With the rapid and dramatic improvements focused on improving value-based care, the need has never been greater for increased coordination between the multitude of providers who are working together to drive whole patient care. As providers with unique focus participate in greater care coordination and records sharing, such as substance use or behavioral health specialists, the need for tools to facilitate more rapid and accurate coordination of care is becoming imperative.
Every type of health IT software generates unique data in its own way and communicating that data between a myriad of unique programs and databases can be time consuming and costly. Nancy Pratt, a 20-year veteran of the industry and chief operating officer of Airstrip, a company that builds mobile interoperability software, says that “Healthcare is still primarily a cottage industry of products, patching things together as they can.” Other industry veterans agree. Mari Greenberger, director of informatics for the Health Information and Management Systems Society (HIMSS) says that these concerns exist at the federal level, where interoperability is a hot topic, but progress to address it nationally is slow for fear of stifling innovation. She feels that for at least the next 3-5 years, providers will be left on their own to use third party software platforms to help them achieve more efficient and accurate interoperability.
Physicians may remain in a demanding situation for the next few years as national and centralized interoperability looks to be years away, but they are required now to provide a wide variety of data that relies on data sharing and interoperability, such as MIPS and value-based initiatives from private payers. Officer workers without efficient interoperability software or assistance are being taxed as they are forced to make more phone calls and work their fax machines in a mad dash to obtain accurate data in a timely manner.
The drive towards improving value-based care, however, is seen by most as well worth the extra effort and growing pains. These views are backed up by research, showing a high percentage of payers reporting significant improvements, including:
- 80% report better care quality
- 73% report increased patient engagement
- 64% report improved provider relationships
Due to the swift pace of change, many providers feel they lack the expertise needed to fully take advantage of the benefits that come from more efficient interoperability that enables them to maximize the advantages that come from value-based care. Many don’t know where to start as they look to make investments in tools and solutions needed to support these value-based care and population health initiatives. Experts are suggesting providers ask the following questions and consider the potential features:
- Can we effectively share clinical information between practices? Practices can benefit from adopting electronic health records and new processes and technologies to encourage greater collaboration in developing coordinated care plans to improve the accessibility of patient information.
- How can we analyze clinical and financial data? Utilize administrative tools and software to enable the coordination of care, the collection of reimbursements, and capturing of required reporting data. Look for a software platform that offers analytical capabilities to identify vulnerable populations and respond proactively.
- How can we manage care coordination and staff workflow to support population health initiatives? Whatever tools you use, they should help you easily identify patients who are most in need of care to improve outcomes and minimize costs, as well as identify any gaps in care. You should also seek tools that will help you develop follow-up and customized care plans, a prime benefit of greater interoperability to help address whole person care using the most effective value-based methods.
Moving ahead with the right plan and tools you need to enable that plan will greatly increase the impact you will see in value-based care for both your own organization as well as your patients. The benefits for patients already seen have been wide ranging, from ensuring needed information is accessible to them across multiple settings while avoiding duplication, gaps and delays. Additional patient benefits include:
- Utilizing platforms to simplify discharge planning
- Referral management
- Post-acute care to aide transitions
- Feeling empowered as a partner in directing their care, generating greater satisfaction and loyalty
- Utilizing population health strategies to proactively prevent and slow disease progression
- Better management of chronic conditions
Additionally, clinicians utilizing tools to help them are reporting significant benefits, including the reduction of the burden they feel in generating reports on their own by having a third party or software platform process the data for them. Simply put, the increased emphasis on value-based care means doctors need greater access to detailed patient data for reporting purposes, yet they often lack the ability to obtain it. Often, the technology exists but practices can’t afford it, or a lack of interoperability prevents them from accessing the data they need. The data is often trapped in various systems across the healthcare landscape and tracking it down is a labor-intensive process taking time and focus away from patient care.
One clinician, Nick Beechnau, a primary care physician in Michigan, said another benefit in utilizing available technologies is a reduction in redundancy. “Once you get the information from someplace else, you often have to hand input it into your system. For a lot of things, like colonoscopies or pap smears, even if it’s in your electronic health record, you have to report it separately to payers to get full reimbursement.”
Physicians often obtain the information they need but face the additional challenge of it being in an unusable format that takes additional time to dissect. When Keith Aldinger, a Houston-based endocrinologist, requested a patient’s data following a two-day hospital stay, he received a report generated by the hospital’s EHR system that he described as “75 pages of digital dysentery” due to its including “redundant pages listing every vital sign. It takes time to go through it and it didn’t have what I needed.”
Practices and ACOs across the country are realizing the benefits of value-based care as they adopt innovative solutions addressing their concerns and offering robust capabilities to overcome them. Technology today is rapidly responding to the increasing demands of providing great interoperability, and it can provide a foundation for your organization to participate in many nationally offered value-based programs, such as Merit-based Incentive Payment Systems (MIPS) and Patient-Centered Medical Home (PCMH).