Last week, flying into Atlanta Hartsfield Airport, I boarded the plane train and looked around all of the people on the train. Everyone was intently staring at their mobile devices as if our phones controlled everyone’s next step. Reliance upon our mobile telephones and technical devices has become an epidemic. Many of us do not leave the house today without having our phones attached to our side or in our bags. Our mobile devices connect us with work, family and social outlets.
The increased importance of mobile technology on our day-to-day activities also impacts how healthcare is going to be delivered and how providers will ultimately be paid in the future. Specifically, the Patient Protection and Affordable Care Act (“Healthcare Reform”) created the Shared Savings Program, commonly known as an Accountable Care Organization (“ACO”), which intends to integrate providers to fully engage patients and deliver care through patient centered protocols. In order to integrate providers, ACOs require providers to coordinate services to reduce the costs of delivering healthcare. In addition to coordinating services to reduce costs, providers are required to report on thirty-three (33) quality metrics to ensure quality patient outcomes. Providers will not be eligible to share in any of the savings achieved through the coordinated care unless the providers meet the quality level benchmarks set by the federal government. Seven of these quality metrics focus upon the patient and caregiver experience.
Thus, under ACOs if a patient has a bad experience with a physician or a hospital, the provider’s likelihood of payment will decrease. If healthcare providers can improve the patients’ experience and the patients’ healthcare outcomes, the provider’s score on the patient caregiver experience metrics should exceed benchmarks which ultimately supports the provider receiving increased payments. Therefore, in ACOs, hospitals and physicians are looking for ways to engage the patients to be part of the healthcare delivery system and improve the patients’ experience and outcomes.
What better way to engage patients and to make patients more accountable for their care, than to go directly to the device that they hold in their hand every day. Mobile devices have changed our behavior from picking up the phone and calling one another to now texting, face booking, and scanning bar codes to buy goods. People’s behavior has changed based upon the everyday use of mobile applications. Now healthcare is going to change based upon on how mobile applications change the patient’s engagement with the healthcare provider.
One ACO example would be if a hospital and a cardiac surgeon partner together and implement patient centered protocols to redesign the delivery of care. The protocols should drive quality outcomes, resulting from a more efficient surgical experience, by integrating the hospital and the cardiac surgeon processes together to focus upon the patient. Specifically, the patient centered protocol may require a patient to utilize a certain type of diet prior to surgery, the patient would have blood work done prior to admission and participate in a post-surgical rehabilitation program. If the patient is engaged to eat right, get the lab work done timely and participate in the exercise program, the likelihood of a successful patient outcome should increase.
Mobile technology is an integral part of how the cardiac surgeon in the hospital can go beyond bed-side care to engage the patients to be partially accountable for how the delivery of care is provided to them and how to keep them out of the hospital following surgery. Specifically, mobile technology is a tool that will help patients know what nutritious diet they will need to consume prior to and following surgery. The mobile devices can also remind the patients about their need to have pre-admission lab work done and what types of symptoms to look for prior to surgery and after surgery to help them recover faster. Mobile applications can also provide an exercise program for patients who have certain types of diagnoses to help them recover from the surgical procedure in a more efficient way, so the patients are not readmitted into the hospital ultimately causing more cost to the healthcare delivery system. By keeping a patient at home, engaged in their own exercise program, on their own nutritious diet and monitoring the patient via mobile application, the patient may not need to be seen in the hospital again, thus reducing the cost of any visits in the hospital setting.
For providers that are interested in joining an ACO, mobile technology is a beneficial tool that will support an ACO’s success. Ultimately, if the ACO is successful in reducing costs and improving patient outcomes, the healthcare providers will be rewarded by sharing in the savings achieved. As ACOs redesign the delivery of healthcare, mobile devices will redesign how patients are engaged and accountable for their overall personal health.