Problem
This part of the lab is an introductory, exploratory exercise looking at the different parties involved in the healthcare system (broadly abstracted as Patients, Providers, and Payers). The goal of this exercise is to better understand the different needs in the healthcare system through brainstorming and thinking through some of the challenges in the space. As you learn and apply different technologies to health IT problems, it is useful to have contextual knowledge of the needs of different players in the space.
Providers
• During a patient visit, brainstorm at least two types of information that would be useful for a provider to know about the patient. Please provide the response as a numbered list and provide a brief rationale for each (a sentence or two).
• The CMS has many efforts to standardize and encourage value-based healthcare, which can be broadly defined as better care and population health at a lower cost. Brainstorm one way for providers to evaluate whether or not they are providing value-based care.
Payers
• While payers can be viewed as a significant source of infrastructural healthcare problems in the U.S. (i.e. why does my insurance cost so much?), many payer organizations assume significant risk and participate in initiatives to improve patient access to care and overall outcomes. Brainstorm at least two kinds of risks that payers need to account for.
• Historically, medical claims have represented some of the highest volumes of structured data in the healthcare system. Generally, they are focused on communicating costs and codifying procedures. However, they can also be used as a source of indirect medical data. Brainstorm one way to evaluate value-based care based on payer claims data.