Population health management is becoming increasingly more important as the Baby Boomer generation has started enrolling in Medicare, information and data are progressively available, chronic disease is on the rise, and health reform has set a timeline for change. The leading patient care organizations are adjusting to the change, with numerous IT initiatives to aid them along the way.
To this end, about a year ago, Baylor Health Care System in Dallas, Tex., and Scott & White Healthcare in Temple, Tex. became one. The merger of the two organizations has resulted in the largest not-for-profit healthcare system in the state, serving adjacent regions of Texas. Baylor Scott & White Health includes 43 hospitals, more than 500 patient care sites, more than 6,000 affiliated physicians, 34,000 employees and the Scott & White health plan. In the past year, the health system created the Baylor Scott & White Quality Alliance (BSWQA), a 3,700 physician-strong network that is one of the largest accountable care organizations (ACOs) in the country.
According to Nick Reddy, the organization’s senior vice president of information system investments, Baylor Scott & White Health is a “baby Geisinger,” referring to the Danville, Pa.-based Geisinger Health System, a known industry leader. On Dec. 10 at the Institute for Health Technology Transformation’s (iHT2) Health IT Summit in Houston, Reddy will be part of a panel discussion that discuss why data is the key to population health management. The session will address successful ACO models and how to best utilize data to take care of patient populations. Click here to register for the Houston Health IT Summit to see this panel and many others. (iHT2 is a sister organization with Healthcare Informatics under the corporate umbrella of the Vendome Group). In a recent interview with HCI Associate Editor Rajiv Leventhal, Reddy previewed the panel discussion and dove deeper into the IT initiatives at Baylor Scott & White Health.
What are some new ways you are using data for better population health management?
What we have found that’s interesting, is that with data, we have more than 5,000 care sites where people can receive care, and more than 400 different electronic medical records (EMRs), so we’re under a large connection mechanism. We are using dbMotion (Pittsburgh, Pa.) to connect and interoperate. If I showed up to any of those sites as physician, you will know everything about me. Unfortunately, today you don’t. It’s what I call "data for care,” and it’s irrelevant to analytics. If a patient shows up and the clinician doesn’t know everything about him or her at the point in which the patient is there in the site, then analytics are irrelevant. So we’re trying to provide data for care at the point of care. That’s a big part of our initiative.
The second aspect is on the analytics side. We are spending a bit of money on consolidation, for one, going pretty far with one of our vendors, building a warehouse where payer and provider information is merged. We are taking that information and we have analytical tools that give us patient stratification and micro segmentation, things of that nature. So I could tell you, even though it’s common sense in healthcare that 1 percent of patients account for 40 percent of the costs, what you can realize through our tools is that 1 percent is almost insignificant because it’s too late. You can’t bend the cost curve, as those patients are normally terminally ill, in hospice. You can talk about it and be irritated by that, but you can’t move that cost curve. The next criteria are who will be the next 15 percent who will become the 1 percent that I need to prevent. So we’re able to do that through tools and strong case management, with consolidated case management across institutions, starting with very basic things such as readmissions.
The third aspect, and we’re mature in this, is what we’re calling a digital experience of our patients to give them a platinum experience. If you’re a diabetic patient, for example, how do I treat you differently, if you’re not doing something? How do I get triggered and have my case managers get to you? How do you get to telemedicine? It’s a little more exhaustive—there is nothing more inconvenient in this country than healthcare. We just make it so difficult for our patients, and most of us won’t do it unless we have to do it. We want to go after that change paradigm; convenience is a big issue we’re driving.
How are you progressing with your ACO?