




































                               American International Journal of Multidisciplinary Scientific Research; Vol. 3, No. 1; 2018 

ISSN 2638-1249  E-ISSN 2638-1273 

Impact Factor: 5.8 

Published by Centre for Research on Islamic Banking & Finance and Business, USA 

 

 

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A Review on Design of Integrated Healthcare Model through 

Performance Excellence Methodologies 

 

Srideepti Ramayanam
1
, G.V.R.K Acharayulu

2
 & V.M. Prasad

3 

 
1
Research Scholar, SMS/JNTUH, India 

2
Professor of Management Sciences, SCM, Hyderabad Central University, India 

3
Professor of Management, Al Yamamah University, Riyadh, KSA 

 

Correspondence: Srideepti Ramayanam, Research Scholar, SMS/JNTUH, India, Corresponding author, Tel: 

+919160099001, Email: srideeptiramayanam@gmail.com 

 

          

 

Received: September 17, 2018        Accepted: September 23, 2018               Online Published: October 11, 2018   

 

 

Abstract 

Cost based care is evolving as a resolution to address increasing Healthcare costs, and to address the problem of 

clinical inefficiencies. ‘Cost based care’ therefore is designed to be patient centric. While ‘Cost based care’ helps in 

addressing the challenge of rising costs and making the care more affordable, it  comes with its own set of 

challenges for providers as they are paid for better patient outcomes in an evidence based way.  In the regimen of 

‘Cost based care’ providers are grappling with reduced reimbursements. Providers are also required to track wide 

variety of measures to make the care more evidence based. Operations transformation for a healthcare systems 

means that it makes the processes, efficient, flexible and innovative to suit patient centric treatment models. To 

achieve this transformation by excluding wastes out of system, make the processes much more efficient, 

implementation of digital systems across the value chain of the hospital have become the area of focus. Shared 

Services alteration is a subclass of administrational transformation. It is has a lot of potential to smoke out costs, 

making operational processes much more efficient by rationalizing functions, like Human Resources, Pathology, 

Radiology, IT and Supply chain services at Hospitals. Administrational transformation aims to flush out costs, bring 

transformation in revenue cycle, and focus on Patient centric treatment modules. By implementing data visualization 

dashboards across the services would enable transparency and trust for patients. 

 

Keywords: Unaffordable Healthcare Services, Interoperability, Technology in Healthcare Services, Data 

Visualization Dashboards. 

1. Introduction 

Costs of Healthcare organizations across the Globe are escalating faster than the GDP growth making the Healthcare 

unreasonable. Healthcare and Life Sciences organizations are committed to enhancing the lives and well-being of 

people around the world, while people are hoping to receive excellent service quality tend to prefer private hospitals 

or even travel across globe for better quality and cost-effective treatments. Quality of services has become a pivotal 

point in the Healthcare industries today. Hospitals and Healthcare systems continue to produce services that vary in 

quality, leading to inefficient processes and outputs, hence resulting in poor customer satisfaction. Healthcare 

organizations operating in the public sectors are experiencing increasingly low satisfaction from patients regarding 

the quality of services provided. Due to the result, Healthcare administrators face the challenge to advance the 



www.cribfb.com/journal/index.php/aijmsr           American International Journal of Multidisciplinary Scientific Research           Vol. 3, No. 1; 2018 

 

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quality of services in their organizations. Based on the survey performed at different organizations, the outcome 

reflects that the teams are not able to keep its cost comparable, acceptable and approachable to many patients & are 

unable to cope up with the denial of claims by the Insurance companies. There is a need to re-iterate on improving 

Health outcomes by providing Digital technologies & Business transformation solutions to achieve patient 

satisfaction. The proposed integrated model demonstrates building domain knowledge, and expertise in Business, 

Process, and Management would enable Healthcare companies to focus on costs & achieve process efficiencies. 

 

2. Literature Review 

A review of 490 articles across AJMC, Oxford, NCBI, Essential Hospitals, PCPCC journal publications has led to 

discussions with multiple stakeholders across industries. The existing system of health care quality improvement has 

increased the cost of medical treatment. To balance the quality and cost in the corporate sectors and to make the 

world class services available to every citizen has become a very challenging task to the present day administrators. 

The uncovered citizens are unable to avail of these medical facilities and crave for medical help. To achieve patient 

satisfaction by observing the four elements like patient's readiness, speed, instructions, coordination of 

arrangements. Other elements may include the inadequate treatment, discharge process, limited choice, post-acute 

care arrangements, transport issues, billing details and responsibility of discharge. To have effective hospital 

management the capacity planning, reviewing performances and action steps are to be managed appropriately. 

 

3. Methodology 

Empirical research was used to determine patients' perceptions and expectations of service quality. Moreover, data 

from different Healthcare systems will be gathered to understand the variation in cost & quality of services rendered.   

