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The Chase Comparison – Moving Beyond the EMR for Quality Improvement

September 16, 2014
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If there is one thing the panelists of the opening sessions at the Institute for Health Technology Transformation’s (iHT2) health IT Summit* in New York City could agree upon, it was that going from volume to value-based care is a journey.
I think I heard the word journey several dozen times during the panel, titled “Improving Outcomes with Stakeholder Collaboration, Data and Transparency.” And it’s clear from hearing these panelists talk that the journey is still ongoing. For one thing, bundled payments, value-based purchasing, and other payer-provider quality improvement programs have not resonated with physicians, says Jim Walton, D.O., President and CEO of the Genesis Physicians Group in Dallas, Texas.
“The question we have to ask ourselves is what’s not working with regard to the collaborative spirit,” Walton said to the crowd of approximately 150 attendees.
There were many theories and ideas thrown around as to why at organizations, like Walton’s, most physicians are not opting to take part in an accountable care organization. Is it because of issues around data sharing and transparency? Is it because of incentives?  Is it the lack of real-time data? Is it because of a lack of clarity around these kinds of programs? Is it everything above and more? These ideas were all floated among the panelists.
One thought that grabbed my attention came from Dr. Walton, later on in the panel after some initial comments from David Muntz, senior vice president and CIO of GetWellNetwork and former deputy director of the Office of the National Coordinator for Health IT (ONC). The topic at hand was moving management of care beyond the electronic medical record (EMR) for the sake of the patient. In Muntz's mind, you need technology that includes everyone. Without engaging patients, providers, and payers , you won't be able to track outcomes effectively, he said. 
From there, Walton began to talk about the value of the Chase banking app. He said the app is easy for everyone to use and makes him feel as if he connected to a banker.
"HIT has the ability to move us closer to one another, in addition to EMRs. Chase is an example of (technology) that's transformative and disruptive. Where I see us today is that we're not courageous enough to be disruptive. We've thought of physicians in a narrow band, keeping them in the EMR. That's served us poorly," Walton says. 
What Walton is saying is that to move forward in new care delivery models, which incentivize providers for improved quality, physicians can't be limited. They have to participate in technologies that keep them in communication with everyone. Obviously, the EMR is a prominent part of the picture, but staying within it is narrow-minded.
"The idea that a patient, a patient's caregiver, the doctor, the care navigator, the teacher at the school, the priest or the rabbi could all be on a care team, together using the same app's information sharing. It's building relationships," Walton says.
At its core, the idea of care coordination relationship building is disruptive and innovative. Tying that kind of disruptive, innovative technology that makes this happen into legacy systems is no easy task, the panelists later noted. Muntz said that EMR vendors have to "open up their monolithic systems" to allow for easier integration. Walton said that the price point of this innovative technology has to be brought down, in order to get adoption and find out what we don't know. 
Both bring up valid points. Either way, if collaboration is an essential element to care coordination then provider organizations would be wise to look at Chase for guidance. Leave no one behind and take out the narrow-mindedness. 
*The Institute for Health Technology Transformation (iHT2) is sister organization of Healthcare Informatics.