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What’s Missing in the Current Healthcare Ecosystem?

Part 3 of our Emerging Rx series

This eLearning series, which we will release over six weeks, addresses the changing healthcare environment, the importance of technology as a tool to achieve improved care and efficiency, and the opportunities for pharmacists to play new strategic roles.

In the first parts of this eLearning series, we discussed what’s ailing our traditional healthcare model and the gaps it creates in patient care. In this third part, we’ll take a look at some of the critical factors missing in our current healthcare ecosystem.

Part 3: What’s missing in the current healthcare system?

Our healthcare system does have the resources and expertise needed to deliver high-quality care. But in order to optimize efficiency, improve patient outcomes and cut healthcare spending, the players in the system need to be better coordinated and connected.

Some of the greatest gaps in the patient care continuum include: follow-up care after hospital discharge and outpatient procedures, monitoring adherence to prescribed treatments and comprehensive care management of chronically ill patients.

Recurrent hospitalizations represent a substantial and often preventable human and financial burden, with 19% of Medicare fee-for-service patients rehospitalized within 30 days of discharge. Half of these patients never see an outpatient doctor before they are readmitted to the hospital.

Gaps like this highlight the need for a whole-system approach to care delivery, where performance is measured and providers are be held accountable — and rewarded — for performance across the continuum of care.


What’s missing in our current healthcare system?

Technology. The system needs technology to integrate all patient information in a single database, so that medical records are quickly accessible by all care team members, helping them avoid duplicate paperwork, tests and treatment.

Incentives. As we move from a fee-for-service to a fee-for value system, we need to establish an incentive model for each care team player that rewards efficiency and a positive impact on patient outcomes.

Risk sharing. As we work toward improved outcomes and lower costs, all care team members have the potential to share in savings. They also take on risk. The system needs a mechanism for providers and payers to share the total cost-of-care risk.

Next, we’ll dive into some of the new models of patient care that work to fill these gaps. Check back next week for Part Four: The Changing Model of Care.

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