This is the second installment of our look at Jim Adams’ health care IT Top 10 to-do list for 2013. Adams, executive director of research and insights for The Advisory Board Co., delivered the keynote during the 2013 Digital Healthcare Conference produced by WTN Media.
Part I outlined steps 1–5. With apologies to David Letterman, we now present items 6–10 on Adams’ Top 10.
#6: Proposing to patients
Adams noted that emerging payment mechanisms are placing providers at risk for the health of various populations. Since he believes patient behaviors around health and wellness exert greater influence on health outcomes than the separate and fragmented efforts of payers and providers, he suggests that patient engagement efforts should involve recruiting patients to be active members of the health care team.
Patients should be engaged around the episode of care, the management of chronic diseases, and as healthy members of a covered population. In all of these scenarios, technologies like patient portals, text messaging, telemedicine, and home monitoring can facilitate communication with patients. With this in mind, Adams advises providers to:
- Establish governance mechanisms for clinical quality and IT leadership.
- Bolster IT support for disease management and population health management.
- Establish IT platforms and communications infrastructure for consistent support across departments.
“We can’t improve patient satisfaction unless the patients are playing their role and they are activated to do what’s right,” Adams stated. “It’s been a huge focus for most organizations, and it’s part of Meaningful Use.”
#7: Drive data with a BI blueprint
Whether you’re formally applying for accountable-care organization status, entering a shared-savings program, or focusing on cost reductions, Adams believes that business intelligence (BI) is critical to developing a transformational agenda.
“We have to do more than just improve our transactions systems and our EMRs, or make those transaction systems link together,” Adams said. “We have to use that data to improve decision-making, improve performance and patient outcomes, and maybe even to revamp clinical processes.”
To accommodate rapid and accurate decision-making, analytical competencies should manage utilization risks and performance issues like readmissions. With the help of formal governance structures, Adams advises the following:
- Develop and implement a business intelligence plan that aligns with the enterprise plan.
- Prioritize BI deliverables to maximize value, to move to an increasingly data-driven business, and to guide clinical decisions and strategies.
Applying BI also involves the identification and use of predictive, descriptive, and prescriptive analytics. “The questions would become ‘how do we segment these patients and how do we optimize the care so that we minimize the risk for readmissions?’” Adams asked. “Which patients might go to post-acute care? Which patients can go home?”
#8: Master population health management
As health care moves away from fee-for-service, Adams said health care organizations must master the challenges of managing large patient populations, which requires the following steps:
- High utilization and chronic disease patients must be identified and associated with diagnoses and guidelines. The accurate attribution of primary providers is another must.
- Patient care data must be extracted and mapped against care guidelines.
- Providers must engage patients, address any missing required care measures, and schedule visits.
- Office providers must receive appropriate decision support to ensure task completion at the point of care.
- A single point of contact should be identified to manage each patient’s care (across the continuum) and should be enabled with IT support.
- Systems must be established to aggregate and analyze population data at the local, regional, and ACO level.
To accomplish these steps, Adams recommends establishing a population management leadership team, including IT members, and system-leveraging disease registries for population identification and management. In addition, health care organizations must ensure integration of patient-centered medical homes, primary care physicians, or specialty-based efforts with appropriate information architecture and support systems.
“This is a key question throughout the industry — how do I move from a volume-based model, where the more tests ordered, the more I get paid, to where we actually get paid for value and keep this affordable,” Adams said. “Population health management means we’ll assume the risk to manage the health of the populations of patients.”
(Continued)
#9: With IT governance, stop the ‘yes’ machine
Adams maintains that the success of a CIO depends on the effectiveness of the governance process because “it’s the key to reaching alignment with the rest of the organization’s leadership. Our surveys show that most CIOs struggle with governance. Too often, other leaders work around the governance process rather than work through it, leaving the CIO in the room but not at the table.”
According to Adams, CIOs can take on this problem by:
- Learning their capacity and setting limits on the work they accept. IT departments are inundated with requests, but it’s better to be told a definite “no” than face the uncertainty of an IT “yes” machine that fails to deliver.
- Focusing on business initiatives, not IT projects. Leave IT governance to the IT leadership team; instead, govern the scope, risk, goals, resources, and accountability of business initiatives.
- Having IT make IT decisions but communicating the “why” in business terms.
- Nurturing your relationships with other executives. Frequent, informal interaction with other leaders is a must for any successful CIO.
- Making your governance forums “the place to be” for organizational leaders to get done what they want done, get the resources they need, stay informed, and advance their ideas.
- Revisiting your governance in light of recent mergers, acquisitions, and affiliations. Does your governance model still fit your organization?
#10. Educate your CEO
To max out on IT’s potential to transform organizations, the CEO and other non-IT leaders must have the knowledge necessary to engage in IT-enabled business and clinical programs.
“In our discussions with CEOs and other C-level executives, they are often uncomfortable with their knowledge of IT-related topics,” Adams noted. “Many also realize that they ‘don’t know what they don’t know.’”
Similar to patient engagement, CEOs and other business and clinical leaders don’t need to know everything the IT expert knows, but they do have to know enough to successfully fulfill their role in developing and implementing the enterprise strategy for IT. Here’s how:
- Develop an IT-related education plan for key leaders on must-know topics.
- Decide what level of knowledge is appropriate for each topic and how to relay the information.
- Determine the format and venue that’s best for the CEO’s education. Where possible, tie the education session to a business or clinical issue that needs to be resolved.
“In the past, health IT has been more of an individual sport, and organizations depended more on the CIO,” Adams said. “Now it needs to become a team sport because it’s moved from an efficiency tool to a strategic enabler.”
This article originally appeared on the WTN News website.
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