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Throughout the industrialized world, healthcare systems are in crisis. Whether healthcare is shaped by government policy, driven by the market or a combination of both, aging populations and skyrocketing costs are putting unprecedented financial and organizational pressure on state and private healthcare providers as well as payers. The result is often a decreasing level of care.
In response, fundamental changes are taking place in the manner in which healthcare is administered. Patient-centric systems are evolving in which the patient’s well-being and the responsibility for his or her own good health are defining treatment and operational policies. This change is made possible by advances in technology, but it is being driven by market forces and societal desire to improve the health of a nation’s citizens, while reducing healthcare costs.
IBM is deeply involved in the move toward a patient-centric healthcare delivery system. In projects throughout the world, IBM is working with government bodies, healthcare providers and healthcare payers to help implement necessary patient-centric systems and strategies. In this white paper, we will explore the meaning of a patient-centric healthcare system, its benefits as well as challenges, the changes necessary to create a patient-centric system, and the role that IBM is playing to help create new opportunities for all parties.
Healthcare today
You have probably heard some of the anecdotes that illustrate the difficult state of today’s healthcare systems. From patients to providers, everyone is affected:
- The 250 000 people who die in the United States every year due to surgical errors, mistaken diagnoses, incorrect prescribing, hospital-acquired infections and inadequate care.
- The heavy burden that U.S. industry pays to provide healthcare to its employees. For example, healthcare costs account for an estimated US$1500 of every new car that General Motors sells, putting it at a serious disadvantage as compared to some of its foreign competitors.
- The seriously ill woman who must go through the emergency room, rather than her physician, to get a hospital bed because the hospital needs the extra funds it receives from insurers for emergency room visits.v - The 45 million uninsured Americans who delay treatment or use the emergency room as their primary-care facility, shifting costs to private- and public-sector payers. As access decreases and premiums increase, the reputation of the health insurance industry plummets.
The healthcare industries in many countries around the world are at a critical juncture. While offering the finest benefits to some of its citizens, nations are burdened with out-of-control health costs, rocketing insurance premiums, declining coverage and uneven access to quality care. Continuing a patchwork approach will only reduce a nation’s competitiveness as the ability to keep citizens healthy falters.
In the U.S. for example, people expend more, but are getting less. In 2003, among nine industrialized OECD nations, the U.S. spent more per capita for all healthcare services (US$5635) than any other, and more than twice as much as the median amount (US$2280). In addition, the U.S. spends more than any of the 30 OECD member countries for public and private health insurance, with its citizens paying the most out of pocket.
At the same time, the U.S. has the lowest longevity rate at birth among those 30 countries. Although virtually every other industrialized country offers universal health insurance, in the U.S., over 45 million people remain without any type of coverage, and millions more are underinsured.
Today’s health benchmarks are not encouraging. According to various studies, more than 57 000 people in the U.S. die from inadequate care. Healthcare is unevenly available and unevenly priced. The World Health Organization ranks the U.S. 37th in overall health system performance; throughout the nation, similar procedures with similar outcomes can cost 400 percent more in one region than another. And among the 30 OECD countries, the U.S. ranks at the bottom in terms of life expectancy.
The patient-centric approach
To help counter these trends, medical providers, governments and financing entities in the U.S. and a number of other countries are applying patient-centric approaches to healthcare. Patient-centric does not imply a fixed set of guidelines; rather it is a fluid and still-evolving definition characterized by practices that benefit patients: ensuring that they receive the best treatment, at a reasonable cost, while putting into place strategies that will help individuals avoid becoming sick in the first place.
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