🧩Lost in the system

What’s in for today:

• Fragmented system

• AI in healthcare: Recent investments

• Healthcare minimum wage delay; FDA says no to MDMA

LET’S TALK!

Fragmented system

The video humorously (or sadly) shows the issue of fragmentation in healthcare. It highlights the disjointed and uncoordinated nature of the American Healthcare System, where different aspects of patient care are disconnected and operate independently. The way care is delivered and financed is distributed across different groups, each with its own goals and motivations. Because of these separate systems, navigating healthcare can be confusing and time-consuming.

Data from the Harris Poll suggests that adults spend an average of 8 hours per month coordinating care for themselves, and/or their loved ones. 65% of respondents say that managing healthcare is overwhelming and time-consuming.

Story time

I recently had a conversation with a friend about this topic. She shared her struggles in navigating her own healthcare, despite being in the healthcare field herself.

She has been having persistent neck pain. She went to go see her primary care physician (PCP), who then referred her to imaging. Since her PCP’s office does not provide imaging services, she had to go to another facility for scans.

After a few weeks, she returned to her PCP, who reviewed the images and referred her to an orthopedic specialist, who then further referred her to physical therapy. Throughout this process, my friend had to schedule appointments with the imaging facility, the specialist, and the physical therapy office. Additionally, she had to fill out similar paperwork at each location and coordinate with her insurance company to ensure coverage.

It’s surprising to think that even someone in the healthcare field has difficulty navigating such a disjointed process. It must be even more challenging for those who are not familiar with the healthcare system.

How did we get here?

The progress in healthcare technology has led to the development of more specialized fields within medicine, each focusing on specific aspects of health. While this specialization has improved care in particular areas, the integration and coordination among providers have not kept pace.

What does this look like?

Fragmentation in healthcare has many layers, affecting healthcare providers, patients, and their family members.

• Disjointed care transitions: When patients transition from one care facility to another (for example, from a hospital to a rehab center), it’s important for all healthcare providers involved to communicate effectively. Unfortunately, this doesn’t always happen, and it can result in unnecessary medical errors, substandard care, and additional visits. A study found that 34% of PCPs reported not always receiving useful information from specialists about the patients they refer (Read the study here).

• Lack of care coordination: Navigating long-term health issues often means juggling appointments with different doctors. Unfortunately, when these doctors don’t communicate effectively, it can result in conflicting advice. This leaves patients feeling confused and can make it challenging to follow through with their treatments (Read the study here).

• Patient confusion and frustration: Trying to find your way through the healthcare system can be a real challenge. It’s like navigating a maze, with multiple organizations trying to figure out where to go for your specific needs. This confusion can lead to missed appointments, delayed treatments, and added stress.

Why should you care?

Picture this: Instead of having to juggle multiple appointments and worry about coordinating your care across different organizations, you just show up at one place, and everything is seamlessly managed for you. No phone calls to insurance, no duplicate paperwork. It’s like a dream come true, right?

Fragmentation goes beyond just paperwork; it directly affects patient outcomes and experiences. When healthcare providers work together and patients receive timely and appropriate care, it can lead to better management of chronic conditions and reduced patient confusion and frustration. Additionally, reducing fragmentation saves costs, not only for healthcare organizations by eliminating redundant tests, but also benefits patients.

TRACKING: AI IN HEALTHCARE

• Assort Health has just unveiled an innovative AI solution for healthcare call centers. With $3.5 million in funding, this technology aims to revolutionize patient interactions and seamlessly integrate with electronic health records. Early reports show remarkable efficiency and patient satisfaction improvements with reduced call drops and hold times.

• Tempus AI Inc., a healthcare tech company, is gearing up to raise over $400 million in IPO. The company aims to integrate AI across all diagnostic processes, empowering physicians and researchers to make data-driven decisions that ultimately improve patient care.

• Transcarent, a healthcare tech company, has just secured $126 million in Series D funding, bringing its total funding to $450 million. This latest round of investment has also boosted the company’s valuation to a staggering $2.2 billion. The influx of funds will supercharge Transcarent’s AI capabilities and fuel its commercial growth. Transcarent’s innovative platform is dedicated to connecting members to a range of healthcare services, with a focus on simplifying employer healthcare coverage.

POLICY & INDUSTRY NEWS

🩺CA Healthcare Minimum Wage Delay: Governor Gavin Newsome signed a bill to delay the new $25 per hour minimum wage for healthcare workers, pushing the effective date from June 1, 2024, to July 1, 2024 (Read the bill here).

🏥Breach Notification: The U.S. Department of Health and Human Services clarifies that UnitedHealth Group’s Change Healthcare is responsible for notifying affected individuals about data breaches.

🥼An FDA advisory committee has voted against the use of MDMA (aka ecstasy) as a treatment for post-traumatic stress disorder (PTSD).

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