Performance Personified

HCI: Physicians feel very pressured across the country; yet you seem to have a positive culture, one that is still energized, and yet achieves high performance at the same time.

WE HAVE A VERY RICH DATA WAREHOUSE, WHICH GIVES US STRONG LONGITUDINAL DATA ON WHAT'S HAPPENING WITH OUR POPULATION. AND OUT OF THAT, WE CAN DRILL DOWN TO THE INDIVIDUAL PATIENT AND PHYSICIAN LEVELS.-ROSALEEN DERINGTON

McDermott: When we started measuring physician satisfaction about 20 years ago, the physician satisfaction level was about 60 percent; today, it's at about 92 percent. And we just had a physician leadership conference. One comment we got on a recent physician survey was this one: ‘I feel lucky to be a part of Hill Physicians.’ Another comment: ‘Hill Physicians helps me practice better medicine.’ Another: ‘Hill Physicians has helped me extend my practice life.’ One guy said to me that he's enjoying medicine for the first time again in 20 years. What we do is we're constantly trying to both reactively and proactively develop programs and services that really make life better for the patients and the docs, both. Now, my new big thing is affordability, and I've been working on that now for about two years, and we're starting to get traction.

So now, in the P4P program, the concept is that you will be graded on your quality as a group, as you are now; but your financial award under the P4P program from the plans will be based on how efficient you are as a medical group, times your quality. So if you have high quality but also high cost, you'll get nada. And if you're low-quality, but efficient, you won't get much. So the sweet spot is high quality and efficient cost, starting this year. And the pay from the P4P will come from shared-risk funding, where the medical groups will demonstrable reductions in cost savings.

HCI: Tell me about the IT facilitation aspect of all this, from your perspective as CEO.

McDermott: We made an investment in IT early on, and the investment was to create a platform that was scalable and broad-based. No. 2, the IT investments are multiple investments at multiple levels. So we built a data warehouse more than 15 years ago. And we converted to electronic data exchange very early on. And we started making the investment in EMR [electronic medical records] about five years ago. We're up to about 25 percent of our enrollees covered now. It's taking longer because we're doing a deep dive into the EMR, in terms of true meaningful use. So it's taking longer to deploy it; plus, we have 1,600 offices. But we're also really emphasizing bridge technology, such as RelayHealth.

HCI: It's not about buying cool technology, it's about leveraging technology to continue that performance journey, correct?

McDermott: Right. And leveraging the technology to leverage the whole orientation towards innovation. The EMR itself is great. But it also begins to provide a platform to reengineer the practice.

HCI: Craig Lanway, how do you view the leveraging of IT from your perspective as CIO of the organization?

Craig Lanway: Well, we can't do any of this without information. And for a very long time, there's been an effort here to build data collection and performance information to provide information back to the physicians. And it needs to be provided back to them with complete transparency, so that we can drill into that and show them what's going on with their patients. We derive that from claims information, from medication information, from laboratory systems; and as a result, we had to create connectivity through a repository, and needed to do that in a way that's transparent as possible to providers. And the information has to be as close to in real time as possible.