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Showing the Doctors the Data

March 14, 2013
by Mark Hagland
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Ronnie Brownsworth, M.D. of the Piedmont Clinic and Piedmont Healthcare is leading his physician colleagues forward towards accountable care

On March 13, Ronnie Brownsworth, M.D., CEO of the Piedmont Clinic, and executive vice president of Piedmont Healthcare, both in Atlanta, co-presented on a Healthcare Informatics webinar with HCI Editor-in-Chief Mark Hagland and with Marc Golberg, general manager of the Provider/Payer/ACO Market Sector division at Recombinant By Deloitte.

Working with a clinically integrated IT platform from Recombinant By Deloitte, Dr. Brownsworth has been leading his colleagues in the Piedmont Clinic, an independent practice association-based organization with 380 employed physicians and 520 community-based physicians in 150 locations in metropolitan Atlanta, steadily towards accountable care-based healthcare delivery. Among the tools and systems he and his colleagues have put in place at Piedmont Clinic have been an integrated platform serving physicians using a variety of electronic health records (EHRs); a built-in physician portal; clinical data integration and a performance reporting system; population health management dashboards; deep-dive, real-time analytics capability; and, overall, at IT foundation in preparation for private-sector accountable care, with that foundation facilitating intensive quality outcomes reporting and continuous clinical performance improvement.

Clinical performance improvement has been rapid. Even in the first year of the quality-driven initiative, physicians at Piedmont Clinic improved significantly in reducing the incidence of community-acquired pneumonia- and congestive heart failure-driven hospitalization; improved with regard to physicians’ performance on SCIP measures; improved colon cancer screening and pneumococcal pneumonia vacation; and improved with regard to blood pressure control among diabetic patients.

Dr. Brownsworth spoke with Mark Hagland shortly before the webinar, to discuss his organizations achievements and aspirations.  Below are excerpts from that interview.

You have a large number of relatively small physician practices working under the umbrella of Piedmont Clinic, correct?

We have a lot of independent one- and two-physician offices, but also a large orthopedic clinic with 17 physicians, and some hospital physician groups with 20 or so. Our employed group is in 30 locations, some as big as 20 physicians strong, and as small as one or two. Eighty percent are centered around or geographically close to the five Piedmont hospitals. We have a 480-bed tertiary hospital, community-based, in the heart of Atlanta, and four sole-county hospitals.

Ronnie Brownsworth, M.D.

What was the origin of your connection with Recombinant?

I was brought on four-and-a-half years ago to move Piedmont from its then-platform to a clinically integrated platform. And I was looking for a clinical platform, one with performance improvement in it. We developed our own platform, built by Recombinant; it’s not an EHR. In fact, to force all of our physicians to go to one specific EHR would have been very expensive for those practices to shift to, and would not have allowed us to move forward. What this platform does is that it allows us to take 100 percent of the billing and patient information and the information from all the hospitals, and to understand the population of patients we touch. It’s a population health platform as well.

When did you go live with the platform?

We went live in January 2010. They put in place for us a platform that allows for the transference of data to us; we had to have the capacity for information to come out of 150 different billing systems, to be delivered to our analytics database. Then they helped us build the scrubbers, because certain information cannot be held in the database—in Georgia, that includes patient information about STDs, mental illness, and drug and alcohol treatment, so that data must be scrubbed from our database. Also, some of the physicians are part of larger physician groups, with physicians who are not members of our organization, and we have to use data scrubbers to make sure that non-affiliated physicians’ data doesn’t get in. Must be mapped to the correct cells. Once the data gets scrubbed, it goes into the system, and it helps us build HEDIS measures and population health measures. And they also helped develop for us a web portal strategy for our physicians.

There’s a physician portal built into it as well?

Yes. And part of the analytics capability of it is that when the information comes to the physician on a dashboard behind that portal, the physician may want to know their own individual data; how they’re doing within their local group; within their specialty; or how the clinic is doing as a whole. And they have the ability to do that. Likewise, a physician may question the results—how did they get this? So they can drill all the way down to their individual patients’ data. And while they can see wrap-up data on all the patients from all the physicians, they can’t see individual patients’ data. That’s how we comply with HIPAA privacy requirements.

Let’s talk about some of the categories of metrics you’re working with.