Last month, hackers broke into Anthem Inc, the second largest health insurance company in the United States. The hackers stole personal information from 80 million people, including Anthem’s CEO, Joseph Swedish. The latest estimates suggest the breach will cost Anthem $100 million to remedy.
Read MoreThis week at the 2014 mHealth Summit in Washington, DC the conversation on the integration of pre-hospital care into the larger healthcare system was practically non-existent. The absence of this conversation in the mobile health space, and it’s limited engagement in the EMS sphere, reflects a fundamental disconnect between EMS and the larger healthcare industry. It is two-sided disconnect, and it’s an opportunity.
Read MoreThis article was originally published by EMSWorld News and Medlert Inc.
Under the Affordable Care Act, hospitals, as well as physician groups starting in 2015, are being rewarded or penalized by Medicare based on scores on value-based metrics such as clinical outcomes, patient experience, and efficiency. Part of the push for higher-quality care focuses on eliminating hospital readmissions for the same problem within a short period of time. Nationally, hospital penalties for preventable readmissions are predicted to hit $756 million in 2014, and will likely have a trickle down effect in many other health industries, including the ambulance service industry.
Read MoreLast week, I spoke with Matt Zavadsky, Director of Public Affairs at MedStar Mobile Healthcare in Ft. Worth, Texas about how to define value in EMS and the ambulance service industry.
“When we talk about defining value, we have to remember what audience are we talking to,” said Zavadsky. Zavadsky, a leading expert in mobile integrated healthcare, is an advocate of new care models in EMS as well as new ways of defining the value of EMS and ambulance services within an integrated healthcare system. Zavadsky was quick to point out that EMS serves many groups: patients, providers, healthcare organizations, and hospitals. Each group’s understanding of value may differ.
“If you are a patient, you perceive value as having your pain relieved or your breathing difficulty resolved. But the patient’s perspective on value may be different than the payer’s perspective,” said Zavadsky. “The payer may say, ‘What money have you saved me? How have you made an impact on the economics of caring for this patient?’ ”
Zavadsky pointed out that as healthcare providers, one of the value-adds of EMS is the reliable compliance with clinical bundles that have been proven to make a difference in patient outcomes.
Part of the recognition of EMS professionals as healthcare professionals has come out of the push towards more evidence-based approaches to EMS care.
“You can’t be recognized as a player in healthcare today if you’re aren’t based in sound science,” said Ed Racht, MD, Chief Medical Officer at AMR. “Evidence-based EMS and the accountability to be evidence-based is a dramatic change.”
A third big change, Racht pointed to, is a shift towards more sophisticated performance metrics for EMS.