Health care services: growing demand, diminishing resources

There is no shortage of troubling trends in health care: increasingly high rates of obesity and chronic disease, rising costs – all amid a backdrop of falling resources in both the public and private sectors.

But before you succumb to pessimism, take note of some real progress being made to design a health care system that can do more with less.

UNC Health Care is making a sustained effort to improve communication between doctors and patients. As I discussed briefly in a prior post, doctors and patients can be on different pages, leading to inefficient, fragmented care.

For example, a patient heavily influenced by direct-to-consumer advertising may demand drugs that are not appropriate for his situation. And busy work and family schedules can cause patients to delay seeking care, all too often moving treatment from primary care physicians to crowded (and expensive) emergency departments.

A recent Health Affairs report found that acute care – newly arising health problems that are not typically life-threatening – is treated by a primary physicians only 42 percent of the time. Nearly a third of acute care visits – 28 percent – are emergency room visits. The other 30 percent of acute care visits are made to specialists and outpatient departments.

At UNC Health Care, we are working to build team models that coordinate the actions of multiple physicians and help patients become more informed advocates for their own care. This will help close the information gap between health care professionals making treatment decisions and patients receiving care.

One promising concept is the “patient-centered medical home.” This approach teams primary care doctors with specialists, gives patients better cost and quality information and leverages health information technology to avoid duplication and medical errors. It gives patients a convenient and trusted place to go for care, encouraging earlier and less-costly treatment options.

We are piloting the medical home concept with Blue Cross and Blue Shield of North Carolina, our first such partnership with a third-party-payer. Working together to drive quality up and prices down makes sense to both parties and we have high expectations for the project.

We also are working to provide patients with greater access to coordinated care facilities through the establishment of the Triangle Physician Network. Physicians in our network share a collaborative spirit and have access to robust electronic patient records that facilitate coordination of treatment.

These initiatives are early but important steps toward a new era of collaboration between providers and their patients. We believe these efforts will yield more fruitful doctor-patient communications, better coordination among health care professionals and greater consumer understanding of how the delivery system works. None of these improvements will happen overnight, but there are promising signs that we are moving in the right direction.

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