With as much focus on effort and resources that have been spent in working to transform health care over the past decade, there has never been as much uncertainty about the direction that health care should go as there is right now: January 2017!
Tremendous strides have been made over the past decade with improved technology – adoption of electronic health records, creation of health information exchanges, implementation of all payer claims databases, widespread use of video visits, expansion of telehealth use, and development of new drugs that provide definitive relief for some diseases if not cures. In addition, health care coverage is more accessible than ever for those who have been uninsured – particularly those with pre-existing conditions.
Yet, we find that many health care professionals are very anxious right now. Hospitals are restructuring to provide less inpatient care while remaining a viable part of the delivery system. Ambulatory care providers are dealing with staffing shortages while working to provide care to more people, developing team-centered care, and adapting to new payment systems. Public health is struggling to find its path in the midst of all the change and contending with, in most states, reduced funding. These are only a few examples of the complexity of transforming the health care system. The implementation of electronic health records across delivery systems has supported and encouraged more comprehensive and coordinated care; however, this hasn't been the panacea that everyone thought it would be. Even with the implementation of the technology, we have not seen widespread improvements in the quality of health outcomes, although this is moving in the right direction. We have spoken about transparency regarding quality and cost, yet we are only just beginning that journey in most markets to achieve the Triple Aim of improved care in a more efficient manner, with better outcomes and lower costs.
Just as we approach a tipping point with more Americans having health insurance, more improved and connected technology, and better exchange of health care information, we are facing potentially dramatic changes at the federal and state government levels. At the federal level we have a new administration that promised to repeal and replace the Affordable Care Act (ACA). Congress has begun work on repealing the ACA, which could leave many of the 20 million Americans who are currently covered without insurance. This is happening while at least half of the states are projecting budget shortfalls and are having to make drastic cuts to state agencies and programs that are part of the safety net of our health care system.
What can any one of us do? What should we do as an organization? I believe there are opportunities: in times such as these, HealthInsight and each of us must assess our strengths, remain committed, assess developments, and position ourselves to take advantage of opportunities as they surface to improve health care in this country. Changes come with every new administration, so we shouldn't be too surprised or disheartened. Managing change can be challenging in that it can slow our progress, change our direction and focus, and hinder building on and leveraging the foundation that has been laid. Nonetheless, I urge you to keep the faith: remember we are all part of the solution. We have committed ourselves to this life's work on behalf of the patients and families that we serve.