Ever-Changing Tides of Healthcare in the Evergreen State

June 22, 2016

Technology’s role in the migration to integrated care in Washington.

Healthcare is dynamic: the needs of the industry evolve over time, medical research inspires new methods of care, and new regulatory measures are introduced in an attempt to produce the best possible population outcomes. Time moves forward and the only thing that remains consistent is the guarantee of change.

As of April 2016, Washington state’s Medicaid program, Apple Health, began a transition of its care delivery engine into a fully-integrated managed care (FIMC) system. Currently, Clark and Skamania counties are undergoing the process as early adopters of this model, with several other counties in tow who have expressed intent to be mid-adopters. As with any large-scale migration of multiple payer systems, service organizations, and specialists from one infrastructure to another, the process is complicated and without any guarantee of success. In the instance of integrated care, whether of the payment or care model variety, the outcome is largely determined by what kind of technology solution is in place.

An integrated care system requires collaboration between numerous providers across multiple specialties, each with unique workflows and data points. Apple Health, for example, is attempting to transition the governance of primary care, mental health, and substance use disorder programs into an FIMC. Multiple forms of care across multiple service providers means multiple EHRs, all of which must interface in some way and exchange data to promote whole patient health.

Traditional EHR software has been hard-coded to satisfy specific product requirements per specialty and care model. Changing the functionality requires the underlying code to be revised or a new feature module to be bolted on, involving a team of engineers and countless production hours. Traditional software doesn’t lend itself well to integrated care for this very reason. Between the interoperability requirements necessary for integrated care to work and the compliance updates driven by ever-evolving regulatory requirements, the reliance on engineer support is too cost prohibitive for most organizations.

To learn more about why the modular approach of traditional software can’t support integrated care, click here.

The best chance at success in a situation where large provider organizations must wrangle scores of workflows and data sets is to have a rapidly configurable, cloud-architected technology solution in place. Modern platforms are designed to be manipulated at the behest of an administrator without having to rewrite the source code of the application. Reducing the reliance on highly technical forms of support to respond to changing product requirements or maintain regulatory compliance is paramount to integrating several forms of care and funding successfully.

Any large-scale attempt at integrated care such as Apple Health’s transition into FIMC is not going to be without its own significant technical challenges. The challenges of integrated care today in Washington and in the future across the country are best handled by a highly adaptable solution, and organizations will find it in configurable platform technology.

Last Updated: March 29, 2017