Technology will change future of health care delivery

December 1, 2008
Direct coastal competition in local markets. Consumer-driven delivery. Global data collection.

These and more changes will dramatically materialize over the coming months and years as the delivery of health care services takes on a consumer-driven focus.

Such changes — driven by patients, payors and physicians who demand new value from their respective sectors — will likely flip old traditions of delivery into new on-demand services.

In future health care platforms, patients will control all or much of their data, payors — who today control much of a patient's information — will demand higher degrees of performance accountability and return on investment, and physicians will be more subject to consumers whose care decisions will be increasingly based on real and perceived value.

This new consumerism in health delivery will rely heavily on information technology platforms that will measure value for the services delivered. How will this new value be defined? Three metrics will emerge: service, quality and value for cost.


The majority of revenue-generating health care services for hospitals, networks and physician practices appear in the demographic segment age 55 and up. Today, millions of affluent baby boomers are in or nearing that specific category.

Boomers dramatically altered every single facet of American life, and now as they quickly assume the dominant health care consumer role, their influence will be keenly felt. So, what technology-driven changes can we expect?

If recent history provides a clue in behavioral change, Boomer health care consumers will be much more sensitive to price transparency, demand more access to services when they want them (not when the hospitals and physicians typically would provide them) and command near total control of their health care records.

The current near-total bifurcation of records — where patient data is presently spread between numerous doctor's offices, hospitals and insurance companies — will soon morph into centralized sources that are patient controlled.

Today, the old model has physicians and hospitals telling patients how they will be treated, where they will be treated and when they will be treated. As history shows, this generation won't accept that for long, particularly when technology serves up choices.

Hospitals, like all businesses, are driven by revenue models. Today's health care service delivery remains transaction-based. For example, you hurt your shoulder and you go to your general practitioner, who charges you a separate fee and then sends you to an imaging center for an x-ray. The imaging center charges you a fee, and then your GP or radiologist refers you to an orthopedic surgeon. The surgeon charges you a fee for services and then the hospital where the surgery took place charges you a fee.

In the future, instead of individualized billing, technology will create the platform opportunity for bundled payment methodologies, where you will be charged one lump fee for all services. That will force more integration of services between physicians, hospitals and insurers.

That same integration will produce a new continuum of information, where protected digital medical records will flow across traditional boundaries and be largely controlled by the patient.

Performance decisions

The new wave of providers touting the independent evaluation of their services represents the first step in this direction. Patients will increasingly make consumer-based health choices by evaluating performance metrics. The practice of a patient committing to a procedure without knowing its cost is already declining, and this decline will accelerate as technology enables patients to educate themselves.

Today, hospital information technology systems must measure specific performance metrics and document performance standards. This is a critical element because, in the future, patient loyalty to a health care system will be outweighed by how the alternative systems measure up against precise performance metrics.

Strategic technology application can improve patient care and provide faster service. Where technology was once a strong marketing differentiator, it will soon be a consumer-demanded standard.


Horner, a pharmacist and former CIO of Major Hospital, serves as the interim CEO of Major Health Partners in Shelby County. Views expressed here are the writer's.
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