks to ensure continuity of care, system capacity, and access while decreasing emergency department and inpatient admissions.
4. Redesigning health systems into health
As the financial reimbursement models associated with population health and risk continue to expand, we need to start quantifying the partnerships between health systems and community groups. The Commonwealth Fund has a ROI Calculator to help these partners create mutually advantageous financial arrangements for addressing the social determinants of health, which negatively impact communities. Health systems will have to balance non-traditional growth, like Kaiser Permanente’s launch of a tech platform to track the social determinants of health, with the rapid pace of advancement in acute care settings, including higher utilization of technologically-driven surgical and interventional procedures. Redesigning and distributing services across health systems and within their communities is a unique chance for this industry to bring its biggest ideas to the health strata across our country.
5. Changing role of healthcare professionals
Nurses and medical professionals realize that if we don’t engage in new ways to find solutions for our national and global health challenges, other people will change healthcare without our input. Technology has forever changed healthcare, as evidenced by brick-and-mortar health facilities competing with convenient, user-friendly healthcare experiences created by apps and industry giants. Nurses and healthcare professionals are expanding their training to meet present and future health needs by pursuing non-traditional education and experiences to supplement their backgrounds in science (i.e. angel investing, health startups, climate change, medical device design, computer science) to build new solutions. They have the inside edge with their deep experience, which creates unique opportunities for innovation and transformation. As a nurse, I can wholeheartedly share our profession’s ability to navigate complex systems. Ultimately, the passion healthcare professionals have to serve is extending their reach through broader interdisciplinary partnerships for every community.
Oriana Beaudet, DNP RN, PHN, is the vice president of healthcare transformation and clinical leader at Array Architects. She can be reached at email@example.com.