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Is Your IT Team Prepared for Value-Based Care?

To succeed under value-based care models, doctors and hospitals analyze a great deal of data on their patients.

The goal: helping patients — including your employees — take charge of their own health. When people work with their doctors to stay in good health, they have a lower risk of developing costly chronic illnesses or needing expensive treatments or procedures. Clinicians make this possible by tracking whether patients are getting the medical services they need, such as tests or medications. This leads to cost-efficient, high-quality medical care for your workforce.

The process requires access to digital patient information. IT preparedness is crucial — the best time for doctors and hospitals to purchase, install, test and go live with IT systems is before the transition to a value-based care model, which pays providers based on the cost and quality, or value, of their work.

Depending on the size of the organization, providers typically rely on internal IT departments or outside consultants to supply the technical expertise necessary to choose, install and maintain these IT systems. Here are some of the most prominent tools and technology pushing the envelope on high-value care.

Electronic Medical Records

IT preparedness begins with electronic health records, which allow providers to manage clinical processes, such as writing a prescription, digitally. Electronic health records collect, categorize and store information so that it will be accessible later.

Because electronic health records are so fundamental to achieving a highly functional value-based health care industry, in 2011 the federal government developed the Medicare and Medicaid EHR Incentive Programs, known colloquially as “meaningful use,” to encourage providers to buy electronic medical record systems. By meeting specific requirements around the installation and use of these systems in daily patient care, providers earned incentive payments from the federal government, essentially reducing their acquisition costs. By 2017, 96% of acute care hospitals and 86% of office-based physicians had installed electronic medical records.

Electronic Tools Beyond EHRs

While an EHR is the backbone of IT success in value-based care models, other digital tools are necessary to access and analyze digital patient data as well. As providers draft an IT preparedness plan, these two must-have categories of software tools should play a role.

Patient Registries

These tools, including some sold by the vendors of electronic health records, allow doctors and other caregivers to track the health status of either an individual person or a group of patients, such as whether patients have taken necessary steps to manage their health.

For example, doctors recommend that most patients receive flu shots, cancer screenings and occasional blood tests. They may also highlight medical services tailored to a specific disease, such as periodic blood tests for diabetics to measure their average glucose levels. Clinicians can use these tools to see how well they meet quality-of-care guidelines for groups of patients. For example, they may measure the percentage of patients with high blood pressure whose readings are in the normal range with medication.

Predictive Analytics and Risk Stratification

This group of tools helps providers predict when a patient might be at risk for having a costly episode — such as hospitalization or a visit to the emergency department — or developing a chronic illness like diabetes or heart failure.

For example, Community Medical Center in Falls City, Nebraska, used predictive analytics to determine which patients with diabetes were at a higher risk for thyroid disease. “We called the highest risk patients first, and within the first month, we diagnosed 20 new thyroid diseases,” said Ryan Geiler, assistant manager and clinical analyst of family medicine at Community Medical Center.

With a strategic plan in place to implement these tools, hospitals and physicians can gather the information they need to manage their patients’ health effectively and control rising health care costs.