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GovConExecutive Exclusive Interview: Krish Venkat of Cognizant

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Krish Venkat is Senior Vice President and General Manager of Cognizant’s Healthcare and Life Sciences Practice. He recently sat down with us to discuss how patient-centered healthcare can fix our healthcare system, and what Cognizant is doing to address the “meaningful use” requirements.

GovConExecutive: What does Cognizant offer healthcare organizations?

Krish Venkat: We offer a wide range of IT and IT-enabled services to our customers, across the entire healthcare continuum – payers, providers, pharmaceutical companies, and pharmacy benefit managers. These services include systems integration, business process outsourcing, IT infrastructure management, and product implementation, as well as a broad range of consulting service offerings around technology strategy, mergers and acquisitions, IT cost optimization, analytics, process re-engineering, change management, and more.

GovConExecutive: How does Cognizant offer integrated systems between administrators, labs, insurers, and physicians?

Krish Venkat: We provide solutions across all of the stakeholders in healthcare. For example, when we do business process reengineering and remediation services associated with HIPAA 5010 and transformation from ICD-9 to ICD-10, which is one of the important industry mandates today, it cuts across both payers and providers. Revenue cycle management is another example of a solution that extends across both payers and providers. We implement and integrate solutions across payers, providers, PBMs, and other players in the ecosystem.

GovConExecutive: How would you describe a patient-centered system and how does it differ from our current system?

Krish Venkat: If you look at the current system, which is not a patient-centered system, the fundamental problem is that the participants in the system engage in a game of cost shifting, where each entity is trying to pass along to one or more of the others a bigger share of the bill. This creates an inherent bias toward short-term care over long-term care, which is not in the patient’s best interest. In a provider-centered system, the primary drivers are the number of encounters, the number of services offered, how many times you see the patient, how long do you see the patient, etc. In a payer-centered approach, on the other hand, the incentive is to save money today without adequately considering the possibility that this could increase future costs for the healthcare system.

The fundamental objective of a patient-centered approach is to maximize value for patients and their families, so that they receive more value and better results for their healthcare dollars, both as patients and consumers buying healthcare. A patient-centered approach controls costs, because it increases pressure on the providers to justify cost in terms of the demonstrated benefits. At the same time, a patient- or consumer-centered system places pressure to improve results by demanding data from the providers to demonstrate that the anticipated benefits are commensurate with the expected cost.

GovConExecutive: How would a patient-centered approach reduce costs and risks?

Krish Venkat: A patient-centered approach would drive focus on prevention and wellness by keeping the population healthy, detecting diseases at the earliest stage, and rewarding chronic care management, which will drive down healthcare costs. Consumers and patients will have a choice of selecting appropriate treatment plans and providers based on publicly available information and their specific situation. Transitioning to a value-based system will allow us to achieve more value for our healthcare dollars.

GovConExecutive: What is Cognizant planning to do to meet the upcoming “meaningful use” criteria?

Krish Venkat: We are working with policy-making groups and standards bodies like HITSP to define “meaningful use.” We are also setting up teams internally within Cognizant to help our customers assess where they are with respect to the “meaningful use” guidelines, determine what gaps exist in their systems, and develop a road map to fix these gaps. Our objective is to help providers derive real value in systems implementation through clinical transformation. The stakeholders in this ecosystem should not view this as just a technology change for the sake of technology change. It is a fundamental change in terms of business processes, optimizing cost of care, avoiding duplications, easier exchange of information, and improving the quality of care.

GovConExecutive: What do you see as the future of health information technology?

Krish Venkat: Information technology is going to become a much more natural and integral part of care delivery as a new generation of patients and doctors enters the healthcare system. There will be new, simplified products that consumers can understand easily. There will be more publicly available information for consumers to make the best decisions. The current wave of EHR system adoption will also enable the collection of tremendous amounts of data about the care delivery and care outcomes process. Evidence-based treatments will become much more prevalent, so not only will the care delivery process improve, but more importantly the quality of care and health outcomes will improve as a result of advances in health information technology over the next five to seven years. I believe health IT is poised to take off in a big way.

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