Checking the Pulse of Transformations in Clinical Care

With both internal and external factors pressing on the healthcare sector, health systems and hospitals have several golden opportunities for change in clinical care.

Editor's Note: This article is based on roundtable discussion report sponsored by Halo Health. The full report, The Next Evolution of Clinical Care, is available as a free download.

Clinical care is undergoing transformative changes exemplified by the rapid expansion of telehealth services during the coronavirus pandemic.

At health systems and hospitals, there is an opportunity to gain efficiency by making specialty care available through telehealth, says Peter Hill, MD, senior vice president of medical affairs at Johns Hopkins Medicine in Baltimore, Maryland.

"Even in more urban areas, with the contraction of subspecialist coverage at many hospitals, there was movement prior to COVID of patients from one hospital to another simply for subspecialty consultation; I am speaking more of the inpatient side. A lot of that does not need to occur, right? I think bringing the specialists to the hospital via telehealth rather than bringing the patient from one hospital to another is a much more efficient use of resources," he says.

The coronavirus pandemic has had several silver linings for healthcare organizations, such as breaking down barriers to changing the status quo. The pandemic has increased nimbleness and unity at health systems, says David Williams, MD, chief clinical officer at UnityPoint Health in West Des Moines, Iowa.

"U.S. healthcare has never been called nimble before. But during the pandemic, because of necessity, we did not take eight years to determine the best evidence-based practice, then spend another eight years to get it to our patients. We changed on the fly. So far, that spirit has not gone away. And we are coming to consensus. UnityPoint Health is in three states and nine regions across the middle of the country. We have never been a health system before. We have never acted like a unified clinical enterprise. COVID changed that. Now, people care about what happens from state to state, and people on the ambulatory side care about the hospital and vice versa," he says.

With new players in the healthcare sector such as Amazon, health systems and hospitals must be on guard for disruption, says Jason Mitchell, MD, senior vice president as well as chief medical and transformation officer at Presbyterian Healthcare Services in Albuquerque, New Mexico.

"The biggest risk is being picked apart. Everybody is looking at slices where they can pull off a profit and a customer segment, deliver a great experience, and do it better than you can if you are a big health system. Wal-Mart has the potential to be very disruptive. Wal-Mart is everywhere. It has access to the aging population, and now it is putting in a delivery system capability and partnering with health plans. The way to deal with disruptors is to disrupt yourself first. You need to disrupt yourself, move patients out of your hospitals to lower-cost-of-care locations, provide an excellent digital experience, and look for partnerships," he says.

Focusing on quality is the key to making the shift from fee-for-service care to value-based care financially viable, Hill says. "From my perspective, it starts with the quality and ensuring that we are producing the clinical outcomes that we should produce. That is one of the two tenets of value—you need to control cost as well as quality. So, if you do not have quality, then you are dead in the water. For us, that is certainly what we are focusing on right now."

View the complete HealthLeaders Roundtable report: The Next Evolution of Clinical Care