Given how immersed we all are in trying to improve healthcare while dealing with regulatory changes, cost pressures, emerging retail models and the shift from a volume-based system to one based on value, sometimes it’s helpful to step back and look at the bigger picture. Are we succeeding in our goal of improving the health of patients and populations with more efficient and effective care?
Plenty will argue that payers, providers and patients often don’t share a common view regarding the best approach to this goal. However, all stakeholders are aligned around one point of consistency: there is much to be gained by ensuring that appropriate care is delivered in an appropriate setting. If that can be achieved, then we will indeed improve care quality and patient satisfaction while driving significant cost out of the system.
Ultimately, providing the right care in the right setting is dependent on our ability to deliver actionable data to the point of care. So let’s take a look at how close we are to making that capability a reality across the healthcare system.
Building the Data Infrastructure
In order to bring actionable data to the point where it’s needed, three foundational activities must be accomplished.
Collecting Electronic Healthcare Information
The digitization of healthcare was accelerated with ARRA, the HITECH act and the arrival of meaningful use requirements. However, as we all know, even the widespread adoption of electronic health records will not be sufficient on its own to transform the healthcare system. Data is critical, but if that data remains locked up within a physician clinic, pharmacy, or health system, providers along the care continuum will never be afforded a holistic view of the patient.
Aggregation of Healthcare Information
What’s necessary, of course, is for data to be accessible wherever it’s needed. But how can we promote the kind of connectivity that will integrate the entire healthcare system? In early 2013, McKesson co-founded the CommonWell™ Health Alliance with other leading healthcare information technology companies.
The alliance is energetically working to implement a shared set of standards that can support data liquidity across care settings, regardless of the setting’s technology vendor. Free flow of data supports better care with timely access to a patient’s medical information at the point of need, in every setting. It also supports better business with the data to make smart operational and financial decisions by management and front-line staff.
Turning Data into Insights via Analytics and Decision Support
While data liquidity unlocks information needed to make the appropriate medical and treatment decisions at the point of care, it is not the end of the story. In order to act on data appropriately, we need tools that will surface insights from the data.
Data analytics will be critical. We need analytics that allow us to look at populations of patients, and to tailor programs and drive best practices that improve medical care in aggregate and for individuals in the population. In addition, we need real-time decision support that helps providers and payers determine the right care and right setting for a specific individual patient.
Both forms of data analytics are important in achieving better health. Surfacing the right data at the right time through alerts, CPOEs, dashboards, e-learning platforms and personal health records are helping to automate the delivery of actionable intelligence to the decision maker at the point of care.
From the perspective of those already fatigued by reform and the latest IT adoption, this may seem daunting. Fortunately, however, building a systematic connectivity and data strategy – one that meets the challenges of collecting healthcare information, sharing it across the care continuum, and applying data analytics to help improve decision making – will not add complexity to current processes but help remove it over the long-term.
Leading organizations, such as those listed in the Most Wired honor roll, are developing the foundation for such capabilities because they see the clear benefits. Success stories can be seen in the achievements of the organizations highlighted in this issue, each of which has been named to the American Hospital Association’s Hospitals & Health Networks® Most Wired list for 2013.
Success Over the Next Decade
McKesson has outlined a vision of the future of healthcare we call Better Health 2020™, where four critical factors will determine success. Over the next decade, organizations will need to navigate evolving payment models; optimize performance and quality; coordinate care; and maximize the value of technology to provide a foundation for growth beyond the four walls of the hospital.
McKesson has a breadth of solutions that span and connect the settings of care. Our 180-year history and expertise in the segments of care – from payer to provider – give us a 360° degree view of healthcare that informs our Better Health 2020 vision.
We should all be encouraged by how close we are to reaching the goals that have been set out. We are getting nearer to solving the great challenge of our generation. This is an exciting time to be in healthcare.
Rod O’Reilly is senior vice president of Strategy and Business Development for McKesson Technology Solutions. O’Reilly leads portfolio management, mergers and acquisitions, and integrated planning. He also is heavily involved with public affairs and regulatory activities, while helping drive McKesson’s Better Health 2020™ strategy. Prior to his current position, O’Reilly was president of McKesson’s Health Systems Enterprise Solutions, overseeing product development, implementation services, customer support and the sales and marketing functions for Horizon Clinicals®, STAR, Series, HealthQuest® and other classic revenue cycle solutions.
Four Keys to Informing Care with Actionable Data
It’s not what you have; it’s how you use it. Just having the supporting hardware and software is not enough. It’s how you apply it. Below are four keys to hard-wiring your care delivery to address accountable care and risk-based payment models. You can learn more tips by reviewing the criteria used by the American Hospital Association’s Health & Health Networks® magazine for its Most Wired survey.
- Measure caregiver adoption and performance. Caregiver adoption and performance is the key to effective improvement. Use CPOE, alerts, analytics and other health IT to help you incorporate best practices, workflow efficiencies and decision support into your processes. Share the vision and performance scorecards at all levels to reinforce your strategic goals.
- Exchange clinical data in ever-widening circles. Start with your non-employed community physicians. Connect and collaborate with community, regional and state providers via health information exchange. Make data available wherever the patient is, including the home.
- Use enterprise intelligence that provides an integrated view of your financial and clinical performance. Having an integrated view helps you balance quality of care and cost requirements as you assume more risk with the various stakeholders in your care delivery network. This is a key to addressing risk-based reimbursement and hard-wiring best practices.
- Review strategic partnerships with the best providers in your area. To maximize your performance under accountable care payment models, you need to align with partners that will help you deliver the outcomes and cost basis you need in order to thrive under value-based reimbursement. It also gives you the opportunity to better coordinate care for improved outcomes.