Filling the Knowledge Void in Healthcare

In my previous post, I had written about how Health Counsel Providers (term courtesy Sunil Chiplunkar) can help fill in the predominant knowledge void in patient care. This is needed because health care is a different business model. Business models are generally defined in terms of a shareholder value model: high performers consistently deliver superior returns to their shareholders through industry and economic cycles and across changes of leadership. Healthcare is different because the diversity of the provider market and the multitude of individual business situations within it means that what actually constitutes high performance will vary, provider by provider. In the case of a managed care program such as a disease management (DM), high performance value should be measured by two broad categories—improved outcomes and increased business excellence (patient retention in the program driven by superior service). These two categories are further broken down into several distinctive capabilities—clinical quality, customer satisfaction, operational performance and financial longevity for the program.

In this project, the provider must always achieve business excellence that is driven by operational effectiveness which leverages information and resources to enable more informed clinical decisions. Improved decision-making helps both, doctors (customer satisfaction & clinical quality) and the provider (operational performance & financial longevity), better achieve high performance. The next step for success, then, is to develop strategies to monitor and track trends and performance.

I think we can measure performance efficiently and effectively in a hospital setting through the smart use of technology. Business intelligence – a group of tools (discrete or combined in software form) that collect and analyze internal and external data to generate knowledge and value for an organization – can help to support decision making at a strategic, tactical and operational level. Business intelligence tools embedded in hospital software can help the hospital take immediate action to address itsunderperforming areas, thus creating better value for its patients.

This will help both the doctors and the providers (hospital) accrue the following important benefits:
1) Effectively measure performance of doctors and service providers
2) Improve agility and responsiveness to changing healthcare delivery scenario
3) Align around common reporting and standards at the hospital (especially if it is a chain operating in multiple cities)
4) Increase organizational competitiveness
5) Data collection over long periods (useful for Outcomes Research to demonstrate value of managed care)

I think this will help both doctors and hospital/nursing homes review the progress of the value that they deliver from outcomes driven by improved clinical quality, which can be achieved through increased patient safety and satisfaction and a focus on regulatory compliance. They can also measure customer satisfaction through ratings from a broad constituency, including patients who receive medical services, physicians who choose such programs for their patients, care-givers and hospital employees. Therefore, I think programs such as DM can be used to specifically measure and monitor the distinctive capabilities overall healthcare delivery: clinical quality, customer satisfaction, operational performance and financial longevity.

Healthcare should soon be seen to achieve high performance consistently, accommodating evolving standards and delivering excellent patient care. Doctors and hospitals should strive to increase satisfaction among all important stakeholders. This is probably the ONLY way that India can make a mark as a high-quality, reasonable cost healthcare destination.

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