Marc Helberg

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Healthcare has become one of those “just don’t go there” topics in the United States, and this unspoken rule goes way beyond the family dinner table. The divide has become so polarizing that even healthcare providers find it difficult to discuss ways to control costs and improve care. Yet we must. What everyone agrees on-political parties and patients alike-is that healthcare is 

So why is healthcare reform so controversial? At its heart, the healthcare argument is a question about rights. On one hand, some believe 

 that the government is obligated to meet. In fact, more than half of Americans support this idea. On the other hand, some believe healthcare is 

It’s easy to get caught up in this political binary and forget the overarching goal: ensuring better, more cost-efficient care and solving problems within the U.S. healthcare system as a whole. Regardless of personal beliefs, the system always has to work for patients, including on a financial level. Otherwise, it’s simply not sustainable.

In the current political discussion about healthcare, both sides seem to be missing critical pieces of a broader picture. On the left, there’s no incentive to provide exceptional care. On the right, there’s less benefit for a significant number of patients.

Market Forces That Change How Payers See Healthcare

When having these critical conversations in healthcare, we should remove political variables from the equation and discuss outcomes-based healthcare-not whether healthcare is a fundamental right (and certainly not in terms of dollars).

Moving to an outcomes-based system would control costs for both providers and patients. In turn, it would move the industry forward and improve patient care and financial accountability. An outcomes-based healthcare system would also incentivize practitioners to hit the sweet spot of best possible care and lowered costs. Here, everyone wins.

Canada provides a strong example of how an outcomes-based model can bridge the divide between healthcare that’s universal and financially sustainable. There’s a perception of socialized medicine creating tremendous costs, bloated administrations, and inefficient care that leaves patients waiting months or more for appointments.

That’s true to an extent: Wealthier Canadians do visit the U.S. for care or rely on 

 for specialized services. However, Canada is also learning to improve, and the country is doing so by tracking and improving outcomes with 

To shift the conversation away from an “us versus them” gridlock, healthcare executives must explain how outcomes-based care helps all parties involved.

Parties could argue this in their own ways. On the Republican side, outcomes-based care costs less and results in stronger financials. On the Democratic side (or the universal healthcare side), it unclogs the system. Positive results exist down the line, including healthier people, better working conditions, more workers employed, and more efficient care.

To get there, the industry must become dedicated to tracking and analyzing relevant data. Additionally, healthcare executives should practice sharing data with healthcare providers in the field to help make better-informed patient plans.

 found that physicians already receive data, but not anything that leads to better outcomes. About two-thirds of physicians regularly receive feedback on their performance and productivity, but only 28% hear anything about costs. This neither incentivizes nor empowers physicians to find lower-cost treatments or testing options for patients.

The saying “you can’t manage what you can’t measure” exists for a reason: It’s true. We’re not providing physicians with any kind of data that will help control costs.

The way we’re talking about healthcare now isn’t working. We’re at a standstill, with one side in direct opposition to the other. By shifting the conversation from healthcare access versus healthcare financials, we can begin to move forward.

 is the managing vice president at the Philadelphia office of 

, a consulting firm driven to create innovative, growth-oriented, and people-first solutions. Read more about the work Pariveda Solutions does 

Articles

The way providers talk about healthcare-already one of the most contentious topics in U.S. public life-is sure to change over the next year.

Opinion: Outcomes, Not Politics, Should Drive the Healthcare Conversation

“Disruption” is a watchword of the business world, whether we’re talking about Uber upending transportation or Amazon redefining retail. It’s no less applicable in the healthcare space. Technological disruption brings positive and negative changes-as well as more complexity-to the industry. But when guided by a clear vision of social responsibility, disruptive technology offers impressive benefits.

Predictive analytics in healthcare powered by artificial intelligence represents one of the most disruptive shifts. After all, it’s fundamentally changing what it means to deliver value to both patients and society. Because this is especially pertinent considering the importance of social responsibility in healthcare, the industry is racing to find new ways to take advantage.

Accurate prediction is crucial to successful medical interventions. It’s not surprising that advances in this technology would be in such demand. Initial offerings have been very promising, and machine learning systems are already working to predict risk of 

This isn’t limited to specific illnesses, either. Currently, there are multiple organizations holding competitions to find AI-based solutions for other healthcare-related issues (such as unnecessary hospital readmissions). We’re also likely to see advanced analytics assist doctors in the development of personalized patient treatment plans. It’s clear that the benefits of predictive analytics in healthcare could be extended to nearly any aspect of medicine.

Part of the technological challenge involves using massive data sets that incorporate information from many patients. This has its own difficulties, including adhering to privacy laws, ensuring data sets are “

,” and finding the right modeling approach to glean the most insight.

How Three Hospitals Use Predictive Analytics to Reduce Readmissions

However, conquering these big data challenges in healthcare will pay off in many ways. It’s likely to play a major role in the search for cures for some of our most devastating illnesses.

Another major benefit of predictive analytics in healthcare includes revolutionizing the customer journey. Clear, accurate communication is incredibly important to patients and families, and AI could provide online chatbots, interactive information kiosks in hospitals, and other systems that provide information on demand.

In this regard, systems for predictive analytics in healthcare shouldn’t be seen as disruptors, but as enablers. They’ll enable patients and their families to access healthcare that’s much more efficient, safe, accurate, and private. Likewise, they’ll also make it easier for medical professionals and administrators to provide that experience. This will allow the industry to adhere to a new vision of social responsibility, deliver solutions to stakeholders in a modern way, and help doctors humanize patient interactions.

Social responsibility and benefits for all

The benefits of predictive analytics in healthcare (as well as implementing new solutions as a whole) will usher in a new era. But whether this causes complexity and increased overhead for overburdened healthcare centers or streamlines and enhances services will depend on how it’s implemented.

When considering the many potential disruptive technologies to implement, executives should always prioritize a sense of shared social responsibility. It’s crucial to gather insight from many different players, whether they’re C-suite executives, administrators, doctors, patients, vendors, or others. By working together, the industry will make great strides toward not only an enhanced patient experience, but also reduced costs, increased accuracy, and streamlined information management.

Besides this, leaders should keep patient experience and centricity top of mind. To start, emphasize researching treatments for endemic illnesses such as cancer and ensure the research keeps accessibility at the forefront. Without this focus, the gap between those who can and can’t afford cutting-edge medical care will only widen. Just because something is disruptive doesn’t mean it’s a panacea. Without proper planning, any new technology can create socially divisive pitfalls and implications.

Predictive analytics will bring disruption. This is certain. But with the right planning and consideration by executives-including a focus on social responsibility as a whole-the disruption itself can be incredibly positive.

 is the managing vice president at the Philadelphia office of 

, a consulting firm driven to create innovative, growth-oriented, and people-first solutions. Read more about the work Pariveda Solutions does 

Predictive analytics in healthcare powered by artificial intelligence represents one of the most disruptive shifts. Here's how to take advantage of it.

Marc Helberg

Articles

Opinion: Outcomes, Not Politics, Should Drive the Healthcare Conversation

Disrupt or Be Disrupted: Predictive Analytics and Healthcare