Healthcare Innovation

Perhaps more than in any other professional field, the healthcare system seems destined for change. Bloated patient rosters, inefficient practices, and a la carte billing techniques have left organizations in a state of disrepair, unsustainable for all but the elite healthcare providers at the top of the chain of command. Innovation and reform, however, stand clearly on the horizon ready to bring about positive change. The intricacies, opportunities, and challenges that come with meaningful growth deserve broad consideration. In this essay, I will define some of the most important variables shaping the evolution of modern healthcare and discuss these factors that may ultimately contribute to long-term sustainability. While the present system contains ample opportunity for growth, identifying the key variables to provide effective advancements needed for positive change in healthcare remains an entreaty of the highest order.

It may be most useful to begin by examining why innovation and healthcare have conflicted so often in the past. Fundamentally conflicting parties with specific interests each bring their own area of expertise to the field. Such parties include hospitals and doctors, technology-focused entrepreneurs, insurance providers, and politicians. Those individuals in leadership often conflict with technology entrepreneurs with zealous products that do little to positively affect the patient; insurance providers clash with hospitals over agreeing which treatment solutions are truly appropriate for the transmission of funds (Herzlinger, 2006, p. 2). Politicians ultimately carry their own point of view for improving the system, not the least of which includes helping them win votes on election day (Herzlinger, 2006, p. 2). With fundamentally conflicting interests, it may seem impossible to achieve meaningful innovation.

Innovation itself, nevertheless, heralds a new era for taking care of patients with chronic and acute illness. It may present itself in many different forms. Omachonu and Einspruch (2010) highlight the process, the product, and marketing as the three areas where innovation may achieve the most significant impact in healthcare (p. 5). As goods and services are driven by increasingly scrutinized open-market strategies alongside tightening budget scenarios, each of these three variables will be examined in order to provide a comprehensive consideration of future trends.

In the case of the process, hospitals will change their methods of communicating with patients as technology advances. Morse (2010) foresees an era where patients will have their own health profile that they can log in to view securely as they communicate with their doctor, confirm the results of lab tests, and renew prescriptions (p. 9). Although such advancement may appear risky in terms of patient confidentiality, other researchers come to similar conclusions. In fact, in their article examining social networks, Keckley and Hoffman (2010) highlight the presence of online organizations that allow patients to share their health data not with their doctors, but with other patients in the form of websites such as PatientsLikeMe and MedHelp (p. 5). Such an effort demonstrates the reality of a global movement focused on niche social networking within a vast amount of interests. In regard to actual hospital and patient interaction as realized today, Keckley and Hoffman (2010) focus on the increased use of "social media to engage in crisis management, help consumers understand their treatment options and obtain feedback on their services" (p. 7). In the wake of advancements in technology, the increased dialogue will become more easily facilitated in order to engage patients both vertically with their caregivers and horizontally with other patients.

In the case of the product, the method of its implementation must come under greater scrutiny. The statistics confirm a stark reality; the United States falls behind in the global competition for effective healthcare in areas of infant mortality and chronic disease despite investing $2.4 trillion in the system in 2008 (Stencel, 2009, p. 1). These troubling figures led Congress to invest another $1.1 billion in comparative effectiveness research (CER) designed to find areas to improve on the product itself (Stencel, 2009, p. 1). This money led to investigations examining the effectiveness of pharmacological and non-pharmacological treatment strategies in the behavioral disorders of Alzheimer's patients ("100 initial priority topics," 2010, p. 2). As the cost differences vary significantly, research finding the most efficient treatments deserves note.

Innovation and renovation in the healthcare sector are imminent to combat product cost issues. Even as the Affordable Care Act (ACA) was passing through Congress, Keckley and Hoffman (2010) composed a report detailing the need for innovation in the realm of payouts using accountable care organizations (ACO) (p. 4). The need for such innovation comes because the product, as noted by Stencel, has become so inefficient. Keckley and Hoffman (2010) suggest that change must ultimately come from an increased focus on quality patient care rather than payment plans that itemize services and financially reward high-volume processing (p. 6). The innovation of the ACO seeks to provide for the needs of pre-selected group of patients to provide "evidence-based care" where "longitudinal outcomes and costs" are considered in an environment of "accountability at the local level" (p. 7). Such an investment of practicality in the implementation of the healthcare product could lead to meaningful results amid an overloaded system.

In the case of marketing, CER, as highlighted by Stencel (2009), will lead to initiatives that place a heavier emphasis on the cost of treatment (p. 1). This innovation has already been implemented in the case of ACA instilled by President Obama with insurance market reforms, the expansion of Medicaid, the Health Insurance Exchanges, and the Independent Payment Advisory Board (Keckley et al., 2011, p. 16). Like it or not, marketing change is here.

