Question

First, develop a summary of healthcare data and analytics.  Next, describe the issues and challenges, as well as identify the apparent barriers to improved healthcare quality that exist in this situation. Finally, explain why the healthcare quality deficit in this situation is particularly important and should be addressed.

Answer 1

First we need to understand what is the mean by Health care Data analytics

Health data analytics, also known as clinical data analytics, involves the extrapolation of actionable insights from sets of patient data, typically collected from electronic health records.

In the context of the health care system, which is increasingly data-reliant, data analytics can help derive insights on systemic wastes of resources, can track individual practitioner performance, and can even track the health of populations and identify people at risk for chronic diseases.

Identifying patient health problems before they become severe is an important aspect of healthcare organizations. Without sufficient data, healthcare facilities don't have the patterns or information necessary to prevent health crises, but data analytics can provide patient health tracking to predict these problems.

describe the issues and challenges, as well as identify the apparent barriers to improved healthcare quality that exist in this situation.

Over the years, providing and funding high-quality healthcare has come up against a number of challenges. Due to an ageing population, an increase in demand and associated spending has contributed to augmented stress to Australia’s healthcare system.

1. Costs and transparency. Implementing strategies and tactics to address growth of medical and pharmaceutical costs and impacts to access and quality of care.

2. Consumer experience. Understanding, addressing, and assuring that all consumer interactions and outcomes are easy, convenient, timely, streamlined, and cohesive so that health fits naturally into the “life flow” of every individual’s, family’s and community’s daily activities.

3. Delivery system transformation. Operationalizing and scaling coordination and delivery system transformation of medical and non-medical services via partnerships and collaborations between healthcare and community-based organizations to overcome barriers including social determinants of health to effect better outcomes.

4. Data and analytics. Leveraging advanced analytics and new sources of disparate, non-standard, unstructured, highly variable data (history, labs, Rx, sensors, mHealth, IoT, Socioeconomic, geographic, genomic, demographic, lifestyle behaviors) to improve health outcomes, reduce administrative burdens, and support transition from volume to value and facilitate individual/provider/payer effectiveness.

5. Interoperability/consumer data access. Integrating and improving the exchange of member, payer, patient, provider data, and workflows to bring value of aggregated data and systems (EHR’s, HIE’s, financial, admin, and clinical data, etc.) on a near real-time and cost-effective basis to all stakeholders equitably.

6. Holistic individual health. Identifying, addressing, and improving the member/patient’s overall medical, lifestyle/behavioral, socioeconomic, cultural, financial, educational, geographic, and environmental well-being for a frictionless and connected healthcare experience.

Related:The Future of Healthcare Leadership

7. Next-generation payment models. Developing and integrating technical and operational infrastructure and programs for a more collaborative and equitable approach to manage costs, sharing risk and enhanced quality outcomes in the transition from volume to value (bundled payment, episodes of care, shared savings, risk-sharing, etc.).

8. Accessible points of care. Telehealth, mHealth, wearables, digital devices, retail clinics, home-based care, micro-hospitals; and acceptance of these and other initiatives moving care closer to home and office.

9. Healthcare policy. Dealing with repeal/replace/modification of current healthcare policy, regulations, political uncertainty/antagonism and lack of a disciplined regulatory process. Medicare-for-All, single payer, Medicare/Medicaid buy-in, block grants, surprise billing, provider directories, association health plans, and short-term policies, FHIR standards, and other mandates.

10. Privacy/security. Staying ahead of cybersecurity threats on the privacy of consumer and other healthcare information to enhance consumer trust in sharing data. Staying current with changing landscape of federal and state privacy laws.

“We are seeing more change in the 2020 HCEG Top 10 than we have seen in recent years and for good reason. HCEG member organizations express that the demand for, and pace of change and innovation is accelerating as healthcare has moved to center stage in the national debate. It shouldn’t be surprising that costs and transparency are at the top of the list along with the consumer experience and delivery system transformation,” says Ferris W. Taylor, Executive Director of HCEG. “Data, analytics, technology, and interoperability are still ongoing challenges and opportunities. At the same time, executives need to be cautious, as individual health, consumer access, privacy, and security are on-going challenges that also need to remain as priorities.”  

