And, they added, “The project will enable adopting practices to fulfill the practice-based risk stratification milestone set forth by CMS in the Comprehensive Primary Care Initiative (CPCi). In addition, it will enable private payers (Rocky Mountain Health Plans) to adopt practice-wide IndiGO values as the basis of risk-adjusted payment and gainsharing arrangements for the purpose of CPCi and other payment reform initiatives—and begin retiring plan-based, claims-oriented risk adjustment methods that are less clinically-pertinent, less predictive and segmented by payer source.”
BECOMING A LEARNING
Gordon compares the early stages of any data-driven initiative like this to “a hockey stick—it’s a long, slow process of getting to that critical tipping point; the health plan and physicians have been working on some of this stuff for a decade now.” But, he says, at some point, “You get to sort of a critical tipping point of engagement, and the learning process and the pace of change accelerate. And we’ve seen that in terms of the quality improvement and the competence of use of data measurement and methodologies.” At that point, he says, “you really get to what Don Berwick had envisioned in terms of a learning collaborative, in terms of active, collaborative learning. And that’s how we’ve gotten community engagement. QHN has been doing that for years now with health information exchange. We’re just beginning to get to a critical tipping point now, after eight years of work.” Among the initial results, Gordon reports, are improved patient medication adherence, behavior change, and shared decision-making, following physicians’ use of the IndiGO capabilities during patient visits.
Given that what Gordon, Lassaux and their colleagues have been doing, here on the leading edge of data-driven, region-wide population health management, do they have any advice for the CIOs, CMIOs, and other IT leaders in other organizations who might try to follow their example?
“One of the phrases we’ve been using,” Gordon says, “is, ‘waiting is wasting.’ Waiting for a perfect IT infrastructure architecture, for perfect health information exchange, and so on, is unrealistic. Every day, you miss opportunities to develop your own insights and develop new solutions. Data production and analysis remain insufficient, so we’ve had to create our own models. It’s costly and takes time, but had we not rolled up our sleeves and done the hard work of data aggregation, and developed policy insights from that work, we would not be where we are now.”
Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.