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New business models key to cost-effective emergency, hospital care

Report predicts that over the next few years only a minority of healthcare services will be delivered in hospitals.

Jeff Lagasse, Associate Editor

Innovative business practices can transform overcrowded hospital emergency rooms into efficient, patient-centric operations, while disruptive technologies will keep more patients out of hospitals and streamline their care, according to two new articles published in the latest issue of Health Management, Policy and Innovation.

In "Strategies to Improve Care in the Emergency Department -- the De Facto Multispecialty Clinic of the 21st Century," Yale University scholars offer operational, payment and insurance suggestions to not only ease overcrowding, but to improve both cost-effectiveness and clinical care.

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"In addition to trauma and acute care, emergency departments are centers for screening, diagnostic and therapeutic services that can lead to faster care and improved patient outcomes," Howard Forman, MD, professor of management, radiology, economics and public health at Yale, said in a statement. "Yet hospitals are struggling to effectively manage multi-faceted emergency room care. We propose supply-side solutions to decrease patient intake, increase patient discharge, and improve throughput, including moving patients from the emergency room to inpatient beds, and creating the right payment incentives to make this all work."

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Healthcare delivery is poised for a digital transformation through artificial intelligence, robotics, telehealth and other technologies, according to "A Vision of the Future: Organization and Delivery of Healthcare in the Digital Age." The HMPI article was co-authored by Dr. Christopher Gibbons, founder and CEO of The Greystone Group, a health technology company that works with federal and industry clients, and Dr. Yahya Shaikh, Greystone's chief data officer. Gibbons and Shaikh are also adjunct assistant professors at Johns Hopkins University, as well as senior advisers on health innovation and connected care, respectively, at the Federal Communications Commission in Washington D.C.

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The authors predict that over the next few years, only a minority of healthcare services will be delivered in hospitals as cost pressures, patient preferences and emerging technologies foster the development of home-based care and so-called geographic ecosystems -- virtual health systems that serve as a care network without walls. For example, in some cases, patients who 20 years ago required stays in intensive care units followed by lengthy hospitalizations, can now go home with small portable devices that perform the work of previous ICU-based machines.

"Looking ahead, hospitals will focus on patients who have the highest acuity and are the most critically ill and medically complex, likely representing only 10 to 15 percent of the market," Gibbons said in a statement. "In addition, with advances in and increased availability of 5G broadband, healthcare services will increasingly happen at the patient's demand, regardless of location."

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