By Maria N. Ward, M.Ed., RHIA, CCS, CCS-P
“Look around you, at where each of you are sitting,” said Christine Kalish, MBA, CMPE, as she gazed across the room of seated attendees, with aisles and rows separating them into sections. “This is how disconnected we are in the way that we access healthcare and the way we get information.” Kalish and Penny Crow, MS, RHIA, of Brittain-Kalish Group, LLC, took a closer look at the expanding horizon of today’s continuum of care in their session “It’s Not Your Momma’s Healthcare” at AHIMA19: Health Data and Information Conference on Monday.
Patients today have a number of choices for how and where they access healthcare services, many of which exist beyond the traditional physician office and acute care hospital. Take for example urgent care centers—completely different from a free-standing emergency room or a mid-level clinic. Generational differences and the demand for individualized care, along with ever-increasing advancement in technology, have a significant impact on healthcare that will continue to bring about change in the industry.
There are several generation considerations to take into account. Individuals in the “Silent Generation” (born between 1925 and 1945) tend to stick with the traditional means of accessing care, going to a physician in a practice setting and following the orders provided. Baby boomers (born between 1946 and 1964) are still likely to see a physician, but they are also more likely than Silent Generation individuals to argue with the physician and may be more interested in self-directed care. Members of Generation X (born between 1965 and 1980) tend to attempt to self-educate before seeing a physician but may or may not maintain loyalty to a provider. Millennials (born between 1981 and 1996) prefer a strong provider connection, but are less likely to discuss concerns with them. Finally, Generation Z (born between 1997 and present day) are all about preventive wellness and want two-way communication regarding their health information—and they want it fast. Generation X, Millennials, and Generation Z are the three groups most likely to use patient portal technology to access their health information and interact with providers.
What does this mean for the acute care setting? More and more, the acute care setting is going to shrink. There are over 100 health systems that have begun to partner with retail chains to provide primary care clinics, including CVS, Walgreens, Walmart, Target, and Kroger. These are one-stop shops where patients can get in to see a physician, fill their prescription, and do their shopping. In a span of 10 years, the number of consumers visiting these clinics has gone from one in 10 to one in three. Concierge medicine is another shift taking shape in healthcare, with more physicians practicing some form of subscription- or retainer-based medicine. And we would be remiss to not mention telemedicine, which continues to grow. More than 15 million Americans received some kind of remote care last year, and that number is expected to grow by 30 percent this year. What’s more, the popularity of wearable devices and other mobile health devices that can transmit information is astronomical.
Now for the big question: Where is all of this patient information being stored?
And how will this information affect employers, payers, healthcare systems, and individual healthcare consumers? Providers have begun to identify the challenges of determining and mitigating the disparate avenues through which patients are accessing care. Changes in the patient population and changes in technology make it difficult to care for the whole patient. Awareness is key; health information management professionals need to anticipate the challenges that come with the expanding scope of the care continuum and their implications for workforce, regulatory issues, and reimbursement risks. “We found that we need to be aware of all disruptions in our industry,” Kalish explained. “We have to stay aware and understand our role to protect the patient.”