A Global Approach to the Dynamic Shift in Healthcare

Felisha Bochantin ^a

The command in outpatient care is in full swing, and it has drawn an increasing share of attention. Inpatient care, for over decades a core business for facilities, is now in decline. As the procedures are out-migrating from facilities to ambulatory and outpatient centers the technology will need to compete effectively in the outpatient arena.

The 3M HIS presentation will discuss the increasing shift of services from inpatient to outpatient settings and from outpatient to ambulatory settings, setting the stage for a complex strategic planning process. Key questions will be addressed regarding how we currently look at tracking the overall outpatient patient experience. Are we connecting the dots globally? Are we using the correct KPIs and are we using them consistently? In this presentation we discuss if the case mix is relative for outpatient services. By crafting an outpatient strategy, leaders should expand their perspective beyond simply attempting to win outpatient versus inpatient volumes and focus more holistically on offering a unified value proposition.

Regardless of the site of care, consumers should want to choose their system carefully. Achieving this value proposition is no easy feat, and hospital and health system leaders will have to evaluate an array of factors to do so, 3M offers a wide range of population health grouping methodologies, including the following:

Ambulatory Potentially Preventable Complications (AM-PPCs) Classification System. This clinically based methodology identifies ambulatory surgeries/procedures with patterns of complication of care, based on computerized discharge abstract data. The output from the AM-PPCs Classification System can be used to compute complication rates for facilities and providers. Higher than expected complication rates may indicate opportunities to improve the quality of procedures being performed on an ambulatory basis.
3M IR-DRGs are used by researchers, hospitals, outpatient/ambulatory facilities worldwide as a part of their funding systems and for budgeting, outcomes analysis, benchmarking, and performance measures. The system compares resource consumption across facilities and regions, supporting local and national health system management.
3M CRGs are also useful as they are patient-centric, focus on the total burden of illness rather than one disease or service, and use a categorical approach to patient classification that provides clinicians with actionable data.

We will examine how these methodologies can assist in connecting the dots across population health spectrum including various healthcare settings.

References

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Beans, B. E. (2016, April 1). Experts foresee a major shift from inpatient to ambulatory care. P & T : a peer-reviewed journal for formulary management. Retrieved January 17, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4811253/
Deloitte . (n.d.). Hospital revenue trends. Deloitte Insights. Retrieved January 18, 2022, from https://www2.deloitte.com/us/en/insights/industry/health-care/outpatient-virtual-health-care-trends.html
Deloitte Insights. (n.d.). Growth in outpatient care - deloitte. Deloitte . Retrieved January 17, 2022, from https://www2.deloitte.com/content/dam/insights/us/articles/4170_Outpatient-growth-patterns/DI_Patterns-of-outpatient-growth.pdfKumar, P., & Parthasarathy, R. (2021, July 1). Walking out of the hospital: The continued rise of ambulatory care and how to take advantage of it. McKinsey & Company. Retrieved January 18, 2022, from https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/walking-out-of-the-hospital-the-continued-rise-of-ambulatory-care-and-how-to-take-advantage-of-it
Person. (2019, January 8). The outpatient shift continues: Outpatient revenue now 95% of inpatient revenue, New Report reveals. Advisory Board. Retrieved January 17, 2022, from https://www.advisory.com/en/daily-briefing/2019/01/08/hospital-revenue

^a 3M, United States

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