The healthcare system of our dreams is far from where we are right now. A system where patients and their families don’t have to worry about being unassisted, where providers perform their duties with ease. A system where clinically vital information about patients is accessible to providers and patients alike, where patients are tended to even after their discharge. An infrastructure where the system is marked with progressive innovation and is driven towards making healthcare a birthright, extended to each and every citizen.
The healthcare we have today is fragmented. Americans often don’t get the care they need even when the U.S. spends a lion’s share of its budget on healthcare. Preventive care needs a lot more exploration and implementation, and chronic diseases account for about 7 out of every 10 deaths in the States. Lack of coordination of care for patients, entities working independently with divided responsibilities, and underutilization of technology make up the rest of the roadblock.
My idea of ideal healthcare
If I could design the ideal healthcare system, it would have the following elements:
- Patients are the primary focus. Making patients a priority of the healthcare system is not a new idea, and luckily, the healthcare industry is already moving toward this goal. This component of my ideal system is not as much about patient engagement as it is about making all the developments and innovations centered around patients. Patients or their families would be aware of all the procedures done or are about to come, and they would be a part of any important decision-making. We are seeing some progress toward this goal. HealthIT.gov has reported an increase in the number of hospitals that allow patients to view and analyze their health information from 10% in 2013 to 69% in 2015. CMS has assigned a 25% weight in their Hospital Value-Based Purchasing Program to patient experience of care. There are also encouraging efforts in the development of patient-centric technologies.
- Information flow is streamlined. In my ideal system, there will be 100% interoperability between all electronic health records and other software that stores patient information. Relevant information will not only be convenient for treatment, but it will also avoid unnecessary care and care that results from faulty or inadequate information flow. Preventable readmissions and return trips to the emergency room would become a thing of the past. Healthcare data and information would also be available to patients to empower them to make their decisions that reflect their preferences—either alone or in partnership with their physicians.
- Innovation-driven healthcare improves outcomes and reduces costs. In recent times, the world has witnessed spectacular leaps in healthcare technologies, including pharmaceuticals. Instead of reducing costs as it has in other industries, these advances have often led to an exponential increase in costs. In my ideal health system, technologies would be designed to improve efficiency, improve outcomes, and reduce costs. There is also a need to have technologies that support both personalized care as well as population health so that everyone proactively will receive the care that is customized to their needs and no opportunity to improve outcomes is left off the table.
- We finally understand that health insurance does not equal healthcare. All too often we measure our current healthcare system by the number of people insured, even though the availability of health insurance is just one measurement of the robustness of a system, and it is certainly not an indicator of health. In the ideal system of the future, everyone will have health insurance and we will measure the success of our system by measuring and monitoring the health of people served—are they living longer, are they living healthier, are they able to live up to their potential? Moreover, the health insurance people have access to is only partly insurance, and mostly a pre-payment for services. This leads to huge gaps in administrative costs for just routine procedures. Concentrating on how service is being delivered and its quality and shifting our focus from volume to value is the matter of substance.
- Healthcare is affordable and equitable. The cost of healthcare keeps increasing—it is currently 17.1% of GDP. Yet, our health outcomes are hardly in line with the goal of having an ideal healthcare system. Although it is true that the healthcare system in the country is complex and ever-changing, it is crucial that we work on improving the standards. I believe that quality, affordable healthcare is every citizen’s right. Although there have been several reforms in healthcare policies and many efforts are underway to realize this goal, we still have a long way ahead of us. Moving in the right direction combined with dedicated reforms will lead us to the day where affordability and equitability in healthcare aren’t far-fetched.
An impossible dream?
We dream of what we believe is possible. The healthcare system I envision is definitely achievable, but having said that, in order to make this dream a reality, our actions from now on need to be goal-oriented.
This ideal system calls for fully-coordinated networks of healthcare providers, integration of care delivery systems and group practitioners to individual physicians, and everyone coming together with a single aim: To deliver patient and family-centric quality healthcare that delivers superior outcomes. Although there are many approaches to work toward that end, I believe that the one that is most consistent with these goals is the formation of value-focused organizations that are purposefully designed to deliver better quality with great efficiency.
As for how the government and governing bodies can close the gap between what we have now and the ideal system of the future, I believe that no single policy will fix the system. Healthcare requires many different laws, regulations, and policies that take the system forward with quality and affordability as the top-most priority. It is time to abandon the fragmentation and patchy coordination of our current healthcare system that it has been holding. To achieve the healthcare of my dreams (and hopefully yours as well), we need to move away from a system where entities work independently, and towards creating an organized, concrete system which is accountable, affordable, and equitable.