A Robust IT Framework: The Lynchpin in Delivering on the Promise of Value-Based Care
By Robert Davis, CIO, Arizona Care Network
Robert Davis, CIO, Arizona Care Network
It used to be that a company’s IT staff was holed up in a chilly room in the back of the office surrounded by scores of computers, servers and other equipment.
Nowhere has that scenario changed more than in healthcare, which has become more data-driven than ever before. And the IT team sits at the center of the industry’s transformation from volume- to value-based care.
The shift to value-based care is not new; as those of us who work in healthcare know well, the industry was headed in this direction long before the passage of the Affordable Care Act.
More importantly, value-based care is here to stay. In fact, by 2020, America’s health insurance leaders predict that three-quarters of their business will be in value-based contracts.
If our aim is to deliver better care at a reduced total cost, then technology’s role is clear: Metrics must be built upon an ever-growing variety of data systems: EHR, HIE, satisfaction surveys, claims data, data warehouses, connected wearables, CRM and population health tools.
"Technology is driving the future of healthcare and it’s a key to ensuring the financial stability of physician practices and hospital systems alike"
Consider how a digitized IT infrastructure can inform both care and business strategies for everyone in the healthcare spectrum – from independent practitioners to multi-hospital systems. Technology also can help close the loop on a patient’s journey from a primary care physician to a specialist and then back to the PCP. And meaningful data can predict the onset of diseases among the larger population.
Beyond care delivery (whether it’s preventive or for a chronic or an acute condition) clinicians and hospital systems rely on technology to succeed in a changing healthcare environment.
This extends far beyond the EHR.
In value-based care, EHR is just one piece of the puzzle; IT has a hand in everything from creating clinical care pathways and patient engagement tools to workflow management, financial and performance reporting systems. Technology is essential in aggregating, analyzing and sharing information about a broader swath of a population, too, as a means of measuring service utilization, identifying gaps in care and validating provider quality and efficiency, among other things.
I am fortunate to be part of a large and growing accountable care organization in metropolitan Phoenix called Arizona Care Network that is pioneering a progressive, value-based model of care designed not only to improve patient outcomes, but contribute to the safety and quality of life of the entire region as well. A key element of ACN’s plan – and a lynchpin to delivering on the promise of value-based care – is a robust IT framework that breaks down data walls among providers and hospital systems.
Of course, building solid information, data analytics and reporting platform is no small task. For ACN, it was important for our 5,000 clinician members to have a shared understanding of the value of data and all that it can do. This required a bit of a sea-change from a culture of keeping information close to the vest to one of trust, transparency and a sense that we’re all in this together. Strong administrative leadership and physician champions are vital to initiating this type of change.
Along with a change in mindset and culture came an investment on the part of our members and ACN. The idea was to ensure that our IT systems were aligned across the network so we could readily share information and best practices, improve efficiency among caregivers, and ultimately deliver the best possible care. This isn’t something that happens over night; rather, it is an evolutionary process, with small changes that have the potential to make a big impact over time.
If you have been through this process, then you know that it requires a commitment from everyone involved. For those of us in IT, driving this kind of change demands the ability to manage the day-to-day technology needs of an organization like ACN, a hospital system or an individual practice, while also looking ahead.
At ACN, we are constantly asking ourselves how we can make finding physicians, specialists and other resources in our network easier for patients, how we can keep patients in-network to ensure that they get quality, cost-effective care and how we can avoid a duplication of services among providers. We also consider ways to harness technology to keep patients healthy and help physicians navigate a rapidly changing industry.
Keeping our finger on the pulse of day-to-day issues and always staying ahead of the curve (using data, of course) has helped us forge new partnerships to manage patient referrals, create a mobile application to bolster in-network utilization. It also help us develop a comprehensive approach to tracking our members’ performance data, processing claims and analyze the health of the broader population.
Technology is driving the future of healthcare and it’s a key to ensuring the financial stability of physician practices and hospital systems alike. For Arizona Care Network, a robust IT framework is also a gateway to achieving the most important goal of all: the Quadruple Aim of delivering high quality care, improving the patient experience, managing the rising cost of care and driving provider satisfaction.