Just What the Doctor Ordered: How To Achieve Smarter Care

Enabled by cutting-edge technology, our personal devices are increasingly interconnected and personalized. If this is the case for retail and entertainment, why should health and social care be any different?

At Tuesday’s GovLoop training, Government Health and Social Care Collaboration to Control Costs and Improve Outcomes, moderated by Christopher Dorobek, we spoke with Dr. Nick Yphantides, MD, MPH, Chief Medical Officer, Health & Human Services Agency, San Diego County; Joseph Fiorentino, Associate Partner, IBM Global Business Services, State and Local Government; and Daniel Stein, Co-Founder and Managing Partner, Stewards of Change to learn how to obtain this personalized experience we’ve come to expect. The panel provided some great tips on starting the journey toward smarter care, what obstacles you may face on your way, and how to successfully navigate these barriers.

What is “Smarter Care?”

There are different ideas but what it really comes down to is changing behavior and providing more personalized care, said Fiorentino. We are moving away from the one-size-fits-all approach to a more coordinated one, integrating information and data across stakeholders. When given access to this data, stakeholders can address patient needs and drive better outcomes. It’s also critical to focus on the individuals and families at the center of it all, said Stein. The question is less about the services themselves, but how you build them around patient needs. Yphantides described smarter care as being “proactive and informed.”

Why do we need to change in the first place?

There are billions of dollars being spent on less effective, reactive measures, said Yphantides. Healthcare is an enormous cost driver on an unsustainable path. Given this fiscal state, being proactive is a mandate, he said. By having enough meaningful data and being able to assimilate data from a variety of sources, agencies are given the opportunity to enact such pre-emptive measures. We are wasting a lot of time, energy, and resources with siloed and duplicative efforts, Yphantides continued. Current systems have a transaction-based design but being patient-centered is key. It’s also critical to “buck the trend of over-specialization” and think laterally, said Stein. We need to “think broadly across the spectrum of needs,” he advised. Data facilitates this, giving medical providers access to better information to understand complex patients. For example, a patient’s ailments may involve both health and social care – say, a child with asthma (health) caused by mold in dilapidated housing (social).

How do you draw value from big data for Smarter Care?

Start with the basics, said Fiorentina. There is always attention given to “big data,” but putting even basic demographic or programmatic data into the hands of the right people can make a significant difference. Collaboration and getting to the pockets of data that make sense is key, he said. Access to data requires better responses from the medical community but also shifts the burden of responsibility to everyday people, allowing us to make better decisions about our own health, said Stein.

Great, but how do you start such a large initiative? What do you prioritize?

It’s not really an “either, or” process – many factors must be considered in prioritization, said Yphantides. A health care initiative is a huge deal that takes an enormous amount of energy and leadership, said Stein. Therefore, a thorough assessment needs to be conducted before embarking on this journey:

  • What is our current state? Prepare a baseline readiness assessment.
  • What are we getting into and why? What’s our end-goal? Are we focusing on a current political trend or something that our community specifically needs?
  • What are our strengths and our areas that need further development? Be honest!
  • Where should we focus our resources to mitigate risk/surprises?

What challenges should we expect and how do we move past them?

It comes down to the people, said Stein. Articulating a clear vision and getting buy-in is key. Without a strong leader driving the change and staying on message, it will be very difficult to move forward, Fiorentina echoed. In the move towards smarter care, we really need to be stewards of change, Yphantides said. This is ultimately about changing a process and there’s going to be a lot of legacy and tradition to deal with.

Demonstrated proof is also very useful. In San Diego, Yphantides oversaw a small pilot attempting to reduce hospital readmissions of high-risk residents. With integration of information from “the ivory tower down to folks in the community,” the pilot was extremely successful. Pilot intervention reduced readmission from 13% to 2% (30-day period) and 24% down to 8% (for 90-day period).

Fiorentina explained how IBM’s three layers in approaching smarter care help generate successful outcomes such as those in San Diego and elsewhere:

1. Foundation: Although boring, the “basic plumbing” is key. This means gathering and understand structured and unstructured data.

2. Coordination: The ability to make data actionable and enable a coordinated care platform. You must manage the process across a full lifecycle of helping a family.

3. Analytics & Cognitive Services: Learn from historical data to provide more intel to people working with clients or across multidisciplinary teams. Focus on a variety of data sources (lifestyle, health, etc.) for a more holistic and integrated approach.

By taking such factors into consideration and consulting with those who have been through the process, you can confidently start your journey to Smarter Care.

To learn more, watch the full presentation!


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