Parsing data to improve results

Most healthcare providers realize they need to get better at data analytics to be successful under payment models that will reward them for improving outcomes.

But knowing where you stand within a group of peers is just part of the equation. The other is being able to use those metrics to actually get better results over time.

In some ways, Chicago-based Iclops was a company ahead of its time when it was formed in 2002 with the goal of using practice data to improve the health of chronically ill patients.

Theresa Hush, former director of the Illinois Medicaid program, co-founded Iclops with Dr. Tom Dent, a family medicine physician, to work with physician hospital organizations. They brought on board developer George Hernandez to hone the technology side of the business.

By 2008, Iclops received CMS approval as one of the first 12 clinical-data registries that could report for the physician quality-reporting system, the CMS initiative that links physician payments to quality metrics.

Its CMS designation as a qualified clinical-data registry allows it to do more-sophisticated data analysis, such as tracking trends over time. Iclops has patient-level data, which allows it to factor in variables such as a patient's medical history, lifestyle and socio-economic status.

Data registries aren't new, but Iclops aims to provide the tools to allow physicians to make changes that affect outcomes.

For instance, it's good to know that your readmissions are increasing, but that won't necessarily help you identify why, Hush noted. “You at least need to know if it's a systemic issue or a series of one-off problems,” she said. “What we try to do is provide a mechanism to make that available to them.”

Many population health programs focus on getting patients in the door and tracking a single measure, such as A1C blood-glucose levels in diabetics, Hush said. But they don't provide the longitudinal information necessary to see which interventions are working, such as whether a particular care-management program has been effective.

“When you start looking at those outcomes, you don't see improvement; you see a steady, flat line,” Hush said.

One study Iclops cites is a 2014 paper in JAMA that looked at outcomes for a medical home pilot. The medical home did little to reduce the utilization of hospital or emergency room services and did not lower costs, the authors found.

“The data in healthcare is just now coming to the cusp of maturity,” Hush said. “We're looking at how we use outcomes over time to actually effect change.”

Benefis Health System in Great Falls, Mont., began working with Iclops in 2013 as it was forming its own medical group and looking for ways to align more closely with community physicians.

The system has been using Iclops' benchmarking tools to determine which quality metrics to report to the CMS under the physician-quality reporting system. Providers that report PQRS data through a registry like Iclops are allowed to pick and choose which metrics to include—allowing them to share only the measures where they're performing well.

But the software also allows Benefis to identify areas where there's room for improvement.

One example was smoking cessation. “What we found is that the nurse or nursing assistant would ask about smoking,” said Julie Wall, Benefis' director of nursing and inpatient specialty providers. “But the provider never took it to the next step in counseling the patient. With our electronic health record, we couldn't really capture that. But Iclops can.”

Another was medication reconciliation, or making sure that the drugs patients are taking match what's in their medical record. Iclops' technology allowed it to determine which providers were meeting the mark and which weren't. “It's just a great tool to drill down and do case review,” Wall said.

The typical Iclops client is a medical group with about 200 physicians employed by a health system. But the company also works with free-standing physician practices.

Iclops is privately funded and does not disclose revenue.

This year, the company's clinical-data registry will be eligible to collect Medicare claims information, providing it with even more data. Its technology also will fulfill the public health reporting requirements under meaningful-use stages 2 and 3.

“There's a feeling among providers that if you simply show them the data, they'll self-correct,” Hush said, adding that what Iclops is able to do is get “under the hood.”