By Jerry Shultz via healthcare-executive-insight.advanceweb.com
While a great deal of attention rightfully focuses on patient engagement, many healthcare executives in both provider and payer organizations are also focusing on the impact of provider engagement on the success of effective population health management. When providers do not have access to relevant information, use it sparingly due to lack of workflow integration or are experiencing information overload, population health management can become a major business problem. It is increasingly apparent that selecting a system physicians will fully embrace and engage with is a critical decision.
Many organizations are finding that a fully integrated, end-to-end platform that places critical data directly into providers’ workflows helps increase physician acceptance. When clinicians can access specific information (i.e. quality measures and/or analytics), see coding gaps and monitor performance at the point of care, they are far more likely to embrace the technology and use the system regularly. As the transformation from volume to value accelerates, here are five key technical capabilities that organizations should look for in a population health solution as it relates to physician engagement.
Engage providers with patient-specific quality measures
Physician engagement in population health management is more effective when a clinician has access to real-time quality measures data at the point of care. Doctors are highly trained scientists and possess a natural tendency to value empirical and evidence-based data. When they can see relevant and accurate information in their daily workflows, they are more likely to engage and utilize the system. Technology can push notifications and alerts to the point of care, where they are most useful to physicians and more likely to boost adoption. When physicians can easily view, report, and electronically submit all measures required by CMS and other quality reporting programs directly from their existing workflow, they are more likely to embrace the enhanced efficiency.
Share information between the organization and physicians
The capability to share data to enhance coordination with other providers is also critical. System wide clinical integration with care management functions greatly reduces time spent calling or faxing physician offices to acquire clinical information. This efficiency frees up precious care management resources to focus more on actually managing care and provides a more complete record to physicians. To effectively manage a person’s overall health, it is critical that all physicians on their care team have a complete understanding of their longitudinal medical record. Facilitating requests for information through automated tasking within a provider’s natural workflow improves efficiency. When physicians are armed with the most complete, up-to-date information possible, more appropriate decisions can be made to improve quality and lower cost.
Push care gaps into EHR systems
A tool that can push information into any EHR system and notify providers of their patients with gaps in care correlating to evidence-based guidelines, HEDIS measures or other metrics is of high value. An open platform approach that can manage the secure exchange of information across disparate EHR systems will offer significant benefits to physicians and further improve engagement.
Identify coding gaps
While adhering to specific quality measures standards, Medicare Advantage plans require proactive management of patient populations in a cost-effective manner. Alerting physicians to potentially inaccurate, outdated or missing HCC codes at the point of care will help improve coding compliance and clinical documentation. In an era of reduced payments from CMS, concentrating on HCC coding and documentation accuracy is one of the best ways to improve quality of care and performance benchmarks.
Monitor performance improvements
Advanced technology that monitors performance at the physician and patient levels allows care teams to prioritize action necessary to improve performance. These tools can help identify quality improvement opportunities or cost/utilization overruns, pinpointing the root cause of where corrective action is appropriate. Distributing provider scorecards makes providers aware of their individual strengths and weaknesses against organizational benchmarks as well as their peers. Physicians should know where they stand on the cost quality matrix and how it impacts their bottom line personally.
Extend the selection process to find the best technology fit
Healthcare executives responsible for evaluating population health technology should look for vendor agnostic solutions that can aggregate data from disparate sources and transform it using evidence based guidelines into truly actionable information. However, in many cases it is up to the end user client to purchase and integrate disparate technologies from separate vendors to support the overall mission, adding unnecessary workarounds and expenses. There is real value in a unified, end-to-end solution. Look for technology vendors who can offer a full suite of patient and physician engagement tools, complete analytic reporting (including predictive modeling), as well as seamless integration of varied data formats directly into any EHR or clinical workflow.
While selecting a well-known legacy vendor can make one feel more secure in their decision, leadership should consider extending the selection process to include vendors with newer technology that meaningfully engages physicians. Selecting the right population health management solution can be a critical factor in achieving success in a value-based world, and taking the time to carefully review multiple vendors for technical capabilities that match the unique needs of your organization – and their clinical staff – will be worth the investment.