Transitioning to value-based care (VBC) requires effective patient data capture and integration into provider tool sets, a concept we touched on in The Accountable Physician Enterprise: A Powerful Tool for Success in Value-Based Care. But it is not enough to optimize data aggregation from EHR native tools, because value-based organizations need to integrate data from external sources (e.g., state registries, insurance claims, patient portals, pharmacy benefit managers), all while reducing the amount of data manipulation needed on the provider’s end.
In part four of our continuing blog series, we highlight how VBC has raised the demands of information technology (IT) frameworks—and the integral role IT plays in VBC models.
Supporting Workflows and Staffing
The primary goal of VBC is twofold: lower costs and enhance patient care. This requires efficient workflows, adept staffing, and impeccable coordination between healthcare providers and their teams, along with an intensified focus on patient engagement.
IT is central to accomplishing these objectives. To remain efficient and competitive, health systems must focus on:
- Automatic information capture, compilation, and display to providers to decrease time spent on data collection and review.
- Actively tracking patient-entered data to drive inclusion in care management initiatives and outside-the-walls care.
- Using gathered data to drive downstream actions automatically (e.g., opening quick visits, adding patients to a care plan, satisfying care gaps, queueing orders).
- Decreasing administrative tasks and EHR documentation, which contribute to provider burnout.
- Increasing data literacy among providers and staff so they understand the patient data available for incorporation into pre-charting, reporting, ordering, and decision support.
Tools to Facilitate Value-Based Care
Tools used for VBC care may be classified broadly into three categories: risk stratification and analytics, care management and coordination, and patient engagement.
Analytics tools are incredibly powerful in extracting insights, identifying trends, and supporting decision-making processes. However, their effectiveness largely depends on the underlying structure and strategy of data management.
- Analytics tools are vital for assessing performance on measures included in payer contracts and identifying noncompliant patients.
- Reports can incorporate scoring algorithms and predictive models to prioritize patients for care management.
- External data can kick off automated actions, such as marking annual wellness care as complete or sending a care plan to the patient portal.
- Successful deployment requires continuous improvement and adaptation of new data sources and reporting metrics to align with changing goals.
Combining data from different sources may be challenging due to data completeness and data standardization obstacles.
Once patients are stratified with the help of reporting and analytics platforms, health systems can use EHR tools to engage with patients more effectively. Specifically, organizations can:
- Send care plans and synchronous or asynchronous visit requests to manage patients with chronic illnesses and increase patient touch points.
- Coordinate and share clinical data with specialists when deciding on referral strategies for patients who need to manage a chronic condition.
Lastly, to facilitate engagement with current and new patients, health systems can integrate tools into their digital front door framework. Tools may include:
- Automated patient outreach (i.e., campaigns), which are offered natively within many EHRs or can be used within customer relationship management (CRM) tools.
- Campaigns can be tailored to outreach to patients that meet specified criteria, such as those with an open screening.
- Campaigns may standardly come with reports to assess success metrics like conversion rates or impressions.
- Direct and open scheduling, which integrate with provider scheduling templates and allow patients to conveniently schedule visits in advance or book the next available time slot.
IT Strategy Considerations
While there are many advantages to adopting the tools mentioned above, organizations may run into obstacles that delay or prevent implementation. Specifically, they may need to choose between implementing EHR-native tools or incorporating third-party solutions. Considerations for native and third-party tools are outlined below.
Advantages:
- EHR-native tools:
- Offer seamless integration with existing applications (e.g., scheduling, clinical care, revenue management).
- Incorporate data across the care continuum, benefiting multiple areas of healthcare.
- Third-party solutions:
- Address specific points of the patient care continuum.
- Offer predefined workflows, vast content libraries, and user-friendly interfaces.
- Can cover functionality gaps not addressed by EHR-native tools.
- May be faster to implement than EHR-native tools.
- Implementation concerns:
- EHR-native tools may have longer rollout timelines and might need additional licenses.
- Some third-party solutions may not integrate well with EHRs, leading to workflow issues or data integration challenges.
- Ongoing IT support and training:
- Due to the evolving nature of VBC IT, continuous provider and staff training is essential.
- Ensuring up-to-date end user knowledge is crucial.
- Implementing a strong superuser program can foster a learning culture among staff.
A successful VBC program is characterized by advanced analytics and reporting, seamless care management and coordination, and enhanced patient engagement. None of this is possible without IT, which enables providers to foster team collaboration and elevate patient experiences. Organizations adopting a holistic approach continue to benefit from efficient team operations and an unparalleled patient journey throughout the care continuum.
Contact ECG experts to learn about adopting this holistic approach.
Edited by: Matt Maslin
Published January 31, 2024
