The 4th Industrial Revolution is defined as “a fusion of technologies that are blurring the lines between the physical, digital, and biological spheres. It involves the transformation of entire systems across countries, companies, industries, and society as a whole.[i]” New technologies in health care include artificial intelligence, cloud computing, social media, data science, 3D printing, connected wearable devices, quantum computing, robotics, and genetics that are progressing at an exponential rate.[ii]
How will clinicians adapt to these massive changes in the way they work? According to Peter Senge, “Today’s problems come from yesterday’s solutions.”[iii] The causes of problems often arise from unintended consequences of prior solutions. Technology has become a disruptive force against our existing model of healthcare.
Disruption also comes in the form of ever-changing regulations. For example, consider the impact of Value-Based Reimbursement. Not only does an organization need to pay heed to the financial consequences of prescribed interventions, but also the organization and its physicians must learn the implications of the migration from Fee-for-Service to a much larger perspective of value over volume. Value-Based Purchasing is intended to improve delivery system models that link payment to improved health care quality.
How will it work? As explained on CMS’ website, the “Value Modifier provides differential payment to a physician or group of physicians under the Medicare Physician Fee Schedule (PFS) based upon the quality of care furnished compared to the cost of care during a performance period.”[iv] The Value Modifier applies to physician payments based on performance in CY 2016. What does this mean to the physician? It means understanding and tracking quality metrics, generally provided by technology (the other disruptor). “90% of Medicare Will Be Value-Based Reimbursement by 2018.”[v]
Healthcare’s behavior patterns will require adjustment to reduce cycles of instability resulting from disruptions in regulations and technology.
[i] GmbH, Schattauer. "IMIA Yearbook: Are We Ready for the Fourth Industrial Revolution?" IMIA Yearbook. Schattauer GmbH, 10 Nov. 2016. Web. 12 Dec. 2016.
[iii] Senge, Peter M. The Fifth Discipline: The Art and Practice of the Learning Organization. Revised ed. New York: Doubleday/Currency, 2006. Print.
[iv] "ValueBasedPaymentModifier." Centers for Medicare & Medicaid Services. Centers for Medicare & Medicaid Services, n.d. Web. 12 Dec. 2016.
[v] Bresnick, Jennifer. "90% of Medicare Will Be Value-Based Reimbursement by 2018." Health IT Analytics. Xtelligent Media, LLC., 27 Jan. 2015. Web. 12 Dec. 2016.