Fixing What’s Broken: Rebecca Baker on AI, Value-Based Care & Patient Experience in Healthcare

Healthcare today, especially in the US, is often fragmented and transactional. Instead of focusing on patient outcomes, the system has historically paid for the number of services provided. This leads to skyrocketing costs without necessarily improving health or longevity. Rebecca Baker, a seasoned healthcare leader, shares her experience with back surgery, highlighting how she, an experienced nurse, had to repeat the same information to four different departments due to a lack of system interoperability. This fragmentation not only creates inefficiency but also poses risks, especially for vulnerable patients.

Defining a Satisfying Patient Journey

A satisfying patient journey, in the context of value-based care, is one that is carefully orchestrated, navigated, and facilitated. It means delivering personalized care at scale through good workflows. Rebecca emphasizes the importance of identifying where patients fall through the cracks and ensuring tight coordination and connection. This involves understanding patient needs, communication preferences (some prefer virtual visits, others in-person), and social determinants of health. Involving patients in the design of care models is also key.

Unifying Care Models

While diseases and treatments vary, human beings are fundamentally similar in their desire for respect and consistent care. A unified model requires data sharing across the healthcare ecosystem. Even with the same diagnosis, like congestive heart failure, patients present differently. AI can help by collating data from multiple sources, including social determinants, to provide a holistic view of the patient. This allows for proactive, predictive care rather than reactive treatment. The goal is early identification, quick assessment, and swift intervention.

Addressing Friction Points in Healthcare

Key friction points for patients include not being known by their providers, repetitive questioning, and a lack of personalized care. Assumptions made by providers are also a major issue. Other frustrations include long hold times when making appointments, providers focusing on computers instead of patients, and communication preferences being ignored (e.g., calling when a patient prefers text). Difficulty in getting timely appointments, especially for high-risk patients, is another significant pain point.

Key Takeaways

• Fragmentation is a major issue: Lack of system interoperability leads to inefficiency and potential patient harm.

• Personalization at scale is possible: Good workflows and understanding patient needs are crucial.

• Data sharing is vital: Healthcare systems must share information to provide coordinated care.

• Proactive care is the goal: Moving from reactive treatment to predictive, preventative strategies.

• Patient experience matters: Addressing friction points like repetitive questions and poor communication is essential.

• AI as a tool: AI can improve efficiency, reduce administrative burden, and enhance patient access.

• Focus on workflows: Clearly defined processes are critical for data accuracy and successful outcomes.

• Start small: For startups, a phased approach to development and implementation is recommended.

AI and Automation to Reduce Burden

AI is a tool to improve efficiency, not replace clinicians. It can help with scheduling, allowing patients to book appointments easily. AI can also assist in capturing risk adjustment data by collating various sources, including social determinants, to give providers a comprehensive patient overview. This enables predictive insights into disease progression and potential interventions, such as addressing food insecurity for heart failure patients.

Improving Access for Underserved Populations

Digital tools can significantly improve access for underserved and rural populations. Rebecca highlights her work on a grant to create a rural center of excellence, addressing the challenges faced by communities with limited access to healthcare. Enhancing telehealth, providing devices with built-in Wi-Fi, and offering clear instructions are ways to bridge this gap. The goal is to ensure that even in remote areas, patients can connect with care providers easily.

Designing Future Tech Tools

To ensure future tech tools solve real problems, they must be built with clinicians in mind. EHRs, while capable of being care tools, are often used as cash registers. A shift towards systems that allow clinicians to tell patient stories, with AI extracting key data, is needed. Ambient AI, while promising, needs to improve its understanding of human nuances like emotion. The focus should be on augmenting clinicians, not replacing them, allowing them to spend more time with patients. Data quality is paramount; AI models must be trained with clean, well-defined data, and guardrails are necessary to prevent errors and ensure the AI solves specific problems.

Evaluating Tech-Enabled Models

Evaluating tech-enabled models requires close monitoring of outcomes and a willingness to pivot when necessary. This involves testing systems, ensuring data accuracy, and collaborating between clinicians and tech teams. For startups, the advice is to start small, learn from mistakes, and then scale. A minimum viable product should encompass both the technology and the clinical model.

The Ideal AI-Powered Care Experience

The ideal AI-powered care experience would involve easy appointment scheduling via virtual assistants, quick access to providers, and seamless interoperability between different care settings. AI can orchestrate and navigate information flow, ensuring providers have all necessary data to deliver coordinated, human-centered care. It's about making care more accessible, efficient, and patient-focused.

Rebecca Baker's insights underscore the potential of AI and technology to transform healthcare by addressing fragmentation, improving patient experience, and enabling value-based care. By focusing on clear workflows, patient needs, and smart technology integration, the industry can move towards a more effective and human-centered future.

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