Limitations of the Problem-Oriented Health Care Model

If you are a doctor, a CFO, a CEO, or even a practice manager, in a physician practice or clinic, you might already know about the problem-oriented healthcare model and come across Problem Oriented Medical Records (POMRs). This patient-focused approach involves recording a patient’s health details in a way that a physician can easily read and revise. They help healthcare providers (HCPs) understand a patient’s medical history.

But despite having been a crucial resource for supporting patients with chronic health issues, POMRs have several limitations. This post discusses the limitations of the problem-oriented healthcare model and why value-based care emerges as the ideal approach.


health care model

The Problem-Oriented Healthcare Model

HCPs have depended on POMRs for many years, and for good reason. The problem-oriented healthcare model involves monitoring the patient’s medical conditions, offering a plan of action for each listed issue, and documenting follow-up and feedback from patients. Therefore, POMRs can be said to have what the healthcare providers need to offer optimal care for every patient.

However, POMRs have several limitations, including:

They are Cumbersome

Healthcare providers reveal that the data overload of POMR systems is overwhelming. Therefore, some physicians do not have the right tools at hand to meet performance goals. Although HCPs grasp the ins and outs of the system quickly, they find it hard to maintain after making the entries. Patients may discuss multiple problems in a single encounter, and such massive information may overwhelm HCPs.

They are Inefficient

Doctors need to find the connection between different medical problems, particularly those with more than one chronic disease. Unfortunately, POMRs do not emerge as the most efficient model to help with that. For instance, blood pressure measurement information may fall under problem headings such as ‘ischemic heart disease’ and ‘hypertension.’

Also, the need to link across entry barriers often arises — when there is a close link between one problem to another or when one medical issue results from another. For instance, a patient undergoing operations for a broken hip may suffer pneumonia as a secondary problem due to prolonged bed confinement.


Limitations of the Problem-Oriented Health Care Model
Our Solution – Emphasis on Value-Based Care 

Considering the limitations of problem-oriented healthcare, there is a need for HCPs to find a solution and value-based healthcare emerges as a more efficient healthcare model. That is where Clinify Health comes in. We get the appropriate level of detail from patients’ data and equip care managers with it to help them connect the dots.

We also provide actionable data that emphasizes patient outcome instead of volume of treatment helping care managers provide real value to their patients. For instance, you can show your patient how to eliminate a medical condition and prevent another one that may have a link to the first condition instead of just treating it. And you do all that in real-time!

The Problem with Demand and Supply in Medically Underserved Populations 

The number of services that HCPs offers follow the law of demand and supply. An increase in supply for the services occurs when there is increased demand for the services. But there is a problem. Medically underserved populations (MUPs) suffer a shortage of primary healthcare services. On top of that, the generalized problem-oriented approach is not very efficient for them.

Medically underserved populations include residents of a geographic region with either a high poverty level, high infant mortality rate, or a large elderly population and no primary care providers. Typically, these populations face language, economic and cultural barriers to healthcare. The healthcare services they receive are fewer than needed for their healthcare problems.

Benefits of Clinify Health’s Tools

Clinify Health has crucial tools to help the situation. Below are some benefits of these tools:

Provides HCPs with Access to Actionable Patient Data for Value-Based Care 

HCPs are unable to explore the value-based model of health care due to a lack of actionable data. All they have is basic electronic health records. Actionable data goes beyond that and capture what a patient needs instead of solely denoting their health status. Further, when doing value-based contracting in healthcare, the insurers require this type of data. Fortunately, Clinify Health serves as a bridge between the data and access to value-based contracting terms stipulated by insurance providers.

Improves the Operational Efficiency of HCPs

One of the limitations of POMR is its overwhelming nature. Since physicians do not have the right tools to achieve performance goals, operational efficiency slows down. Clinify Health has novel technology that assists healthcare providers in transitioning from a problem-oriented approach to value-based healthcare arrangements in MUPs. Further, the platform’s integrations allow HCPs to perform real-time insights analysis while examining what any value-based contract from an insurer requires and ensuring these requirements are met.

Build Financial Stability and Sustainability for HCPs

Physicians often do not have the time to comprehend getting the best incentives for what they do. They are attending to patients and maneuvering the challenges of work-life balance. Furthermore, HCPs serving underserved communities have no assurance of financial stability or sustainability with the current payment models.

Therefore, healthcare providers working in MUPs are at risk of closing shop. However, Clinify Health uses clinical data from individual practices to help HCPs pinpoint areas of focus where they can receive higher payments when they offer value to patients. In short, HCPs can get value-based payment arrangements in healthcare that are ideal for them, whether from independent practices, multi-specialty groups, or even small and large practices.

Healthcare providers can build financial stability and stay independent through the help of proprietary tools available on Clinify Health. Such financial freedom is a great deal for HCPs in MUPs as they can remain open for business even when most patients in these communities depend on Medicare and Medicaid.

Bring in Better Contract Terms Offered by Insurance Providers 

HCPs serving in MUPs do not have to struggle to compete for better contract terms. Clinify Health does the work on their behalf by connecting insurance companies with value-based contracts to them.

Provide Point-of-Care Clinical Decision Transparency 

Organizations can leverage the proprietary population health technology from Clinify Health to get crucial insights to ensure the right patient receives appropriate care timely. Besides, payers, providers, and patients can become more aware of crucial social determinants that affect patients’ daily lives thanks to our leverage on several geographically-steered socioeconomic datasets with specifications and recommendations. Most of the time, such social determinants go unnoticed.

Shift to Value-Based Contract

Although POMRs have been a crucial resource in helping HCPs offer care to patients, it has several limitations. Value-based care is a more efficient healthcare model for medically underserved populations. At Clinify Health, we provide the necessary tools and support to enable value-based healthcare. Contact Clinify Health today to learn more.

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