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Why slow and steady IT development will best support value-based care

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Recently, my son has been listening to an adaptation of the classic story—the tortoise and the hare, a parable that supports the notion that slow and steady wins the race.

What does this story have to do with shifting healthcare to a value-based care system? Expectations and hype (the hare) cannot be allowed to overcome practical, thoughtful adoption (the tortoise). No change, especially fundamental change, can be expected to occur overnight. It takes time for reform to seep in, be implemented and be refined. And, we’re finding out, that it takes time for information technology tools to mature and provide the exact kind of support that providers will need to succeed.

A recent joint survey by Quest Diagnostics and Inovalon shows slow, but growing acceptance and recognition that value-based care is here to stay in healthcare. In comparison to the 2016 version of the survey, more physicians (and health plan executives) see that the technology tools are in place for value-based care.

Specifically, newer physicians are more apt to think that the American healthcare system is becoming value-based. Some 31 percent of physicians with 20 years or less of practice say they believe that there is a value-based care system. The shift in viewpoints is important because those physicians with fewer years of experience are the ones who will need to work within the new system for the longest.

An increasing percentage of both physicians (43 percent in 2017 vs. 29 percent in 2016) and health plan executives (53 percent in 2017 vs. 44 percent in 2016) say they believe that physicians already have the tools to succeed with value-based care. However, the survey notes that misperceptions about the current benefits provided by electronic health records systems fuel the rosy view among health plan executives.

Somewhat surprisingly, 54 percent of physicians believed that EHRs have everything that physicians need for VBC success. However, 70 percent of physicians also did not see a clear link between EHRs and improved patient outcomes. The disconnect is not easily explained by the survey results, but a quick scan of common complaints voiced elsewhere supports the lack of connection for improving care.

But the positive response on the capability of EHRs by more than half of physicians does represent a silver lining in the survey. As EHRs are slowly refined and modified to fit within practice workflows, the benefit for value-based care should become more apparent.

A common belief is that technology takes multiple iterations before it begins to approach promised usability. EHRs, a digital technology, are no different from the technical perspective, but not in the use perspective. While people complain if their iPhone or other modern device does not perform as advertised at first, the medical industry cannot afford to have tools that impede or subvert practice.

Ultimately, the Quest/Inovalon survey should give us hope. Views of value-based care and the supporting role that health IT can play are trending upward. Additionally, the views are changing at a measured pace, which suggests that unfounded expectations are hopefully coming down to reality. Dreaming is good, but can cause frustration. It is important to think of the tortoise’s approach that one foot in front of the other at a pace that can be maintained for a long time is often the way to win the race.

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