Turning challenges into opportunities

Reducing costs means lower revenue for providers and almost all of the players in healthcare––except for consumers and payers, says Mark Nathan, CEO and founder of Zipari, a health insurtech company. So while there are many incentives to keep healthcare costs high, if consumers are provided with the information they need to improve their health and drive down their personal costs, then we could see consumers en mass making decisions that drive down costs across the industry, he adds.

“Predicting cost in the traditional health insurance environment is shockingly complex,” Nathan says. “The most advanced payers can simulate claims and predict the cost of procedures. However, as you layer in full episodes of care, such as knee surgery, it becomes much harder to accurately predict the patient's total out-of-pocket cost. Bundled value-based payments start to make cost transparency a little easier to predict, but most plans still have a way to go to get to that type of offering.”

Lack of advancement opportunities. Fifty-one percent of healthcare workers said lack of advancement opportunities posed a significant challenge in their current or previous position. The number was slightly lower among nurses: 49 percent of nurses identified advancement opportunities as a challenge, compared to 52 percent of other healthcare professionals.

Explain why the healthcare quality deficit in this situation is particularly important and should be addressed

Maintaining a safe environment reflects a level of compassion and vigilance for patient welfare that is as important as any other aspect of competent health care. ... Most important, improving the work environment may also improve the quality and safety of patient care.

Quality improvement is directly related to the service delivery approach, level of patient satisfaction, efficiency and outcome. A successful program always incorporates principles of quality improvement to achieve an enhanced level of performance and a successful organizational healthcare system. Here are four key principals that the healthcare systems can consider for quality improvement:

1. Work as Systems and Processes –

An organization needs to understand its own delivery system and key processes, rather than considering it as small and simple or big and complex. The key to the quality improvement approach in any size of an organization should be, to streamline “Input – Process – Output” to meet the needs of a specific organization’s health service delivery system.

2. Focus on Patient –

The major concept behind the quality improvement in healthcare is to get the patient’s needs and expectations on the same page. Services that are designed to bring needs and expectations together include:

• Patient Safety
• Patient Engagement
• Systems that support patient access
• Evidence-based care provision
• Patient-centered communication
• Health literacy of patients

3. Focus on the use of data –

Data is the cornerstone of quality improvement. It describes how current systems are working, tracks the changes, allows comparison and monitoring for sustainable improvements. Data-driven insights deliver better outcomes, minimum variation, fewer re-admissions, lower infection rates, and fewer medical errors. Both qualitative and quantitative methods of data collection are used to improve the quality of the healthcare system.

4. Focus on Care-coordination –

It is the coordination of care activities. Care coordination software maintains the Master Patient Index and Longitudinal Health Record for each patient (It becomes very effective if it is a case of a chronic condition). It helps reduce care fragmentation of a patient, by providing a secure network of trusted healthcare providers and ensure effective referrals and smooth transitions between two or more healthcare providers.

5. Include Human Factors Inputs

As defined by the Human Factors and Ergonomics Society, human factors is a body of knowledge about human abilities, human limitations, and other characteristics that are relevant to design. Human factors engineering is the application of human factors information to the design of tools, machines, systems, tasks, jobs, and environments for safe, comfortable, and effective human use. These relate closely to quality improvement.

Benefits of Quality Improvement in Healthcare System

1. Safe: Systematic and organized approach is intended towards optimizing care for the patients it serves and avoids harm. It embraces a culture of safety, quality, and transparency.
2. Effective: By improving the ‘process’, an organization reduces the chances associated with failure and redundancy. The improved healthcare system is more on data-driven science rather than anecdote-driven.
3. Patient-centered: Improved efficiency of managerial and clinical processes leaves transition space for doctors and staff to provides responsive, respectful and value-based care to a patient.
4. Proactive: Improved processes recognize and solve the problems even before they occur.
5. Cost-effective: Quality improvement processes are budget neutral. It avoids the cost associated with process failure, poor outcomes, and errors. Reliable and streamlined processes are less expensive to maintain.
6. Efficient: Improving process makes wasteful activities associated with equipment, supplies, ideas, and energy more obvious and makes it easier to eliminate.

Overall improving the quality and performance in the healthcare environment can help providers with reliable, cost-effective and sustained healthcare processes and enable them to achieve their goal of improving care delivery and enhancing patient outcomes.