Revamping Cayman’s healthcare system to make it more affordable while maintaining or improving its quality lies in ensuring information about patient outcomes and treatments is disseminated, understood and analysed, several healthcare experts and analysts told a healthcare conference in Grand Cayman.
The message from speakers from several countries and jurisdictions was that healthcare systems worldwide were wasteful, but to identify and cut out waste, data on patients and systems needed to be gathered and studied because the problems had to be identified before they could be fixed.
Speaking after the second national Healthcare 20/20 Conference, health minister Mark Scotland said the three-day event had been a success and much information and expertise had been shared. The next step would be using that information and implementing it as part of a national health strategy that would both improve quality and bring down costs, he said.
“We have good quality healthcare here, in both the private and public sector, but we need to bring all this together and work better together to make healthcare more affordable,” he said, adding the entire system needed to be more data-driven. “We should have been doing this a long time ago at the Health Services Authority.”
“We should be collecting data, we should be planning better how to spend the money. We see a lot of things, it’s just that we need to commit to implementing some of the experiences we have seen from other organisations and countries … We want to take some of that and get the leaders in our organisation to commit to that,” the minister said.
Several speakers addressed the common belief that cheaper healthcare means a drop in quality, arguing instead that an increase in the quality of healthcare leads to lower costs because fewer mistakes are made and thus do not have to be rectified at a high cost. Also, chronic diseases can be prevented or caught earlier and ultimately patients are healthier and do not need as much care.
Speaker Keith Allred, founder of non-partisan citizen’s group The Common Interest, who made a commitment to solve healthcare issues in Idaho when he was running for the office of governor last year, acknowledged that changing the way an entire system – healthcare or others – operates can be difficult because it involves a change in mindset and methods of working.
“An approach to this dual mandate that seems to be contradictory, bringing costs down and improving quality, … is really to focus on being more evidence based in our care,” he said.
He said the use of electronic patient records and enterprise data warehouses – electronic data libraries – was key to the evidence-based approach to reforming healthcare systems, but it was vital to involve doctors and nurses and frontline staff in the process, and not just the IT personnel, insurers and administrators.
Mr. Allred and other speakers cited the example of Intermountain Healthcare, an integrated healthcare provider in Utah, as an institution which has successfully tackled the challenge of bringing down costs and improving quality. United States President Barack Obama has mentioned Intermountain’s approach as one that could be adopted within America’s healthcare system and, according to the Dartmouth Health Atlas, an authority on healthcare quality, if Medicare had adopted a similar system as Intermountain, it could save as much as 30 per cent a year on its spending, with better health outcomes.
Dale Sanders, chief information officer of the Cayman Islands Health Services Authority, who previously worked at Intermountain and built its enterprise data warehouse, highlighted the importance of analysing data about patients and also streamlining the existing system of complex clinical procedure codes.
He said in the United States, 31 per cent of healthcare costs are in administrative overheads associated with billing and claims processing.
Mr. Sanders said the new CarePay system, which is being introduced in Cayman to make payments and billing for medical treatment of members of Cayman Islands National Insurance Company – or CINICO – less complex and time-consuming was a welcome measure.
Delegates also heard from Tami Hutchison, vice president of employer services at Cerner in the United States, who explained how her company implemented a wellness programme awarding employees with lower insurance premiums if they were non-smokers, had healthy BMI rates and took active steps to lead healthy lifestyles.
Like the Cayman Islands, Bermuda is examining its healthcare system. Jennifer Attride-Stirling, chief executive officer of the Bermuda Health Council, presented the model being used in Bermuda to revamp its system. Seth Avery, chief executive officer of Applied Revenue Analytics, also looked at what could be learned from the steps Bermuda was taking to address its healthcare issues.
Premier McKeeva Bush, who opened the Healthcare 20/20 Conference at the Ritz-Carlton on Thursday night, said: “We have to urgently put our heads together and find better, more sustainable ways to do things,” he said.