CAROLINAS HEALTHCARE SYSTEM 6
Current situation and issues
The Carolina Healthcare System is currently being faced by numerousissues and or problems as it is stipulated in the case. Thehealthcare system is said to rely on non-standard basis in its work.In other words, the healthcare system’s work is not based onevidence. The issue that the case seeks to highlight is the absenceof patient data analytics which would be essential in enhancing thequality of care and reducing the cost of healthcare (Rodriguez &Quelch, 2016). Patient data analytics is a process that looks at thepatient data such as demographic information, financial informationand biographical information in order to plan on how to provide thebest care. The issues that are affecting the hospital can beaddressed through an effective consumer analytics program atCarolinas Healthcare system.
The adoption of the Affordable Care Act in 2010 presented the healthcenters such as the Carolina one with various issues that needed tobe addressed through consumer analytics. To start with, the CarolinasHealthcare System was forced to deal with the fact that thegovernment would consider partly, the quality of care that patientsreceived in the hospital rather than their mere visit for service.This meant that the government’s reimbursement of the medical costswas based on the outcome of the treatment as opposed to the mere feefor service (Rodriguez & Quelch, 2016). This is a huge issue thatfaced healthcare providers. In order to track the health progress andimprovements for patients, hospitals sought to adopt consumeranalytics which would ensure that the health improvement of thepatients is tracked. Additionally, Carolinas Healthcare System wasfaced by the issue of high rate of readmissions. It is essential tonote that the government imposed fines on healthcare givers with highrates of readmissions. This called for an improved patient care andfollow up after discharge.
Another issue presented in the case is the issue of digitalizationof healthcare. The US Center for Medicare and Medicaid Servicesoffered incentives for hospitals that adopted electronic medicalrecords that run up to two million dollars. Whereas the ACA allowedpatients to view their data in the EMRs, the healthcare givers werefacing a challenge since they could not model the data even if thepatients requested for changes in their data. However, Google andApple were in the frontline in 2014 in making medical recordsavailable to patients through their Iphones (Rodriguez & Quelch,2016). The adoption of consumer analytics at the Carolinas Healthcaresystem would ensure that the healthcare facility adoptsdigitalization of their healthcare services, education and research.
Another issue presented in the case is the shortage of nurses. It isessential to note that the shortage of nurses has a direct effect onthe quality of care provided. The adoption of the Affordable Care Actincreased the number of patients significantly with 2014 having anadditional 32 million people into the healthcare system. It is clearthat this is a major problem to the healthcare institutions such asCarolinas Healthcare System (Rodriguez & Quelch, 2016). Nurseshortage will have a direct effect on the quality of care that isprovided to the patients. Follow up will also be extremely difficultfor the few nurses. However, consumer analytics and the enhancedcomputer powers, the CHS could afford to deal with the problem ofnurse shortage.
Many healthcare facilities such as CHS have always encouraged theirpatients to seek outpatient services in a bid to reduce the cost ofhealthcare. It is clear from the case that the cost of seekingtreatment through inpatient health services or the emergencydepartments is extremely expensive. It has become apparent that 58%of the health costs in the US are from outpatient services (Rodriguez& Quelch, 2016). However, this has become an issue for thehealthcare facilities since the patients do not seek services fromtheir facilities but rather go to new entrants such as CVS and Krogerwho are said to offer convenient and affordable services. There arenumerous walk-in clinics in the US that are coming up and which areoffering services at a relatively low charges compared to visits todoctors or a visit to the emergency room.
Carolinas Healthcare System lacked an integrated consumer analyticsteam that would collect, store and analyze patient data in a bid toenhance service delivery and offer personalized care. When CHSadopted the electronic medical records in 2006, it was evident thatthe cost was enormous. This aspect had held back the institution fromengaging in consumer analytics. This lack of consumer analytics havemade the CHS to fail to offer personalized care and it has alsoaffected the quality of care provided (Rodriguez & Quelch, 2016).Lack of consumer analytics also affected the predictive modelingwhich is vital in healthcare. It is clear that the institution had nowarehouse for patient data storage. This is the data that theanalysts analyze in order to establish patient behaviors and healthstatus in order to provide personalized, quality care.
It is also clear from the case that the institution had a poorcommunication and engagement with the patients. One of key elementsof improving the quality of healthcare is engaging with the patientsand the clinicians in a bid to understand areas which requireimprovement. It is essential for healthcare givers to engage withpatients in order to guide them to change their behaviors such aslifestyle and therefore improve their health (Rodriguez & Quelch,2016). Lack of a communication strategy was hampering suchengagements. The results were high rates of readmissions and poorfollow up and hence poor quality of health care. Consumer analyticsis an approach that will help Carolinas Healthcare System to dealwith these issues and therefore reduce the cost of healthcare andimprove quality.
In conclusion, there are various problems that have been identifiedin the case. The Carolinas Healthcare System is engaged in thedevelopment of consumer analytics which is a process of collectingdata and analyzing patient behavior in order to make the rightdecisions regarding service provision and cost reduction. TheAffordable Care Act stipulated new regulations which have affectedthe operations of the healthcare institutions. It is now mandatoryfor healthcare institutions to offer quality services since they canonly be reimbursed for outcome and not for mere services. The numberof patients has also increased as a result of the ACA while thenumber of nurses still remains low (Rodriguez & Quelch, 2016).Lack of a consumer analytics has affected the quality of care that isgiven to the patients at Carolinas Healthcare System. It has beendifficult to engage with the patients or even to guide them on how toimprove their health through behavioral changes. It is also essentialto mention that there has been a problem with regards to sharing ofdata amongst the various healthcare stakeholders.
Rodriguez, M. & Quelch, J. A. (2016). Carolinas HealthcareSystem: Consumer analytics. Harvard: Harvard Business School.