Business Process Outsourcing in Health Care Providers: Health Shared Competences

The population ages and uses more resources in the Healthcare System. In the healthcare market, new drugs and technologies are introduced, often in an additive and non-substitutive way, usually at a higher cost.

In this scenario, this health cost continues to rise, above the growth of economies, in a frightening inclination and tends to make the system unsustainable. In markets that remunerate consumption, with an important participation of the "fee for service" model, the scenario is even more worrying. The pursuit of value-based medicine, for the most part, lies much more in theory than in practice.

The solutions are not easy; however, some steps seem obvious: they go through the proper use of resources, aggressive cutting of waste, rigorous evaluation of the value of new technologies, commitment to the outcome, and productivity.

“The segmentation of complexity, by specialty, more than desirable, is imperative in a model of excellence of the healthcare ecosystem.”

Regarding productivity, we need to have new models of relationships between market players. Verticalization is one of the strategies, but it is not the only one and does not work in all situations.

The value proposition that needs to be better explored should be the search for productivity through specialization and sharing of structures and resources among providers, seeking the best use of assets, with the best efficiency of flows and processes and the best results that will come from greater experience.  All of this, aiming a lower cost, with a better outcome.

It should not be an objective for all services to do everything. In this situation, we have underutilized technology parks, idle physical areas, poorly used human resources, lower casuistry, and predatory competition in the market, with inadequate outcomes.

The model of partnership between providers can and should be considered in the designs of the health market, including hospitals, diagnostic centers, and outpatient clinics of different Institutions.

 A shared provision of services could be created as an interchangeable link in the value chain. The segmentation of complexity, by specialty, more than desirable, is imperative in a model of excellence of the healthcare ecosystem. The proposal of reference and counter-reference, and the performance within the structure of the partner will allow the Institutions to focus on their greater competence, and at the same time, offer their clients and patients the best of their partner. Hospital X can have Oncology coordinated by a partner Cancer Center and this Cancer Center can have Cardiology offered by hospital X. Hospital Y can offer pediatrics for one, or both, addressing in the Hospital of origin the cases of small and medium complexity and transitioning the patient to high complexity. This model allows taking advantage of the most specialized assets and skills, but ensures the navigation in the same patient healthcare journey!

Of course, we have a long way to go. The Integration of medical records (perhaps the "push" needed for the universal medical record), sharing protocols, and navigating patients on their "interinstitutional" journey are challenges that should not be underestimated, but it is possible to take progressive steps in this direction.

There are examples around the world of partnerships of this kind. But in some markets (many!) this should be the preferred model. We have BPOs (Business Process Outsourcing) already acting in auxiliary activities (facilities, cleaning, nutrition, security, etc.). Why not BPOs in Pediatrics, Cardiology, and Oncology? Why not share partner structures and resources?

The challenge of the economic model is not trivial, but we will have multilateral gains in cost and results. And most importantly: gains for the Healthcare market.

The proposal of the evolution of the logic of BPOs to the model of Healthcare Shared competencies (HSC) for service providers can be an outlet in the search for value and cost-effectiveness in the Healthcare Market. It's not the only model, but it can be efficient in many situations.