siliconindia | | DEC 2019 - JAN 20209 The provider has to ask me the same questions again, plus a few new ones.Furthermore, the actual process of bringing patients into the entry-points of the healthcare system can be riddled with unique workflows that make things like referrals, lab and radiology services delivery, and care coordination all the more challenging.What if the patient-centered approach became the gold standard, and we engineered the patient-centered system to also work for providers, ancillary services, finance folks, etc., instead of the other way around? Robert Wachter takes a similar approach in chapter 7 of his book, The Digital Doctor. Titled "Toward a Brighter Future: A Vision for Healthcare IT," it envisions perhaps one of the most impressive future states of a truly integrated clinical-care delivery network that I have ever read about. And yet, as I transitioned my role from chief medical information officer to chief medical officer, I realized that healthcare IT was only part of the solution. Even the most elegantly developed software with strong emphasis on end-user experience can be hobbled by poor integration into a particular process or workflow.So, based on my Google Project Fi experience, my humble advice is to consider re-engineering healthcare in this regard. Yes, it will involve some pain ­ but it need not be overly burdensome or costly. Managing cellular communication is incredibly complex, involving everything from semiconductor technology to municipal ordinance, cellular towers, and even negotiations with satellite system operators. But this is all made invisible to the consumer.What if we engineered systems that leveraged integrated EMRs and federated data-sharing agreements?Insurance payers' stipulations should be front and center, allowing the consumer to see just how restrictive their carrier plan is and base their care on realistic options tied to the plan they have chosen. Doing this would cut out 80 percent of the preauthorization back-and-forth that occurs in between patient visits, which can unfortunately delay care and hamper the patient experience.Data-sharing agreements between EMRs would need to be in place for health systems to safely exchange information with each other. Epic's Care Everywhere and the Cerner-backed CommonWell initiative suggest that we are finally getting traction on this concept.Data sharing paves the way for universal registration, and ties in to insurance transparency, bringing revenue-cycle transparency into the mix and leading us to the final hurdle in the consumer experience ­ price transparency and the creation of a unified billing experience.With all of this in place, my version of Google Fi (let's call it Healthcare Fi) would involve:· A health insurance experience that clearly lays out my options for care based on the plan I have chosen.· One clinically integrated EMR experience that my providers can share as and when required, via permissions that I set.· One single registration experience.· One bill at the end of the entire episode of care with very few surprises.· One portal from which I can access all of this information, based on the severity of my presenting complaint, and access and schedule care via telemedicine vs. AI supported triage into urgent care, my primary care provider, or the emergency department.When Google unified its Android operating system with hardware that it had designed in the form of the Pixel, the industry applauded. Incremental gains in battery life, camera performance, and the usability of the stock Android experience were appreciated. The game-changer, however, was when they married this with their own cellular service, or Project Fi, controlling every aspect of the cellular-ownership equation and optimizing towards customer experience. I believe we in healthcare can learn from this to make the experience for our patients cleaner, more integrated, and, as a result, better. Even the most elegantly developed software with strong emphasis on end-user experience can be hobbled by poor integration into a particular process or workflow
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