Tammy Hawes is CEO and Founder of Virsys12, a Salesforce Consulting and Appexchange Partner focused on healthcare technology transformation.
Covid has done many things to our society and culture — and some of them are good, such as making us look carefully and thoughtfully at our nation’s health care systems. For example, because the influx of Covid patients made hospital beds scarce, home health care became a much more viable option.
As the senior program director for the Accreditation Commission For Health Care, Susan Mills, noted recently, “Home health care typically falls into a rehabilitative or maintenance role in the continuum of care after a patient leaves the hospital or an inpatient rehab facility. However, it’s now commonplace for nurses and caretakers to treat patients with higher acuity needs in the home with skilled treatments and services, such as home infusion therapy, physical therapy and hospital-at-home programs, allowing people to heal in the comfort of a familiar environment. The pandemic has been a catalyst for home health agencies to further adapt their service offerings with new technologies and enhanced infection prevention measures to keep patients safe at home.”
Home health care is one of those rare win/win/win/win options in medicine that meets the so-called “quadruple aim” of the health care industry: It is medically effective, it saves money, it is high in patient satisfaction and it is a better experience for providers. On the patient satisfaction side, patients prefer being at home instead of in a hospital because they are close to family, they can enjoy home-cooked meals instead of hospital food and, in general, are treated more like a person and less like a number. Additionally, patients who are treated at home tend to move around, not just lay in bed, so their condition is more likely to improve. Providers like home health care because it allows them to forge deeper relations with patients, which leads to better treatment and outcomes.
The story of the rise of home health care during Covid is an excellent example of how the pandemic helped to nudge America’s health care system away from the less effective and less efficient fee-for-service model to the value-based care model — which has been a major goal for many years. In a nutshell, value-based care changes the focus in health care from transactions to a more holistic approach that focuses on outcomes and building clinically integrated networks that bring together all types of professionals — not just physicians and nurses, but also social workers, nutritionists, pharmacists, home health care workers and others — to provide the right level of care to patients at the right time.
Home health care brings to the fore another important aspect of value-based care: social determinants of health, which are nonmedical factors that influence health outcomes. Such social determinants include income, housing, education, employment, access to transportation and other factors that have a definite and often profound effect on our health. For example, if you must choose between buying food for your family or buying medicine for yourself, you’re likely to choose food for your family and your health will suffer. Because home health care workers are in the patient’s home on a regular basis, they are much more likely than hospital-based providers to know about — and do something about — these situations, and this is another example of how value-based care makes a difference.
Although Covid has forced us to begin moving away from fee-for-service to the value-based care model, we still have a long way to go, as the vast majority of medical care in the United States is still provided on a fee-for-service model. As is the case with most things in modern life, access to data will be key to moving us forward. One place where the rubber meets the road in the sharing of data is the creation and maintenance of provider directories — the listing of medical professionals who are in a provider network that is created by a health care system, like a hospital system, or by a payer, like a health insurance company.
If America is ever to fully move to value-based care, patients must have complete, accurate and up-to-date information about health care providers — beyond simply knowing which providers are in their network, which is just table stakes in this game. Patients also need to know how they can access care, such as knowing which providers offer telehealth and how to access these telehealth channels. They need to know which services are provided at which locations, and which providers are at which locations on which days.
Patients should not be simply passive consumers of health care. Under the value-based model, patients have some responsibility for finding and making use of the care they need. The more they feel empowered through access to valid and useful information like a complete and up-to-date provider directory, the more likely they are to share in the responsibility for their care, the more likely providers are to deliver care effectively and efficiently and the more likely health insurance companies are to cover claims without push-back.
By putting a strain on the way we have traditionally delivered health care in America, Covid has pushed us toward this better way of staying healthy, one that better meets the needs of everyone: patients, providers and payers. Through the careful application of technology to manage the mountains of data that drive health care decisions, such as provider directory systems, we can build on these small but important steps we have made toward a better health care system for all.