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How clinical pathways speed recovery – While benefiting employers and insurers

There are some things in life you just can’t put a price on and good health has to be top of the list. Staying fit and well is crucial to everything we do, whether at work or leisure, so when a health problem does arise, it’s important to know that your employees will receive the best possible treatment.

Providing a premium healthcare package that includes defined recovery care based on the best medical evidence doesn’t just offer reassurance to your staff, but also benefits you as an employer. If your employees receive the most effective care possible, they will miss fewer days of work, resulting in higher morale and greater productivity.

And comprehensive healthcare packages will help you attract and keep talented employees, too. In 2015, 60% of respondents to Glassdoor’s Employment Confidence Survey cited benefits and perks as a major factor when considering a job offer, while 80% of employees said they would choose additional benefits over a pay rise.


In 2015, 60% of respondents to Glassdoor’s Employment Confidence Survey cited
benefits and perks as a major factor when considering a job offer, while 80% of employees said they would
choose additional benefits over a pay rise.

The role of clinical pathways

An important part of being able to provide premium care is having access to internationally approved treatment and recovery clinical pathways (CPWs), also known as integrated care pathways.

CPWs are structured, evidence-based care plans, which contain detailed steps for multidisciplinary healthcare teams to follow when diagnosing and treating patients with specific health problems. This approach is based on ‘best practice’ and is clinically proven to deliver optimum medical outcomes, so it’s a win-win solution for patients, medical professionals and insurers alike.

Since the 1980s, CPWs have been used globally as one of the key methods of managing healthcare quality. Now well established in the US and Europe, they are gaining momentum in Asia, especially Hong Kong, Indonesia and Malaysia. Due to increasing population and rising wealth, this region is fast becoming one of the strongest drivers of health spending in developing markets. China introduced CPWs in 2009, with the aim of assuring quality, reducing risks, increasing resource efficiency, and controlling costs.

Just how do CPWs help?

A CPW defines the entire medical process followed by doctors, nurses and other healthcare professionals for a particular diagnosis or procedure. It’s a tool used internationally to help healthcare teams make well-informed decisions based on good clinical evidence, and was developed to improve the quality of patient care, reduce variation in practice and minimise costs, especially financial waste due to unnecessary or inappropriate interventions.

Cost-efficiency is increasingly important as healthcare inflation continues to rise at levels significantly higher than general inflation. According to consultancy PWC, over the past decade global growth in healthcare spend has risen anywhere between 6.5% to 11.9% a year – consistently several percentage points above general inflation – and the trend is set to continue. It’s not rocket science that rising healthcare costs equal rising health insurance premiums.

Just one example of how use of CPWs and drug formularies in the US has led to savings is by encouraging doctors to prescribe generic drugs, which are 80 to 85% cheaper than their brand-name equivalents, according to the US Food and Drug Administration. Around 85% of drug prescriptions in the US are now for generic rather than branded drugs. Meanwhile, a 2017 report by the Association for Accessible Medicines claims that generics have saved the US


One example of how use of CPWs and drug formularies in the US has led to savings is by encouraging doctors
to prescribe generic drugs, which are 80 to 85% cheaper than theirbrand-name equivalents, according to
the US Food and Drug Administration.

Importantly, CPWs can also be used as tools to improve provider performance and achieve quality targets.

How do CPWs help in recovery care?

Using evidence-based guidance, healthcare professionals can make consistent, well informed decisions on what care is appropriate, helping patients achieve a speedier recovery. Using CPWs in recovery care:

Helps keep costs low: Sticking to a defined route of recovery care as recommended by a consensus of healthcare experts leads to consistently good patient outcomes, with the added benefit of keeping costs low and administration to a minimum.

In 2016, a study in Current Oncology looked at a cost impact analysis of the Enhanced Recovery After Surgery clinical pathway on colon cancer patients in Canada. Complications were found to decline by around 13%. Similar results have been seen from this programme around the world.

Helps reduce the risk of complications: Using CPWs to provide an accurate diagnosis and effective treatment plan helps ensure the best possible medical outcome. In this scenario, the chances of post-treatment or post-surgery complications or the need for unplanned interventions during recovery are greatly reduced. This not only brings down overall medical costs but also paves the way for smooth and trouble-free progress during recovery.


In 2009, a meta-analysis published in medical journal BMC Medicine looked at the use of CPWs for hip and knee replacements, an increasingly common operation, when compared with standard medical care. It showed significantly fewer patients suffering post-operative complications in the CPWs group when compared with the standard care group. A shorter length of hospital stay in the CPW group was also observed and lower costs during hospital stays were associated with the use of the CPW.

Lowers the chances of hospital readmission: As CPWs are implemented for a specific medical problem or surgical procedure, patients benefit from receiving the most appropriate care as early and as efficiently as possible. A CPW is based on a collaboration of different healthcare professionals to provide a tried-and-tested treatment and recovery programme. Following such a well-founded regime means that the risk of complications and even possibly readmission into hospital is as low as it can be. A well-organised recovery plan can optimise patient outcomes, as well as reduce complications and readmissions by more than 15%. This in turn translates into cost savings for both insurance providers and healthcare companies.

Restores patients’ independence more quickly: As recovery care can be specifically targeted to meet employees’ individual needs, CPWs enable patients, and their families, to have all the evidence-based information, precise discharge instructions and the appropriate medication regimes necessary to manage an effective recovery. This also ensures the responsible use of hospital and healthcare resources and reduces costs.

Promotes a successful teamwork approach: When it comes to healthcare, working as a team is vital for ensuring high-quality treatment and effective recovery. A report by the Institute of Medicine shows that 70% of medical errors relate to teamwork communication and 30% relate to other factors. There is a relationship between healthcare quality and an improvement in teamwork communication and this relationship has a positive impact on patient outcomes. In 2012, a systematic review in the journal Social Science and Medicine concluded that care pathways have the potential to help support inter-professional teams in improving teamwork, leading to better communication and greater effectiveness of a collaborative plan.


A report by the Institute of Medicine shows that 70% of medical errors relate to teamwork
communication and 30% relate to other factors.

In the end, CPWs benefit everyone

When it comes to putting together a talented workforce and keeping that team on board, a comprehensive healthcare package that includes the best possible recovery care is a must-have for any successful business. It gives employees reassurance that everything is in place to fulfil their healthcare needs – while for the company, it’s a low-cost route to a healthier, more productive workforce.

Numerous studies have shown that using well-defined CPWs is one of the most efficient and cost-effective ways of improving medical outcomes for a wide range of conditions. For insurers, using CPWs is a sure-fire means of aligning members with the best possible recovery care available. Offering an internationally approved treatment and recovery plan not only helps achieve optimal medical outcomes but also cuts out any unnecessary treatment, reduces the risk of complications and also lowers costs.

All in all – a win-win situation.

John Le Boeuf
Author
John Le Boeuf | Founder and CEO of Inova Care

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Inova care is an industry leading consulting and health care administration company specializing in managed care, clinical pathways and cost containment solutions for corporations and insurance companies.

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