The traditional fee-for-service healthcare model, which reimburses providers based solely on the quantity of services delivered, is undergoing a much-needed transformation. The choice now is of value-based care initiatives, that are more focused on improved patient outcomes and preventive care, rather than simply paying for services rendered.
At the core of this change is a fundamental realignment of the mission, processes, metrics, and cultural values for healthcare providers and clients, rather than just adopting new digital technologies such as telehealth and remote monitoring. From maximizing billable procedures to optimizing care quality, preventive services, wellness, and superior outcomes for patients – the conventional approach needs a whole new direction.
Understandably, making this transition is tough. It involves dismantling long-established organizational processes focused on transaction volume and reinstalling new workflows centered on value and patient-centered care models.
The Upside of Healthcare’s Value Journey
Cost reduction is one of the primary reasons why this shift is falling into place. But the new value-based narrative represents far more than a financial change – it is restoring healthcare’s most important aspect: the transcendent provider-patient relationship. By recentering the entire industry around improving holistic human wellbeing, this movement is rededicating medicine to its main purpose and spiritual core.
From my perspective, there are three areas of transformation – coordination of resources and people, turbo-charging care teams, and personalized patient outreach and engagement.
GenAI’s True Healthcare Potential: Preventive Care’s Preemptive Strike
Traditionally, the industry’s most skilled and caring professionals have been burdened with the monotony of administrative tasks. But once patients are engaged, turbocharging existing care teams through AI-powered co-pilots, that are focused on maximizing patient interaction time, becomes the new imperative.
Studies reveal seemingly endless indirect tasks such as scheduling, medication reminders, and check-in chores consuming up to 40% of a nurse’s day. That is two-fifths of their life’s work spent in bureaucratic drudgery rather than delivering hands-on care. Intelligent AI co-pilots can take over dull and repetitive work, helping human teams refocus on core clinical activities that merit their training and expertise.
Relieving clinicians from bureaucratic jobs is a crucial first step, but it is not the final goal in realizing value-based healthcare’s full potential. To achieve that, reinventing healthcare delivery as a personalized human experience is required. A study by The Beryl Institute found that 73% of patients say a positive experience is more important than the cost of care.
Sometimes, steering through the healthcare system is like navigating a maze blindfolded. And unfortunately, a lot of us are stumbling around in there. The National Academy of Medicine found a shocking 40% of adults struggle just to figure out how to get the care they need. This data highlights a compelling need for more streamlined and coordinated care models, such as flexible care clusters, that can facilitate a smoother experience for patients.
So, rather than patients navigating complicated provider networks, flexible care clusters can help coordinate with different stakeholders including healthcare professionals – doctors, therapists, technicians, social workers, etc. – based on each patient’s changing needs. The very notion of ‘going to the doctor’ may dissolve, as healthcare becomes seamlessly embedded into daily living.
In fact, rather than patients navigating complicated provider networks, flexible care clusters can help coordinate with different stakeholders including healthcare professionals – doctors, therapists, technicians, social workers, etc. – based on each patient’s changing needs. The very notion of ‘going to the doctor’ may dissolve, as healthcare becomes seamlessly embedded into daily living.
As examples, intelligent patient monitoring leveraging AI, wearables, and internet of things (IoT) sensor arrays could help identify subacute risk elevations and trigger immediate interventions.
Likewise, personalized treatment paths synthesizing individuals’ genomic profiles, environmental factors, and epidemiological analytics could dynamically adjust through iterative feedback loops.
Even as these emerging technologies hint at a future of greater health equity, their unbridled proliferation could also lead to greater disparities through biased algorithms and unequal access to personalized care. The thin line between perpetuating injustice instead of curing it must, in fact, be skillfully navigated.
Bold measures are required – diversifying data sources, rigorous bias detection algorithms, ethical auditing, transparent reporting, and continuous education. It demands rigorous interdisciplinary collaboration between clinicians, data scientists, and moral philosophers. The profound promise of AI can only be realized by following such a rigorous course.
AI-Driven Preventive Care’s Democratizing Promise
A start-up in rural India is a pioneer in the area of vaginal cancer and it’s transforming product usage data into self-service care paths as an alternative to conventional providers. Inputs from these products feed a cloud-based algorithm, generating individualized treatment recommendations reflected on user dashboards thus forming a powerful feedback loop that circumvents traditional care models.
Such emerging examples of real-world AI healthcare applications are helping realize the vision of value-based care. Arming the providers with tools to identify issues, engage patients, and prescribe personalized data-driven interventions is preventive medicine’s new frontier. For underserved populations, it could democratize access to quality care.
Undeniably, the healthcare sector is complex and evolving; and adopting new value-based care models together with integrating latest tech innovation can be challenging. But the opportunities to genuinely transform healthcare are waiting to be explored.
For innovative startups and health-tech disruptors, the field is wide open. They need to zero in on solving the real and frustrating problems that patients, providers, and healthcare systems face daily. But the solutions will have to synchronize with clinical workflows, clear regulatory hurdles, and lock down data privacy to military-grade standards.
Big healthcare players, on the other hand, should focus on creating a culture open to taking calculated risks and rapidly testing new technologies. Partnering with and investing in cutting-edge startups, too, is important. since recruiting and retaining top tech and data talent is not easy. And for these large health systems, weaving in interoperability and scalability into the fabric of new solutions is important, right from the start.
The bottomline for both startups and industry titans is harnessing the power of health tech to deliver better patient outcomes. Working on collaborations and putting people’s wellbeing before everything else will become the pillars of revitalizing healthcare in ways that cannot even be envisioned.
For the innovators up for that challenge, you would be ushering in a full-fledged renaissance of human healing. And that is an opportunity no true healthcare visionary can afford to miss.
About
Ritwik Batabyal is the Chief Technology and Innovation officer at Mastek. In this capacity, Ritwik facilitates the integration of new and disruptive technologies, monetises Data and AI technologies across industries and builds partnerships with start-ups and external innovation ecosystems.
Before joining Mastek in January 2022, Ritwik was the GDH of Platform and Solutions for L&T Technology Services Limited. He served as the Chief Technology and Engineering Head of Next-generation Business Products at Wipro for six years. During his 26 years in the IT and engineering industry, Ritwik has identified and implemented technologies to transform enterprise systems into digital solutions, provided technical direction and developed strategy for travel and expense