The process innovation engendered in increased social networking lies at the heart of our modern times. Here, the patient no longer answers uniquely to the healthcare provider but rather seeks their own way of becoming educated about their issues through the support of peers. If knowledge is power, the patient stands to gain the most. Patients will go as far as changing their visitation habits in preference of a more economic virtual consultation with a practitioner who can measure their vital signs in real-time and directly address needs (Morse, 2010, p. 14). This innovation will allow for a broader application of healthcare as the population increases.

The product innovation will provide for yet another streamlining effort that focuses on reducing costs. Especially in the case of chronic care, researchers are discovering that there is a lack of coaching to instruct patients how to take care of themselves; the solution, rather, must rest with a "preventive and curative" solution that gives a "broad spectrum of care" from a primary provider (Keckley & Underwood, 2008, p. 4). All of this comes back to the issue of billing methods and objective solutions. In a situation where 30% of children with ear infections in the Colorado Medicaid program received expensive prescriptions rather than cheap antibiotics as a method of first-tier treatment, it seems people are finally beginning to recognize the importance of disseminating a practical product (Berwick, 2003, p. 3). Although the primary care model has detractors, in coordination with ACO, it stands to create a positive change for the patient and the economy above all despite the conflicting interests highlighted by Herzlinger.

The market innovations will, above all, be defined in the soundness of their underlying strategies. In connecting with the patient, Keckley and Hoffman's (2010) research on social networks imply that healthcare providers will benefit from tools that allow them to measure the effectiveness of their services as modeled in the information technology sector (p. 3). As the market takes the collective temperature of its client base, healthcare competition will increase.

Given all the above-referenced information, I have come to some of my own conclusions about the future of nursing as the innovations develop. First, it appears that even greater conflicts lie on the horizon. It is difficult for me to imagine a situation where doctors, pharmacists, patients, and politicians all find a healthy point of agreement. In the end, one party or another stands to be disappointed as they are forced to compromise in areas where they previously enjoyed uninhibited activity. Nowhere has this been more apparent than in the vehement condemnation of ACA, or ObamaCare, as consumers already integrated into the system experience financial discomfort as the law calls for them to pay higher premiums. In the short term, the situation may get worse as practitioners struggle to grasp a new system.

Secondly, healthcare will become more impersonal in light of technological advances. People will begin to be forced to take more responsibility for their own health or face massive inconveniences. Already, the movements appear in place. Organic food stores are appearing everywhere. Personal workout routines gain in popularity for people of all ages even as massive conglomerates continue to market their processed food and beverage products as happy, hip, and wholesome. Tenets of the ACA innovation measures must be expanded to provide public health initiatives that reflect a national interest in each person taking care of themselves instead of relying on the system to regulate their well-being.

Based on the following sources, innovation seems imminent. However, it causes me to question whether it will make a true difference in the way people are taken care of. There is too much money involved for large healthcare providers to gain for them to simply back off and regulate their innovative new products. Nevertheless, innovation will create new opportunities for the patient to empower themselves and find their own solution. These contradictory attitudes only highlight the uncertain nature of healthcare in American society. Time will tell its effect.

References

100 initial priority topics for comparative effectiveness research. (n.d.). Institute of Medicine of the National Academies. Retrieved from http://www.iom.edu/~/media/Files/

Berwick, D. M. (2003). Disseminating innovations in health care. JAMA: The Journal of the American Medical Association, 289(15), 1969-1975.

Herzlinger, R. E. (2006, January 1). Why Innovation in health care is so hard. Harvard Business Review. Retrieved from http://hbr.org /web/extras/insight-center/health-care/why-innovation-in-health-care-is-so-hard

Keckley, P. H., & Underwood, H. R. (2008). Disruptive innovation for a new primary care model. Deloitte Center for Health Solutions, 1, 1-18.

Keckley, P. H., & Hoffman, M. (2010). Accountable care organizations: A new model for sustainable organization. Deloitte Center for Health Solutions, 1, 1-19.

Keckley, P. H., & Hoffman, M. (2010). Social networks in health care: Communication, collaboration and insights. Deloitte Center for Health Solutions, 1, 1-8.

Keckley, P. H., Coughlin, S., Gupta, S., & Vasquez, C. (2011). Comparative effectiveness research in the United States: Update and implications. Deloitte Center for Health Solutions, 1, 1-22.

Morse, G. (2010, March 9). Most-Promising Health Care Innovations. Bloomberg Business Week. Retrieved from http://www.businessweek.com/managing/content/mar2010/ ca2010039_575207.htm

Omachonu, V. M., & Einspruch, N. G. (2010). Innovation in healthcare delivery systems: A conceptual framework. The Innovation Journal: The Public Sector Innovation Journal, 15(1), 1-20.

Stencel, C. (2009, June 30). IOM report recommends 100 initial priorities for research to determine which health care approaches work best. National-Academies.org | Newsroom. Retrieved from http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID =12468