Why organizations need to demonstrate the value of IT progress
Just prior to National Health IT Week, I spent time with more than 500 clients at our Allscripts Client Experience event for hospitals and health systems.
New approaches to healthcare delivery require innovative thinking and action and should support the Four Points of Engagement that we recognize in National Health IT Week. One of the points is focused on the importance of health IT in increasing economic opportunity, which is valuable, but it’s the other three points where healthcare organizations are showing evidence of progress.
Supporting healthcare transformation
Healthcare is now on a fully digital platform, and organizations now can begin to extract value and insights from this information. This transformation is happening through quality and safety initiatives, interoperability progress and a renewed focus on the consumer.
Painstaking quality metric data collection has helped demonstrate performance to regulatory bodies, and forward-thinking organizations are using this information to continuously improve. When the accountable care organization (ACO) model was first introduced in 2011, the goal was to tie payments to quality metrics and the cost of care. Coastal Carolina in New Bern, N.C., and its associated ACO, Coastal Carolina Quality Care, have used data from the EHR to monitor and demonstrate quality performance since its first performance year in 2013. The ACO consistently ranks among the top performers nationally in CMS public quality reports for achieving exceptional clinical outcomes, such as reducing the number of hospital admissions by 22 percent since joining the program.
These organizations address quality and safety with data-driven practices and, as an industry, this data is valuable to clinicians and patients. However, there are still hundreds of different EHRs that have data locked away. Intraoperability—meaning organizations can only share data if they share the same EHR vendor—is not sufficient.
The industry has already technically solved interoperability—it just needs to address the workflow component that harmonizes the information and presents it to the clinician in a meaningful way at the point of care. Pittsburgh-based UPMC has a history of finding and developing innovative technology solutions to improve the delivery of patient care. Through its work to help develop the dbMotion Solution, UPMC sought to bring together disparate health IT systems to improve clinical decision making at every patient encounter. Now, UPMC has 78 systems contributing data and 133 interfaces to its interoperability platform to manage comprehensive lifetime records of care for 8.3 million patients. A UPMC survey found that two out of three clinicians report that accessing comprehensive patient data changed care decisions.
But what will make the biggest difference in healthcare transformation is getting consumers engaged in their healthcare. When that happens, there will be more cohesive care plans and a lower overall cost of care. For an example of how a patient-centered approach improves quality and the bottom line, Nicklaus Children’s Health System in Miami, Fla., used its IT solution to drive patient engagement from 5 percent to 75 percent of patients. Going paperless and digitizing the registration process helped the organization save $4 to $8 per patient visit while achieving 94 percent patient satisfaction by establishing an easy way for physicians and patients to communicate digitally.
Expanding access to quality healthcare
Telehealth is a hot topic, and most people immediately jump to the idea of a virtual visit. One of our staff members, Kim Franks, vice president and general manager of FollowMyHealth, shared this story from another employee.
“We were camping out of town when my youngest son woke up with pink eye. I knew we needed to get him into an urgent care ASAP. I found a virtual urgent care option nearby by scanning the paid section of results on my phone. I went to the site, provided the required information, paid the $35 co-pay and gave my preferred method of contact (face time). A nurse practitioner contacted me within 15 minutes. She questioned both of us on his condition and performed basic tests (follow Mommy’s finger with your eyes). After confirming the diagnosis, she helped me locate the closest pharmacy, sent the prescription, and then, followed up with a very detailed clinical summary. The whole process end to end was about 30 minutes.”
But video is just one option; technology offers a wide array of options for clinicians to connect with their patients. The important step is that clinicians need to meet healthcare consumers with communication options that are convenient and effective. Whether it’s sending appointment reminders by text, offering the option of email visits, engaging patients via chatbots to monitor chronic conditions—all of these options that improve access to care help consumers take better control of their health.
Making communities healthier
Today, one of the most pressing public health crises is the opioid epidemic. Health IT alone will not solve this issue; it will require many efforts from stakeholders across the industry. However, we can and should harness technology to refine our approaches. Large data sets enable us to identify opioid prescribing patterns and track the progression of opioid dependency. The industry has the potential to take a more proactive, and eventually predictive, response to the crisis.
University Hospitals in Cleveland has made significant strides. Addressing opioid abuse and addiction is a priority in this community, and UH has banded together with a consortium in northeast Ohio to form a comprehensive, communitywide response. UH has made opioid prescribing guidelines available to all providers with the help of its EHR. Providers used analytics data from across the care continuum that illustrated opioid prescribing patterns, helping providers gather more data points and design more precise interventions. Tracking this data for one year demonstrated a 20 percent drop in opioid units prescribed by family practice physicians and a 34 percent drop by internal medicine physicians.
These examples of actionable change through health IT represent the reality of positive outcomes achieved by many hospitals, health systems and medical practices. Progress on these efforts across the country must extend far beyond National Health IT Week to profoundly impact healthcare delivery.