The subtitle for last week’s conference was “Moving from Volume to VALUE Based Care”. The theme’s that emerged from the speaker panels, presentations, and one-off conversations I had seemed well aligned:
- Healthcare is currently experiencing a paradigm shift from the traditional provider-centric mentality to that of a patient-centric framework
- One of the biggest challenges providers face in the pursuit of higher quality is figuring out how to appropriately leverage all of the data they’re currently collecting, manually and electronically
- Emerging opportunities for reigning in costs and improving quality including ACO’s, AQC’s, PCMH’s, and others will only be effective if there are standards for implementation and measuring effectiveness consistently across the country
- There are a handful of healthcare providers and payers who have taken significant strides in controlling costs while improving quality by implementing technology solutions that integrate data from across the continuum of patient care.
I was encouraged by the level of enthusiasm in the room. Dr. Allan H. Gorroll from Massachusetts General Hospital and Harvard Medical School made it clear that advancing the quality agenda will require significant investments in primary care; Dr. Kate Koplan spoke about Atrius Health’s push to reduce the problems of over testing and unnecessary treatments; Dr. John Butterly from Dartmouth Hitchcock Health discussed the Patient Centered Medical Home (PCMH) and suggested to all providers that they “have a patient on the team responsible for understanding how to establish the PCMH”; and Micky Tripathi the President and CEO of Massachusetts e-Health Collaborative mentioned the challenges of turning data into actionable information with problems like free text data, inconsistent data collection across care settings and the fear many clinicians have of “change” getting in the way.
I too was a co-presenter at the conference and was delighted by the response to our presentation. My counterpart Neil Ravitz, Chief Operating Officer for the Office of the Chief Medical Officer at the University of Pennsylvania Health System, and I discussed a recent solution we designed and implemented. We were able to automate the collection, integration, calculation, presentation and dissemination of 132 inpatient safety and quality measures across 3 hospitals and 7 source application systems. This new tool consolidates measures from across these hospitals and systems into one place for reporting and analysis through the use of dashboards and dynamic, drill down reports. The major benefits of the solution include:
- Changed the focus of quality and decision support analysts from data production to data analysis and action;
- Automated quality data collection to enable better accuracy and more timely data; and
- Enabled a faster quality improvement cycle time by front line leaders
Dr. Atul Gawande recently suggested in an article in the New Yorker that healthcare should be prepared to start implementing standards for nearly all of the care delivered, from total hip replacements to blood transfusions. As we all know, he is a fan of checklists, one logical tool for standardization. He also states, “Scaling good ideas has been one of our deepest problems in medicine”. When I attend healthcare conferences like the one last week in Cambridge, I’m excited by the progress I see organizations making. When I leave the conference though, I’m quickly reminded of the grim reality of healthcare and Dr. Gawande’s point. And then I wonder, at what point will “patient centric”, “accountable care”, “value based purchasing” and all the other catch phrases of the past few years become the industry standard – and not the exception limited to conferences, New Yorker magazines, and headlines that are only ever heard or read, and rarely ever experienced.