Winning Value-based Health Care with Technology

The healthcare system worldwide is striving to become patient-centric and is actively embracing the principles of value-based care (VBC) that focus on delivering better value to patients in healthcare.
In our last article on VBC, we discussed how the strategic implementation of VBC enables a healthcare organization to achieve the 3Cs – Care Quality, Cost Control (together known as the Cost-Quality Equation), and Consumer Engagement. And how this accomplishment translates into enhanced patient satisfaction and value creation—the real purpose of adopting the value-based care approach.

In this blog post, we have thrown light on how healthcare organizations can fast-track the Optimization of Cost-Quality Equation and enhance Consumer Engagement by leveraging modern technology solutions correctly.

How Technology Drives Your VBC Goals of Cost-Quality Equation Optimization and Consumer Engagement Enhancement

To demonstrate the role of technology in accelerating the optimization of cost-quality equation and customer engagement, we have identified a few areas/use cases where technology can add significant value in terms of elevated care quality and substantial cost advantages.
• EHR Systems:
Modern Electronic Health Record Systems (EHRs) that come with interactive analytics deliver a comprehensive view of patient data and are crucial in the VBC journey.
These systems can ingest, store and process large volumes of data securely to meet all the data needs of healthcare organizations in real-time.
Today, healthcare organizations are actively modernizing their EHRs to automate redundant processes such as medical coding and doctor’s notes summarization. With built-in AI capabilities, these systems are also enabling providers to drive intelligent decision-making by identifying patterns and trends from healthcare data.
The global electronic health records market size was estimated at USD 28.1 billion in 2022 and it is anticipated to grow at a compound annual growth rate (CAGR) of 4.1% from 2023 to 2030 (Grand View Research).
• Clinical Decision Support Systems (CDSS):
From virus detection to personalized cancer therapies, Clinical Decision Support Systems can be used to enhance the quality of medical treatment offered by healthcare practitioners in several ways, such as –
  • Performing calculations for drug dosing
  • Identification of the reportable condition by analyzing the inputs from EHR
  • Evaluating the guidelines for drug formulations
  • Initiating automated reminders for medication or appointments
  • Analyzing the severity index for different diseases to suggest treatment.
When physicians are equipped with easy-to-use CDSS tools, significant improvement in decision-making and performance can be achieved. It can save them additional administrative steps and allow them to focus more on their patients.
Today, AI-guided decision support systems, with predictive and image recognition capabilities, are enabling cost-effective and easy identification of problem areas/diseases across multiple specialties such as ophthalmology, dentistry, and oncology.
  • Yale and Mayo Clinic developed a specialized CDSS application for patients with head injuries. The application evaluated the severity of the injury and significantly reduced the number of unnecessary CT scans.
  • The Department of Veteran Affairs site in Indiana without lowering the quality of the healthcare reduced unnecessary lab tests by over 11% which saved the patients as much as $150,000 – thanks to the CDSS tools it implemented.
• Analytics and Data Visualization Tools:
During the COVID-19 pandemic, many of us were hooked to the BBC website for how it gave us real-time statistics around Coronavirus cases through a mix of infographics, interactive maps, and visualization charts. The pandemic is proof of the incredible role of advanced data analytics and visualization dashboards in tracking and sharing critical details such as the real-time COVID case count, hospital bed availability, status of PPE (personal protective equipment) kits, vaccine availabilities, and more.
Such modern AI-powered analytics and data visualization dashboards can be leveraged across the entire patient journey to make informed treatment decisions, streamline processes, measure and track performance to identify ideas for improvement and enhance the patient experience.
When integrated appropriately with a healthcare practice’s existing EHR system or any other core healthcare platform, these tools offer intelligent insights around –
  • Provider benchmarking
  • Site of Care (SOC) optimization
  • Reports related to care navigation and point-of-care delivery
  • Reports related to patient outcomes
Leading players like Kaiser Permanente, John Hopkins, Mayo Clinic, and many others use interactive dashboards, widgets, and websites to derive interactive reports that display real-time health data and trends over time.
• Care Gap Management Systems:
Care gaps emerge when there is a discrepancy between the actual care provided to a patient and the best practice due to disintegrated healthcare systems and lack of interoperability.
Such gaps in care can be addressed by leveraging modern applications that connect various EHR systems and facilitate real-time data exchange in line with healthcare regulations.
This enhanced data integration and coordination enables providers to be more aware of care gaps through:
  • Gap Analysis,
  • Evaluation of Performance-based KPIs,
  • Timely Intervention,
  • Efficient Patient Engagement,
  • Thereby, Achieve Better Patient Care Outcomes.
Care gap closure applications significantly increase cost savings and also improve performance quality with programs such as CMS Star Ratings and HEDIS.
In the US, with a goal to create a nationwide system of secure and easy sharing of healthcare information across care settings and improve access to data for better outcomes, TEFCA (Trusted Exchange Framework and Common Agreement) was developed. TEFCA scales Electronic Health Information exchange nationwide across Qualified Health Information Networks, or QHINs, health care providers, health plans, individuals, and other stakeholders.

Here’s an interesting story of how a leading healthcare provider utilized technology to achieve better outcomes.

Challenge: The provider had been facing challenges around decreasing the length of hospital stay for patients undergoing hip and knee replacement surgeries.

