The covid-19 pandemic
has validated opportunities to close care gaps in our fragmented system.
Doctors, innovators and advocates are hard at work creating a more united
approach.
By Dan Schumacher, President/COO,
Optum JULY
13, 2020
When a
physician suspects a patient has heart disease, they put their patient through
a stress test. By monitoring the patient’s heart function while exercising, the
physician can more effectively diagnose and treat the problem.
Covid-19
has been a stress test for our entire health system. Over 2 million people in
the United States have been diagnosed with the virus, while doctors, nurses and
first responders have served under the most extreme conditions to provide
patients and families with the compassionate, high-quality care they need.
While
our frontline health professionals performed heroically, the outbreak has put a
spotlight on a persistent and long-standing challenge: health care in the
United States is fundamentally disconnected. The system is composed of care
providers, health plans, pharmacies and others that lack a unified technology
infrastructure needed to share data and communicate with each other efficiently
and effectively. The ability to rapidly share information and coordinate across
the health system is especially important during a major pandemic, as health
officials attempt to accurately report cases, detect outbreaks and help
hospitals prepare for a possible surge.
A
connected, informed and effective system—one that relies on data and actionable
insights to put the right information in the right hands at the right time—is
essential to improving patient care and well-being. Because while many health
professionals may deliver quality services, the lack of coordination among them
often leads to inefficient and inconsistent care for patients and wide
variation in local health system performance. Covid-19 has put these realities
under a microscope and they will continue to impact patient care in the
future…unless we act now and together seize this moment to build a health
system that truly works better for everyone.
Optum
is bringing the health system closer together with health intelligence, data
interoperability, leading-edge technology and deep clinical expertise. And we
don’t do it alone. We bring distinct and broad capabilities to the people we
serve—including through direct care delivery, advanced technology and pharmacy
care services—and collaborate with forward-thinking customers, care providers,
health advocates and other health system leaders to deliver better care and experiences
to everyone, at more affordable costs.
The costs of disconnected care
A
fragmented health system impacts millions of American every day. The United
States lags behind other developed nations on both health outcomes and access
to care. Six in 10 adults in the U.S. have a chronic disease. Meanwhile, the
country has a higher rate of hospital admissions for preventable diseases than
its peers. This isn’t for lack of investment. The U.S. spends $3.6 trillion
annually on health care, nearly 18 percent of our gross domestic product—more
than any other developed nation.
In an
efficient, coordinated health system, primary care physicians are the hub for
patient care delivered by a network of providers. They collaborate with
laboratories to test for conditions, specialists to dig deeper into diagnosis
and treatment, and pharmacists to dispense the right medications. Unfortunately
today, according to a recent study, only about half of primary care providers
in the U.S. say that they receive patient information—changes to medication
lists, for example—from specialists outside their practice.
Medical
care received in a doctor’s office or hospital is just part of the picture. It
accounts for only 10 to 20 percent of overall health outcomes. Other key
factors include a wide range of social determinants such as income, housing
security, even access to basic transportation services.
Today,
much of our health system isn’t equipped to consider a more complete range of
inputs. Doctors can deliver top-notch medical treatment to a patient with
diabetes in their office, but any progress may be short-lived if dietitians,
pharmacists and other health providers aren’t working hand-in-glove with
providers to support the patient at home.
The future is whole-person care
A
connected health care system is one that advances whole-person care, an
approach that synchronizes medical, behavioral and social interventions to
address all of the factors that affect health outcomes. Optum teams have been
at the forefront of whole-person care long before the pandemic, advancing new
approaches and solutions that are driving better health for people today,
including among the most vulnerable patients.
One
example is integrated pharmacies. Because people with serious mental illness
face multiple barriers to recovery, Genoa Healthcare—part of OptumRx—brought
pharmacy services into community mental health clinics. Physicians, pharmacists
and mental health professionals work together with patients to ensure they have
the support they need to follow their treatment plans. As a result, more
patients take their medications as prescribed—reducing emergency room visits
and hospitalizations. OptumRx research shows that coordination among
pharmacies, providers and health plans results in better care for patients at
lower costs—including finding that individuals who use integrated pharmacy
services save 15% on inpatient medical costs.
Innovations
in data analytics and technology are also helping doctors deliver more cohesive
and proactive patient-centered care. Optum, for example, is enabling clinical
data exchange that improves the collaboration between payers and providers. On
the technology side, Optum is among a number of organizations that have
developed advanced telehealth solutions, allowing patients to speak with their
care providers live through digital devices. These services vastly improve
access to care for those who may be homebound, like disabled and elderly
individuals.
Another
example is remote patient monitoring. With the help of smart devices, providers
can keep track of important patient information, such as fluctuating glucose
levels, and detect problems before they escalate. This type of real-time,
intelligent care coordination helps ensure the patient is getting the right
treatment, when and where they need it.
Community
outreach is a key piece of the puzzle, too. For instance, a program in
Chicago—a collaboration of care providers and housing organizations—connects
the dots between good health and a safe place to live. The initiative, which
isn’t affiliated with Optum, provides support for chronically ill patients who
are homeless, combining treatment coordination, housing case management and
other services. The benefits were significant: One hospital linked with the
program reported a 57% reduction in inpatient stays among participants.
There’s
a lot of work ahead to build a more connected health system, and to the
challenge we are bringing the full dedication of our people, our distinctive
capabilities and our relationships with everyone we are privileged to serve
across the health system.
Like a
heart patient’s stress test, covid-19 has helped make the diagnosis clear: we
have to embrace new ideas, partnerships and technologies to build a more
unified, responsive and effective health system—one that improves care, one
patient at a time.
To
learn more on how to change health care for good, visit https://www.optum.com/how
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