Managing the Business of Healthcare More Efficiently between Trading Partners - Essay Example

Topic: Managing the BUSINESS of healthcare more efficiently between trading partners In the significant context of managing the healthcare business more effectively in the U.S. among the business stakeholders, it is important to know the prevailing trends. A trend is a general direction and current feature of a business sector that provides clues of the future market. The slow pace of health reforms through Congress, Health Care M&A activity and dollar volume remaining an all time high in all business sectors, it seems that trends will be changing in future for all industries including the health care industry (Katherine 2009). According to Pricewaterhouse Cooper’s Health Research Institute, the adoption of healthcare IT for managing the increasing healthcare costs is one of the top healthcare trends to be of greater concern. According to David Chin, MD of the research institute, the main attention will be on decreasing the rising costs and adding value in the healthcare system, which “will have a domino effect from one sector to another and redefine roles, responsibilities and relationships.” According to the research report, trends will impact the business of medical insurers, hospitals, physician, other providers, pharmaceutical and life sciences companies and non-traditional market stakeholders making entry in the healthcare arena (Manos 2009). Out of the top ten issues demanding attention of the stakeholders, one is related to the role of technology and communications in the healthcare industry. The government has provided stimulus offer in 2009 for broadband funding for the expansion of healthcare IT. Technology and telecommunications companies are partnering the healthcare sector in a big way. Also, the federal government’s America Recovery and Reinvestment Act is a boost for the IT sector as doctors and other providers are in the race to benefit from the Act by adopting healthcare IT in 2010 to qualify for the bonuses in 2011 (Manos 2009). Other trends are also supporting the role to be played by technology and communications, as all stakeholders – hospitals, physicians, other providers, payers and employers -- want to reduce the increasing medical costs. The adjustments in insurance business, payment reforms, entry of new players and grant programs, reimbursement and pricing issues and wider implications of health care facilities with the increasing consumer demand become inevitable with the passing of health care reform legislation by the Congress. A shift will be seen in the role of pharmaceutical and life sciences’ companies, rising to partnering with health care delivery other than manufacturing and supply; these companies will be focusing more on promoting prevention and patient outcomes rather on lab-related outcomes (Manos 2009). Next-in-line will be emerging alternative care delivery models making inroads to care outside doctors’ clinics and hospitals. Medical services will be made available at work sites, retail health clinics, home health services, and technology-supported services like e-mail, tele-health, and remote patient monitoring. Another new emerging trend is related to community health becoming new social responsibility in 2010 supported by employers, health care leaders and community leaders getting funds from the government for promoting community health (Manos 2009). The reason behind the emerging of these trends is the high cost of healthcare in the U.S. All stakeholders to healthcare – insurers, employers, physicians, hospitals, and others are finding the rising medical costs a hurdle in their businesses. It is felt that new medical technologies are responsible for the rising costs and patients are also contributing by selecting flexible plans. Rising costs affect patients indirectly because huge amounts of revenue are written off as bad debt by hospitals but technology is empowering complex systems to work smoothly. Innovations in technology are happening in both areas, in the management of healthcare sector and clinical area also (Plunkett 2009). According to Applied Management Systems Inc, publishing trend reports since 1990, out of top ten future trends in healthcare 2010, the trend is for electronic records to be accessed via mobile phones, which is second only to focus on patient safety. IT will be revolutionizing the hospital operations while insurance companies will make their stronghold by leveraging through contract negotiation (Katherine 2009). The big question is: Can information technology help by coming to the rescue of all stakeholders of healthcare by its business intelligence tools, as healthcare industry is finding it difficult to cope with the sea full of information into usable data-driven intelligence? As IBM has showcased the suite of healthcare analytics in the HIMSS Conference