 LEAN Six Sigma concepts & methodologies will be used to evaluate and improve the processes. 

 The LEAN concept of identifying the Non-value adding steps are in the entire operations of health care 

systems that are contributing to additional costs are studied in detail by performing a value stream mapping 

of each process step that is critical to quality. 

 DMADV approach of Six Sigma methodology was used in the present study 

 Finally, the proposed model was created using multi-disciplinary teams 

4. Findings and Discussions 

 

Fig.1. The outcome of reviewed proposed design of integrated Healthcare model through performance excellence 

methodologies 

This model (Fig.1) has been articulated based on the local survey conducted across Healthcare Organizations. This 

model is a comprehensive approach that can lower costs, organise active processes, reduce errors in internal 

operations, and enhance care coordination. This model designed to results in better revenues, decrease costs and 

eliminates activities that are not adding value to these systems. The Healthcare institutions are progressively making 

affords to move towards patient-focused care delivery models. As a result, issues like patient engagement, care 

orchestration, and patient satisfaction are now major focus areas for transformation leaders. 



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This model iterates the use of integrated Population statistics, Patient Interactions, Resource Utilization, Care 

Orchestration and organization Performance measurement. In each of this bucket, the Healthcare Systems need to 

identify and target the inhabitants, stratify and capture the risk. Once we accomplish, the receivers of care need to be 

engaged; then at each level, the processes need to be validated to remove possible repetitive tasks. By removing 

these repetitive tasks will then result in coordination with the payers and receivers of care to measure, map and 

articulate outcomes. Once the outcome achieved, these need to be fed back to the population statistics to create a 

benchmark of performance across the provider's space. A quarterly review of these metrics will result in achieving 

‘Performance-based care or the Integrated Care Model.' 

The proposed model would be providing services that include but not limited to: 

 Effective capture of medical history will eventually reduce patient wait times 

 Reduced manual data entry effort would lead to improved staff productivity resulting in reduced risk of 

inefficiencies 

 It would allow clinicians to focus on patient care and coordination for reduced length of stay at hospitals 

 This model would lower the Total Cost of Healthcare as each of the providers would avoid costly point-to-

point integrations with referring physician practices 

 Timely and easy access to lab reports and trends ensured that referring physicians continue to drive patient 

traffic based on clinical condition 

 Instantaneous monitoring of operational metrics at labs enabled continuous improvement in business 

outcomes 

 Technology offers a unique amalgam of solutions to help the organizations to enhance the Patient 

experience, drive out prices and to improve business agility 

 

However, lack of interoperability podium among Healthcare Systems and limited access to consolidated patient 

records are significant uphill tasks for moving ahead this model. Additionally, the Healthcare industry lacks secure 

and intuitive communication and collaborative or interoperable tools. Generally, the clinical staff is overwhelmed by 

technology rather than focusing on what's essential in patient care. 

 

Another major contributing factor to this problem is that all these capabilities come at great capital and time 

investment. These are further decelerating the pace of this change. 

 

Nevertheless, in order to withstand transformations over time, integrated care models require actions that extend 

from organizational, functional, professional and service delivery levels up to transformations on system level 

addressing each area of operational management. For instance, the adoption of multidisciplinary styles goes beyond 

the organization of providers vs. payers and requires alignment of healthcare policies at the technology and system-

level. Given the performance-based evidence system, it becomes indistinct that establishing integrated care is a 

multi-layered and long-term process involving high capital investments. 

 

5. Conclusion 

The literature reviewed during the research provides evidence that integrated care models are introduced and 

implemented as a change management strategy. Reviewed literature also show affluence of implemented and 

evaluated integrated care models that range from individual, disease-specific models and models that embrace entire 

masses. Integrated healthcare delivery is a framework to reinforce people-centered health care providers towards the 

advancement of a comprehensive delivery mechanism of quality services across the course. The proposed design 

needs modification according to the multidimensional needs of the receivers of care and the individuals that provide 

and coordinate multidisciplinary team across of providers/payers space working across settings and levels of care. It 

should be thoroughly managed to ensure optimal outcomes and the appropriate use of resources based on the best 

available facts, with continuous feedback mechanisms to improve performance and to hold upstream causes of 

illness and to promote well-being performance improvement methodologies. 

Healthcare Organization’s covenant with the industry challenges, regulatory concerns, safety and comfort of care 

receivers. These challenges can be addressed by integrating Technology into healthcare practice and uniquely 

position themselves to orchestrate care that is ‘Performance-based care or the Integrated Care Model'. There is 

remarkable consistency in the evidence for some of the key areas of such a strategy. The model further emphasizes 

the many different generic components described above observed as core components of ‘Performance-based care or 

the Integrated Care Model'. 

 



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Acknowledgements 

The authors wish to thank the Healthcare organizations; its employees and the patients who have contributed to this 

research and model creation 

 

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