How can the leveraging of data analytics help transform patient care delivery, at a time of intensive accountable care organization (ACO) development in U.S. healthcare? Healthcare leaders delved into some of the challenges and opportunities facing patient care organizations, during the opening panel at the Health IT Summit in Seattle on Aug. 18, being held at the Seattle Marriott Waterfront, and sponsored by the Institute for Health Technology Transformation (iHT2, a sister organization to Healthcare Informatics, under the corporate umbrella of parent organization Vendome Group, LLC).
The panel, entitled “Analytics Driving Accountable Care,” was moderated by Richard Gibson, M.D., Ph.D., affiliate assistant professor in the Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University, and a well-known healthcare IT leader. Dr. Gibson’s fellow discussants were Jeff Hummel, M.D., M.P.H., medical director for Healthcare Informatics at Qualis Health, a quality improvement organization and consulting firm in Washington state; Kirk Larson, regional chief information officer for NetApp and chairman of the board of the Central Valley (California) Health Information Exchange, and Michael Simpson, CEO of Caradigm.
Panelists (l. to r.) Gibson, Hummel, Larson, and Simpson
The discussion ranged widely, from the subject of engaging primary care physicians in analytics work around population health in accountable care settings, to some of the broader social and societal barriers to improving the health of populations.
Early on in the discussion, Dr. Gibson asked Dr. Hummel, “Dr. Hummel, what do primary care providers need to know about analytics?”
“The biggest challenge is the paradigm shift from one-at-a-time patient care to population health,” Hummel said. “Everybody in healthcare has really spent their entire career in fee-for-service [care delivery], taking care of patients one at a time. So just thinking about the concepts of population health is difficult for physicians. When you start coming down into the working ranks of providers, they’re very good, smart people, and good at data, but are always looking to solve a specific problem of, what I do in the moment, with this patient in front of me? So, looking at broad populations is pretty foreign. So small and medium-sized practices have a challenge.”
In fact, Hummel said, “The technology that people need is pretty simple. The problem is not so much analytics, but it’s really presenting the data in a way that care teams can understand it. How many patients do you have over time with hypertension, or with hypertension that’s not under control? And if you’re screening people for a particular issue—what’s the population you’re looking at—diabetes? And what are you screening them for? So the question is, what did we find, and for those for whom we found something, what did we do? And if you can show run charts that show providers how they’re doing around those parameters, they can start to respond. But even putting information into an organized framework they can understand, is a challenge. So I think that primary care providers need help with that information and using it.”
Gibson turned to Larson, asking him, “Kirk, what needs to happen with making the necessary investments in population health tools?”
“It’s good question,” Larson said, “because it’s not always abundantly clear. It’s not something where you can necessarily run an ROI on to determine what return on investment you’ll get from it in 18 months, for example. When I was at Children’s Hospital,” he said, “when patients would present in the ER, the data was a month old, or four months old. I have a three-year-old son with a chronic illness, and I think of him. And think of the difference between data that’s a month or a few months old, versus data that’s real-time, and what a difference it will make for patients like my son, in terms of how effective the data will be for clinicians at the point of care.” But, he said in order to get real return on any investment in analytics solutions, “It’s going to require clinicians being champions for analytics, to get this to happen, based on advocacy for quality of care, based on what a difference we can make if we provide the technology. I think that will be persuasive to physicians and clinicians.”
One of the challenges in making the shift from fee-for-service assumptions to value-based payment care delivery, said Simpson, is that “It’s not going to be about retrospective analytics, though they are valuable. But the people who cost you money last year are not the same people who will cost you money this year. Of my million patients, which 500 diabetics will hit the ER?” he asked rhetorically. “By predicting those things, you as a provider organization can take a proactive step to intervene. Providers understand that retrospective analytics is necessary and important, but you have to move towards predictive analytics. And to do that, you have to take data from the entire continuum of healthcare, whether from the retail pharmacy or outpatient clinic, or wherever, and then you need to drive that towards actual action. So organizations are beginning to focus on how they can get that data, and how they can use it.”