Dr. Simon C. Matthews, MD
Chief Medical Officer, Vivante Health
Assistant Professor of Medicine and Gastroenterologist, Johns Hopkins Medicine
Long ago, the quality of care was synonymous with clinical outcomes. 1 1999 1999. In, Institute of Medicine It was reported that about 10,000 deaths a year were caused by medical errors (recent estimates) 2 Near 250,000). These facts changed the story in quality, and highlighted that clinical metrics alone do not characterize the overall healthcare experience. As a result, the healthcare community sought to broaden the definition of quality, and System-thinking approach That actively identifies complex interdependencies that affect care.
In my role as a gastroenterologist at Johns Hopkins, I have already seen this shift to a more holistic approach. On time Quality improvement Meetings, physicians and team members speculate, “How could our next patient be harmed?” Instead of focusing on strengthening the clinical metrics, we discuss the whole system of care delivery in general and the unique challenges of a patient that interferes with that system. Fortunately, digital devices can enable it to have a more comprehensive and system-level view – but what does this actually look like in practice?
A detailed definition of quality
Let’s first consider how the current, expanded approach to quality can be divided into four major components – as well as how digital health solutions can play a role in improving quality in these dimensions as well.
- Sick safety: How can we prevent patients from experiencing the harm that can be prevented? The classic example here is the use of EHR-based decision support devices to ensure that appropriate prophylaxis is chosen to prevent blood clots in high-risk patients admitted to the hospital. A more recent and more widely cited example is the on-screen wearable application for cardiac arrhythmias that enables early detection of previously unrecognized risks.
- Clinical Outcomes: Are we providing excellent clinical care? Historically, this question has been answered as structural metrics (e.g. 27 / coverage coverage for emergence procedure by endoscopist), procedure metrics (e.g. rate of colorectal cancer screening in an ambulatory clinic), and accurate outcome metrics (e.g. mortality from colorectal cancer). ). However, as technology advances, we have the ability to create novels Digital results measures That provides a more comprehensive and sustained understanding of health and disease.
- Sick experience: How does the sum of all patient interactions affect the patient’s perception of him or her care? Digital health solutions provide many ways to address the overlapping aspect of the experience, including improved navigation in the hospital, online patient support communities and tools, and crowdsourcing ratings and reviews. These resources are driven by a large trend Healthcare consumerism.
- Price: Are we able to reduce healthcare costs with excellence in the above categories? Decision support tools that help select the most appropriate diagnostic test for a particular clinical situation, algorithms that use EHR and data claims to identify at-risk patients, and text-based reminders that improve clinical attendance and drug adherence are just a few examples. How technologies can improve patient care and experience while reducing unnecessary costs.
Digital solutions can identify and bridge gaps
Traditional health environments are limited to their episodic, personal interactions with patients. Digital platforms, in contrast, can connect a person in different ways, in different places, and at different times. While the market for digital solutions could benefit from even greater AuthenticationThe ability to connect with patients in a novel way for digital health should also be recognized as a unique opportunity to improve all four dimensions of the quality of healthcare.
In Vivante Health, We provide a comprehensive digital solution for self-employed employers and health plans to better manage the digestive health of their population by improving the quality of care they receive. We combine a digital platform with the personal touch of the care team to provide a clinically focused, personalized experience. Our primary approach to quality optimization and cost reduction is by developing disease and symptom-specific clinical pathways.