Right Care, Right Time, Right Place

Sounds like an obvious healthcare provider mission or phrase we might find on the walls of any local hospital or primary care provider, doesn’t it?   Unfortunately, our healthcare ecosystem is not financially nor operationally aligned to truly deliver on this promise, at least in not all communities.

Let’s start by working backwards from “Right Place.”   Traditional healthcare delivery and providers rely on a retail model for healthcare consumption, meaning you need care, you find who you believe is the appropriate healthcare provider.   While we should never take the retail, consumer choice out of this equation, healthcare providers need to be ready to fundamentally shift where care is ultimately delivered. As healthcare payment models continue to change, alternative medicine/therapies gain adoption, new patient engagement channels like telemedicine emerge and value-for-service healthcare delivery become more widespread, we are entering the age where the “Right Place” will not always be the hospital, traditional Doctor’s office or skilled nursing facility.   Equally important as healthcare outcome is patient experience and this is and will continue to challenge where care is ultimately provided.

The “Right Time” seemingly a much more existential question is the glue that holds each of its counterparts together.   Without “Right Time” we may provide the wrong care and in the wrong setting. It is an easy principle to take for granted if we only look at traditional emergent, primary care settings but with a growing aged population, care pathways that emphasize a more longitudinal view of healthcare will expose healthcare process deficiencies and increase preventable cost if not managed affectively.

Last but not least, the “Right care” is more than just selecting the right MD or Provider.   It is a recipe in of itself requiring the right provider, correct care pathway and intended patient outcome.   As we look across the nation’s ACO efforts we see measured progress namely with the formation of smaller, managed care networks that attempt to form a care continuum for its patients. Directionally correct, though these models are being met with some expected resistance as perceptions of limited access and provider choice arise out of these models.   A direct correlation with the earlier comment that we need to make certain we don’t take the consumer and retail feel out of healthcare. Americans are consumers, we value good experiences and choice and subsequently care delivery needs to cater to these accepted paradigms.  

So what to do?   How can we succeed in healthcare? How can we implement “Right Care, Right Time Right Place strategies” to target the proverbial healthcare triple aim to reduce cost, improve patient experience and begin implementing population based healthcare tactics?   All is not lost and the answer we can find by looking a few post-acute healthcare providers across the nation that are learning to care for a growing, more costly yet more technically educated Medicare population.   The answer is truly in the words that started this blog.   We need to deliver the right care at the right time and at the right place. We can do this while empowering consumer based choice and reducing overall cost.

Healthcare providers like Covenant Care in the Florida Panhandle, serving patients from Mobile, Alabama to Tallahassee Florida have learned that quality, value based care means serving the patients when they need help most and where they need it most.   Enabling a broad spectrum of integrated post-acute healthcare capabilities with LEAN clinical processes, providing targeted, value added technologies such as telemedicine and aligning with key, high quality healthcare providers within the broader healthcare system is fundamentally creating value-based care pathways that deliver exceptional patient experience, in the correct setting whether that be a home, SNF, IPU, LTACH and at a cost in alignment with CMS reimbursement initiatives like bundled payments for Comprehensive Joint Replacement (CJR) and Congestive Heart Failure (CHF).

What can acute and other primary care providers in your respective areas take from their success? First, truly focus on partnerships and not just simple referral relationships but true, long standing potentially risk sharing partnerships with leading providers.   Stand toe to toe with them, collaborate and begin every new patient experience with a “care navigation” framework that not only looks to triage the immediate need but the forecasted continuum on how to engage “said” patient beyond any specific encounter.   Second, while telemedicine has its challenges embrace it for all its future potential.   We are on the verge of biometric nirvana which will inevitably align or moreover inform and overtake traditional telemedicine capabilities creating a new era in care delivery and ultimately care pathways. Last, delivering care where appropriate needs to evolve from the current state…we must go here, we must go there.   Go the GEMBA as they say in LEAN and go where the patient needs to be met.   PCMH and home based primary care are beginning to emerge more and more and we will all be better for it.

In closing and I know I have attempted to say a lot in a small venue but as a provider embrace other providers that are on this same journey. Accept the “Right Care, Right Time, and Right Place” as more than words and align people, processes and technology to ensure this standard. As a patient, push for a healthcare system that not only provides choice in a healthcare provider but choice in what care is provided, where and when!

17 Aug 2018

By Todd Fisher