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March 15, 2018
Rethinking the health care access model
By: Dr. Ron Moody

The great Canadian physician Sir William Osler, co-founder of the Johns Hopkins School of Medicine and a visionary in his field, strongly advocated providing medical care with the utmost efficiency. To do less, he noted, “is an injustice to those we treat, and an injustice to those we might have treated.”

Dr. Osler made that observation in 1893. More than a century later, we continue to search for the best practices that broaden and improve access to health care. It takes on different forms in the 21st century than it did in the 19th, but healthcare remains in a constant state of change. We’re shifting from inpatient to outpatient, from the paternalistic to patient-driven. Fee for service is being replaced by value-based strategies.

Within Federal healthcare, we should be moving toward transforming how health care is conceived and delivered, leading to a future of care that is highly available and more easily accessible, satisfying to patients and medical professionals, and cost-effective.

This will involve a change in strategy, policy and emphasis, requiring a cultural change supported today by new technologies, techniques, and processes that redefine the way services are provided.

I recently addressed avenues to improving access and VA experience with expanding virtual care at the annual HIMSS conference this month. And, with the launch of this blog series today, I’ll be examining key issues that flow from our discussion about access—mainstreaming telehealth, the need for meaningful interoperability, and revising the clinic huddle for more efficient care, among other topics.

Access to healthcare is a critical issue at VA, DoD, and other healthcare organizations. Scheduling enough in-person visits to ensure proper care for a growing veteran population is a source of ongoing discussion and a challenge. Expanding access simply by adding staff or acquiring, building or opening new facilities is not a realistic solution.

The solution lies in new methods and evolving the definition of healthcare access to include what is measured and how it is measured. This change is being fueled by access to health information technology and digital mobility. These tools are powerful engines of change. Transformative changes, through video engagement, advanced telehealth, secure messaging and other asynchronous options, are coming. They will be standard tools of healthcare delivery and clinical operations in the near future. To leverage the technology to achieve outcomes requires action today.

Technology is an enabler of change, not the substance. Technology is no longer the primary rate limited factor to expand telehealth. You can talk to technology companies about their tech. But if you want to talk about solutions from a solutions company, that’s where Accenture Federal Services (AFS) comes in. Change management and leadership strategy drive the transformation, and AFS is the mechanism to reach that destination.

The model for future generations of health care planners, participants and patients begins with redefining how the system currently works, and how it should work. Virtual care investment can lead to superior utilization, lower cost, and a reduction in strain on available personnel and resources. Implemented correctly, the results can be enhanced healthcare access across the full continuum of care, and the need for fewer healthcare professionals. The triple—and quadruple—aim can be achieved.

Telehealth isn’t the mainstream of medical care yet, but the VA, the DoD and the nation are moving in that direction. It will mean fewer face-to-face visits and opens the door for increased patient engagement based on patients’ direct access to their health data, and as active participants with their health care team in truly patient-centric, outcome-focused processes.

Today is the start of an ongoing conversation about the future of health care access and delivery. I look forward to hearing your perspective on the changes ahead.

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