Moving Beyond Outcome Metrics
The proliferation of Accountable Care Organizations (ACO), spurred by the healthcare industry shift from fee-for-service to pay-for-performance, has focused healthcare executives’ attention towards clinical outcome metrics. Yet the greatest barriers–individual clinician practices– remain difficult to manage within the population health clinical delivery value chain. The solution: leveraging software as a service (SaaS) solutions to drive greater measurement and adherence to evidence-based practice plans.
This article series is intended to help you do several things: 1) learn about the adoption of SaaS solutions in the U.S. healthcare market, 2) become knowledgeable about how SaaS solutions can help address key barriers to innovation in current clinical practice, and 3) explore how to leverage SaaS offerings to identify Leading Indicators for Clinical Performance (LICP) and better manage clinical oversight of multiple providers. The endgame is to enable and accelerate a scalable implementation of Continuous Clinical Practice Improvement (CCPI).
Adoption of SaaS in Healthcare
Healthcare organizations have been undergoing significant consolidation both longitudinally and vertically along the entire healthcare delivery value chain. Many organizations are attempting to leverage size and breadth in order to weather the shift towards a pay-for-performance infrastructure. Organizations are also widely turning to SaaS solutions to help manage their data analysis needs and enhance their change management capabilities. In this article, we will examine how and why U.S. healthcare organizations have adopted SaaS.
SaaS Healthcare Growing Market Size
According to published data by MarketsandMarkets, the global market for Healthcare Cloud Computing was estimated at $3.73 Billion in 2015. This market, which is broken down into Software-as-a-Service (SaaS) and Infrastructure-as-a-Service (IaaS) offerings, is expected to grow at a compound annual growth rate of 20.5% to reach $9.48 Billion by 2020. This estimated market size includes both provider and payer end-users.
(“Healthcare Cloud Computing Market Worth $9.48 Billion by 2020,” n.d.)
Top 5 Reasons why U.S. Healthcare organizations choose SaaS
Historically, the healthcare industry limited its use of SaaS and outsourced services to clinical data entry and medical transcription, but no longer. Healthcare information management systems, clinical research, Big Data, medical billing, and IT needs around patient data security, are only a few areas of expansion of SaaS healthcare adoption. The following are the top five reasons healthcare organizations choose SaaS solutions.
- Avoid critical mistakes
- Reduce training cost
- Access expert and trained professionals
- Make time to focus on giving quality patient care
- Save cost without compromise on quality
(“Healthcare Organizations Hosting Data Using SaaS Model,” n.d.)
Characteristics of Healthcare use of SaaS by health organizations in the United States
In a 2014 survey of healthcare provider organizations, 83% of 150 healthcare IT executive respondents reported using cloud services, with 66.9% among them using SaaS. The remaining executives reported, 15.9% running an Infrastructure-as-a-Service (IaaS) platform and 2.4% using Platform-as-a-Service (PaaS) applications. The top three most common uses for cloud applications include:
- Hosting of Clinical Applications and Data (43.6%)
- Health Information Exchange (38.7%)
- Backups and Disaster Recovery (35.1%)
Near the bottom of the list is Accountable Care Organizations (6.0%).
(“83% Of Healthcare Organizations Are Using Cloud-Based Apps Today – Forbes,” n.d.)
(“HIMSS Cloud Survey: 80 Percent of Healthcare Organizations Embrace the Cloud – Electronic Health Reporter,” n.d.)
Shifting towards SaaS for Clinical Management
ACO participation has helped U.S. Healthcare organizations broaden their adoption of SaaS for data analytics into managed care. Beyond this, the holy grail of healthcare data analysis is predictive analytics which enable clinical managers to observe care delivery trends that impact patient outcomes. Leading Indicators for Clinical Performance (LICP) are metrics derived from evidence-based practice that measure an individual clinician’s approach for diagnosis and treatment. These metrics include details about each aspect of the clinical encounter (e.g. history of present illness, physical exam, diagnostics, and treatment plan) and include for example, presence or absence of a specific disease history or physical finding. LICP metrics can be aggregated and analyzed using common data analysis tools like SQL based relational databases, such as Microsoft Access and other Visual Basic for Application (VBA) language tools.
A significant challenge in the past has been extracting clinical data entered by clinicians and clinical staff at the point-of-care from legacy electronic medical records (EMR) systems. SaaS solutions such as IMAT Solutions and IBM Phytel offer extraction of clinical data from EMR systems into their proprietary analytics platforms. These new tools offer clinical managers the opportunity to better measure clinical delivery quality, and observe patterns for population health management.
Next Steps toward Faster Clinical Practice Innovation
We’ve covered our initial learning objectives: 1) Review of SaaS healthcare market offerings, 2) how and why SaaS adoption occurs among U.S. healthcare organizations, and 3) introduction of SaaS use case to improve clinical management. If we are to arrive at feasible, scalable solution to accelerate CCPI, our next step must be to better understand the barriers that currently limit this idealistic goal within the U.S. healthcare industry.
- 83% Of Healthcare Organizations Are Using Cloud-Based Apps Today – Forbes. (n.d.). Retrieved August 20, 2016, from http://www.forbes.com/sites/louiscolumbus/2014/07/17/83-of-healthcare-organizations-are-using-cloud-based-apps-today/#4057810a6502
- Healthcare Cloud Computing Market Worth $9.48 Billion by 2020. (n.d.). Retrieved August 19, 2016, from http://www.prnewswire.com/news-releases/healthcare-cloud-computing-market-worth-948-billion-by-2020-511149251.html
- Healthcare Organizations Hosting Data Using SaaS Model. (n.d.). Retrieved August 20, 2016, from http://www.healthitoutcomes.com/doc/healthcare-organizations-hosting-data-using-saas-model-0001
- HIMSS Cloud Survey: 80 Percent of Healthcare Organizations Embrace the Cloud – Electronic Health Reporter. (n.d.). Retrieved August 20, 2016, from http://electronichealthreporter.com/himss-cloud-survey-80-percent-of-healthcare-organizations-embrace-the-cloud/
About the Author
Anthony N. Harris, M.D., M.B.A., M.P.H., C-M.R.O., is the Medical Director of Community Occupational Medicine, LLC and a member of the UL EHS Sustainability Medical Advisory Board. Dr. Harris is Board Certified in Occupational and Environmental Medicine and has worked as an independent healthcare consultant with focus upon performing market research, product design, and business modeling strategy. He earned his Medical Degree and Masters of Business Administration from Indiana University School of Medicine and Kelly School of Business, and a Masters of Public Health from the University of Illinois, Chicago.