Remember the last time you found some amazing headphones on Amazon and you decided to buy them. You look for your favorite model number on the website, go through the user reviews, check for its availability in your region, and finally, you make a purchase and then wait for the delivery guy to knock at your door. Once your headphones arrive you check for its authenticity and by the time you actually start using them, a message arrives in your inbox to rate your experience of the purchase.
This one click on a smiley, whether it be a happy one or a sad one, makes all the difference. From the moment you logged into the Amazon’s website to the moment you tore open the delivery-box, every activity is judged based on that one single click.
Healthcare also follows the same pattern. From the patients visiting the care facility to the test they have to go through and to the medicines prescribed— everything affects the network performance and the quality of the care delivered. With each step, the chances of getting better customer feedback, i.e. patient satisfaction, can either increase or decrease. It all depends upon how a network is built and how its members traverse across multiple turns and rounds of the maze.
The looming barriers along the way to efficiency
The introduction of Electronic Health Records (EHRs) was to mark the dawn of a new technical age in the healthcare space but they grew out to be complicated mysteries of patient’s data scattered across multiple columns and rows. As a result, identifying performance trends across the network through EHRs is now a very difficult task. Since EHRs do not provide a holistic picture of the network, healthcare organizations cannot identify the actual health condition of patients and cannot compute on the measures crucial for both providers and patients.
Additionally, with the existing fragmentation in the workflows of multiple elements in the network, consolidating data and inputting measure data into reporting web interface is a very difficult task. This prevents the healthcare organization from building a proper communication channel with each provider and managing their reporting status.
Most people would agree that quality measurements serve a critical purpose, helping patients to make informed decisions and encouraging providers to work on quality. However, the entire process of assessing and assigning risk scores can be two-fold— it can either drive patients towards or away from the network, and can also put an additional burden on the shoulder of physicians.
A brief history of network performance and quality reporting
I have seen thick binders overflowing with hand-written papers describing various quality measures. A room full of data entry personnel reading patient charts, EHR screens flooded with data fields for a provider who has turned on every outpatient quality measure.
“Let’s capture them at first, then we will figure out later which ones to submit to CMS,” would always be the statement from one or many of those data entry personnel.
The sentence in itself is sufficient to describe the complications in understanding the network, building up a perfect quality reporting framework, and in convincing the physicians to go into that complex EHR screen.
How to unlock the mysteries of a health network
Despite its drawbacks and complications, participating in quality programs is good for a practice and yields better clinical and financial outcomes. However, creating and validating quality reports require an understanding of the specifications and health IT functionality to support calculation and improve reporting efficiency.
A network’s performance can be attributed in multiple ways. Healthcare organizations can follow a simple six-step procedure to unlock the hidden mysteries of their network:
The road ahead
The constant push towards linking traditional fee-for-service models to value-based reimbursement models has made the entire process of reporting on various metrics quite time-taking. Such time-consuming processes reduce the efficiency and sometimes become a hindrance to the ultimate goal of providers— delivering patient-centric care. However, it is a necessary task which they need to do and technology is the only answer to all these inefficiencies. Once healthcare organizations master the process of managing their quality they can look into the hidden aspects of their network and can unlock the doors to 100% efficiency.
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Join Team Innovaccer at PCMH Congress 2018 at booth #103 in San Diego Convention Center, San Diego, CA on 14 – 16 September, and know how we can assist you in understanding the hidden success opportunities for your network.