Time vs. Quality – ACO’s Greatest Challenge

Collecting Data Is a Challenge

Imagine having to collect more than 30,000 data points spread across many offices, multiple IT systems and, in some cases, stacks of paper. Imagine having to complete this process in 10 weeks with a limited staff of nurses and analysts. Sounds crazy or familiar?

For accountable care organization (ACO) administrators across the country, the above scenario sounds all too familiar. Every year, from mid-January till mid-March, Medicare ACOs are required to do exactly that. In order to assess the quality of care, Medicare provides these organizations with a sample of about 3,500 of their patients and asks them to report on average 7-8 clinical data points for each one.

In 2014, Shari Peterson, RN BSN CCM, Director of Clinical Operations for the Northwest Physicians Network, estimated the effort at between 3,500-4,000 hours (including training, travel, record retrieval, data collection and auditing time). With a total skilled staff of 12, she estimated dedicating 8 weeks of her entire staff to the reporting effort. Now consider the crazy implication: for roughly two months, the entire organization’s supporting clinical staff, instead¬†of driving quality care, would be busy reporting on care quality.

Sparing their limited staff, some ACOs choose to outsource the annual data collection and reporting process, easily spending more than $100,000 — an expense that contributes virtually nothing to the quality of care they provide. Other ACOs resort to offloading the work to their disparate practice staff that is minimally trained and often uncoordinated — leaving behind shoeboxes (both physical and metaphorical) full of paper charts and spreadsheets that put them at a serious risk in case of a Medicare audit.

Physicians Need To Be Patient Facing

Many in our health care system have decried the administrative burden imposed on care providers. “We need our physicians to be patient facing, not computer facing,” said Tom Price, then HHS Secretary, in a conference last April. “We simply have to do a better job of reducing the burden on healthcare providers,” he added. But healthcare is not our only highly regulated industry. And yet, banks don’t close their doors for two months of the year in order to comply with government reporting requirements.

The difference: over decades, our banking industry has developed advanced IT capabilities that make information available in real-time. As consumers, we no longer marvel at our ability to stop at any ATM and within seconds check our balance in a bank many miles or even continents away. And yet, under life-threatening conditions, we may enter an emergency room just a few steps from home only to realize the doctors know nothing of our medical history.

For years, both government and industry stakeholders have been touting better interoperability in our healthcare system. At last year’s conference of the Health Information Management Systems Society (HIMSS16), a number of key stakeholders signed an interoperability pledge. The pledge was announced by then-HHS Secretary, Sylvia Mathews Burwell. “We must demand interoperability,” she said at the time.

A year and a half later, in September 2017, one of these signers, and the Nation’s most prominent health IT vendors announced that it would allow patients to share their data with any care provider. The catch: the patient and their data must already be on that vendor’s system. Unfortunately, despite paying hundreds of millions of dollars for a single health system implementation, it is highly uncommon for a single patient’s data to reside within a single health system.

Northwest Physicians Network’s Proactive Approach Saves Valuable Time

For Shari, such industry initiatives have offered little relief. Back in 2014, she stumbled upon an IT solution that offered to make her life easier. Indeed, in the post-reporting analysis, she found that using the solution they chose, her staff spent 69% less time than she had originally estimated — translating into savings of close to $100,000. The secret: instead of waiting for Uncle Sam or Industry Leaders to come to the rescue, Shari’s chosen solution leveraged existing assets (data, technology, and staff) to streamline the process as much as possible.

For Shari, this was a “no-brainer.” Her ACO continued using the same solution every year since. And every year, it has made her life and the lives of her staff even easier: instead of spending time chasing charts and submitting reports, they have been able to focus on what they like to do best: ensure the quality of care for their patients. Indeed, from 2014 to 2017, Shari and her team have improved their quality score by nearly 20%. For this ACO team and many others across the country, this is all that matters. In times where crazy is becoming only too familiar to all of us — can we not agree with them?

Authored by:
Kobi Margolin, CEO, Clinigence

 

By |2018-06-25T22:31:34+00:00October 9th, 2017|Articles|0 Comments