attending to multiple issues like public healthcare quality reporting, personalized medicine, and even dramatic improvements in patient care outcomes, innovative healthcare analytic products can be of big use by providing value through business insight. The existing void in the healthcare sector can be filled via data integration and analysis and help in changing the healthcare canvas for the better. Currently, the disparate processes of healthcare organizations are not capable of adjusting to market changes like pay-for-performance and quality reporting (Plas & Klein 2008). There is huge investment potential in healthcare IT as is evident from the IBM acquisition of Cognos, developing business intelligence software for fulfilling patients’ demand of timely and correct reporting. Promoting performance management through healthcare analytics demands investment in the healthcare IT, which can increase the overall efficiency of hospitals tremendously. By developing a repository of all data, a structure can be provided to it, which through the application of business intelligence tools can help in reducing the costs, inform the consumers, and deliver better in patient outcomes. Workflow issues between the clinicians and administrators can be reduced besides making healthcare possible through demographic computing. Customized demographic dashboard portals with real time information about patients can be accessed by doctors and nurses. Meaningful data mining can be achieved to compete on quality, making it possible to move from static reporting to real time data mining, enabling prediction and modeling of future costs and quality of systems on historical data (Plas & Klein 2008). The ROI has a strong bearing on any investment in healthcare IT. Reporting on metrics can customize processes for better efficiency and further devising of systems on the reporting of metrics can bring transformation in healthcare delivery and outcomes (Plas & Klein 10 March 2008). The flip side of healthcare IT is that Medicare and Medicaid cuts are coming in the way of collaboration among care providers and implementation of IT in healthcare. The current financial scenario is not positive for hospitals because of economic slowdown and government’s fiscal policies to invest in IT systems (Plas & Klein 25 Feb. 2008). Here comes the role of private equity, to raise funds to be invested in healthcare analytics, as neither the hospitals nor the federal and state governments, providers and payers are in the affording capacity. It is also crucial that new healthcare IT applications should be of strategic use, which requires a close working and understanding of healthcare systems involving IT professionals and doctors. Technologies to be pursued in near future include unified communications that link voice, video, data, and mobile applications on fixed and mobile networks. Consumers’ interests regarding the privacy of their health information should be top priority. As such focus should be on identity management and security technologies in healthcare systems. Investment needs to be made in existing security technologies such as firewalls, others like user-access controls and audit logs of patients’ health records. Other important investment areas are developing applications for improving customer care & satisfaction and patient safety. Investment needs to be made in intelligent patient care devices, remote monitoring, patient self-service kiosks, and customer relationship management applications, which will crucially add value in the customer experience over the next two years when the market matures. The healthcare IT will become more competitive in comparison to other industry sectors if the roles of IT professionals are valued for strategic management by providing training to IT personnel in healthcare systems and processes, of course not an investment issue but equally important (Plas & Klein, 25 Feb. 2008). References Katherine, C 2009, ‘Healthcare trends 2010’, CCS, viewed 9 February 2010 from http://careerconsulting.com/wp/?p=311 Manos, Diana 2009, ‘Healthcare IT among PWCs list of top 10 healthcare issues for 2010’, Healthcare IT News, 17 Dec. 2009, viewed 9 February 2010 from http://www.healthcareitnews.com/news/healthcare-it-among-pwcs-list-top-10-healthcare-issues-2010 Plas, J. Vanden & Klein, Mike 2008, ‘Medicare reimbursement cuts threaten adoption of healthcare IT’, WTN News, 25 Feb. 2008, viewed 9 Feb. 2010 from http://wistechnology.com/articles/4563/. Plas, J. Vanden & Klein, Mike 2008, ‘Will business intelligence tools become healthcare analytics solutions?’, WTN News, 10 March. 2008, viewed 9 Feb. 2010 from http://wistechnology.com/articles/4599/ Plunkett 2009, ‘Healthcare Costs in the US’, Plunkett Research Limited, viewed 9 Feb. 2010 from http://www.plunkettresearch.com/Industries/HealthCare/HealthCareTrends/tabid/294/Default.aspx Read More