4 Areas in Need of Innovation

As one of the Healthcare Innovation Lab’s first activities, Director Thomas M. Maddox, MD, conducted interviews with key stakeholders from BJC HealthCare, Washington University School of Medicine, affiliated Washington University departments, and the St. Louis community to understand their innovation needs and the local context in which they operate. These insights were distilled into the following four areas.

1. Health Data Collection and Analysis

Current health data resources and organization are insufficient to effectively serve patients. For example, data sources (e.g., those found in the electronic medical record) are fragmented and siloed, preventing healthcare providers from easily accessing a comprehensive picture of a patient’s health. In addition, there are significant gaps in collecting vital health information, such as genomic information, patient-reported health status and outcomes, and social determinants of health. These gaps limit the ability of the healthcare community to provide comprehensive care to its patients and assess their outcomes.

There is also a need to harness emerging analytic techniques to guide effective and efficient care delivery. Advances in predictive modeling, for instance, can help get triage patients to appropriate healthcare resources in a more timely and efficient manner. In addition, risk models can be used to identify patients at high risk for adverse events, and deploy preventive measures to mitigate or avoid such events. Advances in artificial intelligence can assist healthcare teams in clinical decision-making by integrating and organizing information from multiple and diverse data streams. It can also markedly improve and accelerate pattern recognition tasks in medicine, such as radiologic image and pathologic specimen analysis and interpretation.

2. Care Delivery

There are growing innovation needs related to the structure and process of care delivery within the current healthcare system.

Current inefficiencies include significant and often duplicative information-gathering tasks and other administrative duties that fall to clinical staff. There are also deficiencies in organized care coordination and transition as patients move through the various aspects of the healthcare system, resulting in significant and sometimes dangerous gaps in care. These issues appear to drive significant levels of provider burnout and patient dissatisfaction.

Finally, there is a need to increase and diversify the locations where care can be provided. Some of these locations are physical, such as urgent care clinics, which can increase points of entry for the healthcare system, bringing care closer to where patients live and work. In addition, these clinics can reduce wait times at emergency rooms and ambulatory clinics, particularly for those with less-acute medical conditions. In addition, recent advances in telecommunications and mobile technology mean that care can also be delivered virtually, further increasing access and convenience of care.

3. Community Health Programs

There is a need for effective community health initiatives, particularly for those populations historically underserved by the insurance and healthcare communities. Because many of the prevalent conditions in these populations, such as infant mortality, diabetes, and mental illness, are disproportionately affected by social determinants of health, close partnerships with community-based social service organizations are critical. However, patients’ ability to access these health and social services is significantly limited by incomplete or absent communications between various providers. In addition, there is limited knowledge about the availability and impact of these social services on patient outcomes.

4. Behavioral Interventions

The level of patient engagement and education in medical decision-making and care plan participation is subpar. This lack of engagement and effective shared decision-making can result in treatment decisions that conflict with patients’ preferences and values. In addition, it can contribute to poor adoption of the behavioral modifications necessary to restore and maintain health. Improvements in these areas, potentially assisted by communication technologies, is necessary to improve outcomes and community health. Solutions may  also be found in the fields of behavioral psychology and economics.

Recent insights in these areas about predictable human tendencies have been incorporated into innovative lifestyle modification programs that use these tendencies to encourage people to make healthier choices.