From the January/February issue of HealthCare Business News magazine
By August Calhoun
Attend almost any health care industry event, or read health care social media and news headlines, and you will see a lot of messaging around population health and value-based care.
The volume of information can be overwhelming, so how do you know if you’re on the right path to value-based care transformation, or if you should even be on the path? Here are seven signs that might indicate you could use some help with your value-based care or population health management strategy.
You don’t know where to start
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As a world-class health care leader, you want to own the change from sick care to lifetime wellness, but where do you start? The evolution from quality of care to quality of life requires serious strategy and a deep dive into data to understand your population, your capabilities and your resources. What are the disease management/care management opportunities that most impact your organization?
Before you purchase software, before you start new community-based initiatives – look at your existing technology, workflow, care pathways and resource investments and determine what you need to optimize these to best care for your population.
Design a roadmap that plots how your organization will transition from a delivery model of volume-based care to one that allows for better risk contracting, reduced costs and healthier, happier patients and employees. Don’t be afraid to bring in outside consultants for advice.
You have an EHR to manage your population, and you think that is enough
You may want to consider population health or value-based diagnostic solutions that better leverage the data in your EHR and other connected health care information technology (HIT) solutions. They tend to be more longitudinal and are designed for care collaboration between providers and patients.
You might be missing key diagnostic data
According to a review published in the Journal of General Internal Medicine, “doctors in the U.S. are failing to follow up on results of up to 62 percent of laboratory tests and up to 35 percent of radiology tests.” As a result, they are missing critical diagnoses, including cancer, and causing delays in treatments for many conditions. Those are enormous care gaps.
Incidental findings, previously undiagnosed medical conditions discovered unintentionally during diagnostic testing or treatment for an unrelated medical condition, are a challenge for both laboratory diagnostics and diagnostic imaging. The challenge is even bigger for tests performed on patients in the emergency room. Incidental findings have a high prevalence in the emergency room setting. A 2011 study found that incidental findings were documented in 33.4 percent of 682 CT scans performed in the ED on discharged patients. Of these, only 9.8 percent were reported to patients, according to discharge paperwork. The impact on readmission rates and malpractice claims is certainly substantial.
You aren’t getting the ROI you expected
Your health system purchased population health management technology or has decided to use their electronic health record (EHR) solution for value-based care, yet you aren’t getting the return on investment (ROI) you intended. As a wise colleague of mine once said in a recent webinar, “Sometimes software alone is not the answer when it comes to value-based care transformation.”
Successful transformation may require change – change in workflow, change in clinical practice or change in workforce structure. It is extremely challenging to get stakeholders in health care provider organizations to change. Identify a trusted partner who knows your business and can help you leverage your existing and future investments for maximum impact.