Technology Adoption: The organization leveraged existing research and a validated prediction model to capture presurgery records from the physician’s offices. The propensity score was put into the clinical workflow so all providers could use it in their preoperative patient discussions.

Results: The program successfully decreased hospital stay length, cutting costs and improving patient experience scores in the HCAPHS Care Transition measures.

• Self-Check-In Kiosks:
Modern technologies are allowing healthcare organizations to automate non-physician tasks in a clinical workflow and shift to a non-traditional healthcare setting.
Advanced bot-based solutions such as Self-Check-in Kiosks are eliminating manual patient registration processes and alleviating the administrative burden on staff by streamlining the following tasks –
  • Appointment scheduling
  • Patient record entry and management
  • Insurance verification
  • Consent forms management
  • Staff activities and roster management
  • Billing management
  • Multilingual support and more.
This interactive, convenient, and user-friendly registration experience through self-check-in kiosks is enhancing patient satisfaction and loyalty, and enabling higher cost savings in the long-run.
Johns Hopkins, Cedars Sinai Medical Center, and Novant are some other players in the healthcare industry using this self-service kiosk solution to drastically reduce their administrative burden.
• Predictive Analytics for Early Detection & Preventive Care:
AI’s predictive capabilities are proving to be instrumental in the early detection of chronic and acute diseases like PAD (Peripheral artery disease) among other illnesses.

Image recognition and deep learning models within AI are also enabling providers to make intelligent predictions such as forecasting high-cost claims events for corrective actions. This is yielding better patient outcomes and helping healthcare organizations meet their value-based care goals.

  • Mayo Clinic investigators demonstrated how predictive analytics could be leveraged to accurately predict long-term survival outcomes of patients diagnosed with borderline or locally advanced pancreatic cancer prior to their surgeries.
  • The University of Chicago Medical Center (UCMC) used predictive analytics to tackle the problem of operating room delays. It combined real-time data with a complex-event processing algorithm to improve workflows, create notifications, and streamline the handoffs from one team to the next for each step of the Operating Room process. The effort decreased turnover time 15% to 20% (four minutes per room), which was expected to save the hospital up to $600,000 annually.
• Appointment Management Systems:
Advanced AI-powered appointment management systems enable both the patient and the provider to proactively manage medical appointments. One of the biggest challenges of patient no-shows that healthcare practices face can be easily overcome with modern appointment management systems that come with analytics capabilities to deliver intelligent insights around the probability of patients not turning up for their medical appointments.
Further, healthcare organizations can leverage these systems to cater to the self-service needs of new-age patients who seek an automated system to book their appointments online, check available slots, and modify any existing appointments.
Some of the other features of these systems such as real-time notifications, reminders, and 24×7 Chat Messenger further enhance patient-provider communication and make patients feel more connected and valued.
• Digital Therapeutics to Engage with Patients During Recovery:
App-based digital patient engagement tools can play a significant role in helping patients to stay focused on health goals and give them an opportunity to use them for questions that come up between visits.
While in-person medical visits will continue to exist, providing at-home monitoring options, especially for elderly patients or those in remote areas, digital therapeutics solutions offer exactly the type of care that value-based initiatives promote.
• Mobile/Web Apps: Patient Record Management, Know Your Provider/Payer, and Patient Portals
Easy-to-use and customizable mobile apps replace all paper and spreadsheet-based data collection processes and transform patient experience phenomenally. Remember, patients today are far more aware and ready to take charge of their health. They want to feel empowered, and technology can successfully address their needs. Apps for patient Record management enable access to medical records via smartphones. Likewise, Know Your Provider/Payer and Patient Portals/Applications give out complete details on the provider services, benefits, cost, price disclosure rules, and more at the touch of a button to help patients make informed decisions.

A Technology-led Future of Value-based Care

Healthcare practices that offer quality and convenience to patients and understand their pain points can succeed in this new value-based marketplace. Having a patient-centered approach and ensuring that services and offerings have benefits for patients can improve relations and loyalty with the organization, especially when the status quo is serving patients and customers inadequately.
Leading organizations within healthcare have started taking their patient engagement activities far beyond core patient services to seamlessly integrate them with patient marketing and communications, patient insights generation, and numerous connected devices and wearables to help bring it all together in support of the patient journey.
EHRs like EPIC, Athena Health, and some more already offer digital patient experience and highly enriched patient engagement solutions listed here, embedded within their systems, and are being used by top provider communities.
Providers and payers need to clearly understand the weak threads in their current organizational workflows and identify the scope of improvement. Intermediaries and health tech organizations can play a vital role in empowering these organizations to engage their consumers/patients in the best feasible way throughout their journey and help them leverage the right technologies to accelerate their VBC journey.
KANINI is a trusted IT partner for several Healthcare organizations, guiding them in the right direction to value-based care maturity using the right tools and technologies such as micro-services, mobile platforms, API-enabled core apps, cloud-based data analytics & AI. Find more about our Healthcare solutions here:

Neha Sinha
Neha is leading the business consulting efforts for the Healthcare BU at KANINI. She brings on board 15+ years of experience in driving various critical functions such as Business Analysis, Presales, Client Relationships, and Domain Consulting. Neha has spent over a decade working with healthcare clients and engagements in the US market.
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