We’re finally getting it—or at least, we’re getting closer. There’s a growing understanding that the key to helping physicians, hospitals and health plans improve care quality, reduce cost and enhance the patient experience is freeing data. Putting it to work. Getting it out of those silos!
What’s the point of having data if we’re not going to use it to improve healthcare? As CEO of the Inland Empire Foundation for Medical Care for almost 25 years, I know that sharing data works. When the right hand knows what the left is doing, we’re afforded endless opportunities to make healthcare better.
Eight years ago, Southern California’s Inland Empire region was a leader in our state’s effort to ensure that EHRs could share information. By 2014 we had an exchange that helped eliminate duplicative tests and services and reduce costs. By 2017, this initiative to put data to work by sharing it grew into a robust, not-for-profit statewide health data network, Manifest MedEx (MX), now delivering real-time information to help providers care for millions of patients every day.
At my accountable care organization, we leverage both claims and clinical data from MX (thanks to their unique model that brings together providers and health plans) to give us a comprehensive view of a patient’s history and determine who needs the most help. It’s often the patient who isn’t coming to their provider who really needs attention. Our participants have tools that provide real-time notifications when a patient is seen in the emergency room or is admitted or discharged from the hospital, allowing us to help physicians manage their patients. The data also identifies patients who have multiple chronic conditions and need additional management.
Let’s say “Mrs. Smith” has been to the ER three times in the last month and then released, but her physician is unaware because she hasn’t scheduled a follow-up appointment. Most physicians wouldn’t even know their patient was admitted to the ER until the patient schedules a follow-up appointment, which could be months later or never. By that time, maybe the patient has gone back to the ER several times when timely follow-up care could have prevented those readmissions.
Data exchange affords us insight that’s life-saving, cost-effective and that allows providers to make an impact. Utilizing alerts from our data network, we know exactly when our ACO patients have gone to the ER in any hospital in the Inland Empire. Our ACO has seen improved care for patients and reduced healthcare costs.
Specifically: We’ve seen a 39.4% reduction in patients not seen within seven days of discharge; ER visits have decreased 3.1% from 2017; ER visits leading to hospitalization fell by 5.3% from 2017; and per-beneficiary, per-year spend has also decreased dramatically in a year, helping patients live healthier lives more affordably.
Statistics show that if a high-risk patient is seen by a physician within seven days of discharge from the hospital, the number of ER visits for that patient drops significantly. That sounds simple, but the coordination needed to make this happen is anything but. Technology can be a huge asset, beginning with provider notification that the patient was hospitalized in the first place.
Improving patient outcomes and reducing cost isn’t just about data, it’s about utilizing data effectively and turning it into a usable source. Providers have limited time with patients. They certainly don’t have the time (or ability) to take masses of data and make miracles. According to a recent report from the American Hospital Association, it’s most often the inability to utilize received data within receiving provider technologies that is a major hindrance to interoperability. However, there are tools that come close, ensuring that the patients who need the most care are being managed well by delivering just the right data signal, at the right time.
It’s time to connect to health data networks. Stop waiting. Physicians and patients need this data to be put to work.
