“A central challenge for the United States is that between 18 to 20 percent of GDP is going to healthcare, and it’s on track to go higher,” says Edmund Sabanegh, Jr., MD, MBA, President of Cleveland Clinic main campus and regional hospitals. “This explosive growth in expense is not sustainable and we cannot afford it as a country.”
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In a conversation with Consult QD, Dr. Sabanegh explains that this reality is a principal driver of the operational challenges that hospital executives will face in the future. He discussed three trends that are emerging in response to this challenge and that will shape the hospital systems of the future. All of these trends amount to one thing: making healthcare more patient-friendly.
“The hospitals and health systems of the future will need to be more patient-centric. Patients will not come to health systems- health systems will need to come to patients,” he says.
Retail organizations like CVS and Walmart are moving into the healthcare space, and competition from other non-traditional healthcare sources is likely to be the norm. Amazon, Berkshire Hathaway, Inc., and JPMorgan Chase and Co. have formed a healthcare venture designed to reduce wasteful spending. Just recently, a merger between CVS Health and Aetna was approved.
What will this trend mean for the quality of care?
“I think it has the potential to go either way,” Dr. Sabanegh says. “There is the potential for a degradation of quality if retail outlets go beyond what they are really capable of doing. But if there are clear algorithms in place for identifying patients who need much more advanced care, patients may be able to receive very routine kinds of services at much lower cost.”
“Going forward, people are going to be able to shop for healthcare asking very specific questions — how much does gallbladder surgery cost?” Dr. Sabanegh notes. “And people will be able to compare prices at different institutions. You are going to be able to compare apples to apples.”
This kind of price transparency is being advanced by innovative companies offering niche services at lower cost. As an example, Cleveland Clinic has partnered with Smart Choice MRI to provide patients advanced radiology technology and expert interpretation by a Cleveland Clinic radiologist, for a fraction of what it would typically cost at a hospital. Eighty percent of patients are self-referred, with Internet scheduling or walk-in, convenient locations and extended hours. Patients typically receive a CD of their scan before they leave.
Leveraging the digital revolution
“Why should it be easier to schedule my car service than it is to get a general medical appointment?” Dr. Sabanegh asks. “If I need my brakes worked on, I can go online, click on an appointment and the service center will be expecting me when I pull in. But getting patients to the right doctor in a timely fashion is still a challenge for hospitals.”
Online scheduling of patient visits and online consultations with experts for second opinions are the future, Dr. Sabanegh says. For instance, MyConsult Online Second Opinions allows patients access to more than 425 Cleveland Clinic specialists across the health system. Patients receive a second opinion rapidly, and the system is now available in all 50 states and 115 other countries.
Moreover, hospitals and health systems of the future must leverage technology to allow for remote monitoring so that specialists can intervene during a patient visit without having to be physically present at all locations. “The systems of the future are not going to put all of our specialists in all of our locations,” Dr. Sabanegh says. “The future is really about leveraging technology to allow us to be available at all locations.”
He points out, for instance that at one of Cleveland Clinic’s locations, urologists are able to remotely monitor a procedure in which a patient received a catheter. “The technology is allowing us to do things virtually that are very high quality and maintain a presence in many places at lower cost.”
Photo Credit: Russell Lee
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