I am not the first and will most certainly not be the last to discuss the shift from the fee-for-service model to the value-based model. Additionally, I do not claim to have any answers on where we will end up on the continuum between the two. What is obvious, however, is the fact that we need to begin looking at how we measure success today and how it will be measured tomorrow.
Most articles and studies today focus on large, complex health systems because they are at the forefront of the changes. Given the rocky start to programs like the 2-year-old CMS Pioneer ACO program—where 75% of participants failed to earn bonuses—the buzz on the shift to value is less than positive. So the question remains, how do we get ready for the shift and avoid the pitfalls seen by the health systems?
Change your KPI (Key Performance Indicator) perspective!
Practices today are very focused on cost reduction. As with any business, if you reduce unneeded costs, and maintain revenue, you increase profitability. Well, what if we translated that in the value-based world to Cost of Care? Imagine that you start this now and can soon prove that by reducing unneeded tests, prescribing generic drugs, and adding a rigorous pre- and post-surgery education program, your total Cost of Care is lower. This information could be used to gain bundled payment bonuses, not to mention the added benefits of cost reduction itself.
Other KPIs that should change are around patient access and engagement. Most practices have adopted the meaningful use benchmarks as their high-water mark for portal usage. However, we should change the conversation to true Patient Engagement. Rather than X% of providers sending a message to a patient or completing a VDT task (patients viewing, downloading or transmitting their clinical record), track the value added by your portal. Ask yourself if patients with a portal are more loyal? Do they add on more ancillary services that you provide? Do they refer more new patients to your practice? Do they have a better pre- and post-surgery experience? Aside from these more qualitative measure that can increase value, you can track cycle times for clinical and non-clinical processes, which directly impact costs to you in terms of staff time.
Last but not least is something that health systems already track but that can be adapted to the specialty ambulatory setting, Capture Rate. This is the portion of the patient’s total care that is captured by your practice. This means driving adoption of “other” services or simply grabbing market share. This KPI can be driven up by providing advanced access. This may mean having a percentage of the schedule open for on-demand access, or adding e-visits, or expanding hours. You can dovetail this with a portal to provide a more self-serve model. The concept here is that if you can provide more of the touch points in your practices, you can reduce costs along the continuum of care.
Experiment, Adjust, and Communicate.
Defining your KPIs is the first step towards creating a measurable improvement. While the ones above are some suggestions, your team may come up with more targeted KPIs based on your practice goals. A few quick tips as you go forward.
- Keep it simple – KPIs are not about data for the sake of data. Pick 1 or 2 and experiment.
- Be ready to pivot – We learn the most from mistakes and there is nothing wrong with changing course when you have more data.
- Consider both short- and long-term goals – Don’t try to jump to 100% value-based KPIs in 1 step.
- Communicate! – The biggest mistake you can make is not involving your entire organization. The full team must understand the end goal and then progress toward it. Nothing kills an initiative like the lack of a sense of ownership.
What are your teams doing to get ready for the shift to the value-based model? Do you have KPIs that you’d like to share?
Over the past several years, you probably have heard people talking about “The Cloud.” It sounds very exciting and mysterious! You may have thought:
What is The Cloud?
Am I in The Cloud?
How can I use this whole Cloud thingy?
I want to be in The Cloud!
Let’s see if we can ’demistify’ Cloud-computing and put your mind at ease. In its simplest form, Cloud computing is the centralized sharing of applications, services, data, and resources from a variety of computing devices. What that means is, anything you do on your device is stored somewhere other than in the device itself. Think of The Cloud as a central repository for e-mail, photos, videos, and other data that you can access using the Internet. A Cloud computing company is keeping your data safe and sound for you, so you don’t have to carry around bulky hardware or worry about setting up security solutions. The Cloud also allows you to share or collaborate.
What if I told you that you probably use The Cloud all day, every day? Some simple examples of Cloud- computing include applications like Facebook and LinkedIn, services like Gmail and Twitter, resources like Wikipedia or Google, and all kinds of data. For most of us, every time we snap a selfie, it is stored in The Cloud. All of these aspects of Cloud computing are available to us on almost all of our devices. We can share our personal pictures, videos, and e-mail on all of our laptops, tablets, smartphones, and even our watches!
So how does SRS use The Cloud?
You may be surprised at the answer. Every time you load your main dashboard, shared Cloud resources put together the screen to display your requested data. Every Rx transaction is routed through the SRS eRx Pipeline to be analyzed and submitted for the patient and communicated with the pharmacy. Every ICD-9, ICD-10, or HCPCS code is selected from a shared Cloud data resource. Patient data files are transferred through a routing system called CCX. The SRS Patient Portals are complex Cloud applications offering data to patients whenever and wherever they request it. The benefits of Cloud computing are endless.
So the next time someone mentions “The Cloud” you can confidently respond: “I am all about The Cloud!”
OK, I’ve taken some liberties with one of John Lennon’s most famous lyrics, but it’s the first blog post of the year, so I thought I’d need a little extra attention-getting power to break through the post-holiday fog. Chances are, only a few days ago you were pondering how you would implement change in your life in 2015. You may even have proclaimed those resolutions loudly and proudly as the ball dropped in Times Square. Seven days in, how well are your new year’s resolutions doing at becoming reality? I’ve kept mine so far . . . 😉
All kidding aside, we’re doing more than just hoping that the changes we want to effect at SRS will happen this year—we know they will happen, because we have a system in place to ensure that we keep our promises to ourselves and to others. It’s not complicated, and it’s something anyone can use at home or at work to help ensure that their “Say/Do Ratio” remains high. Simply, there are four key elements: communication, transparency, collaboration, and accountability.
Lose weight. Work out more. Eat better. Since health is always one of the top New Year’s resolutions, let’s start with that example. Experts say it takes 21 days to turn something into a habit, but why do some resolutions become habits while others become failed attempts? Because commitment must be systematized for maximum success. So if my resolution was to get to the gym three times each week, the first thing I’d do is communicate that goal . . . to everyone, not just to whomever happened to be around on New Year’s Eve. It’s easy to tell yourself something and then forget about it. By telling my whole support network—my family, my friends, my team at the office—my motivation to do what I said I’d do is increased immeasurably. In terms of transparency, I’d start posting somewhere (perhaps on Facebook) each time I worked out as a proof point. I’d collaborate with others by starting or joining a workout group, maybe even implementing some sort of competition within the group. Finally, I’d enable true accountability, empowering my supporters to check in on my progress.
At SRS, healthcare is our core focus—and so our corporate fitness is critical to helping our clients strengthen their productivity while remaining focused on the wellbeing of their patients. At our User Summit in October, we discovered what was most important to our customers and then we created a system of actionable initiatives to ensure that our promises become the change we all want to see. And we are doing it by following this same four-step system.
No matter what your resolution is, big or small, by supporting it systematically with these four key elements, you’ll do more than wish for something to be different . . . you’ll turn a resolution into a revolution.
Never before have healthcare professionals operated in a time of such rapid technological change—and faced the great uncertainty of today’s complex industry regulations. Unfortunately, it’s not a trend we see ending anytime soon. It’s getting harder and harder to even understand what the government is asking us to do, let alone satisfy those requirements. Does data collection have to mean data distraction—taking the focus off of what matters most to each physician: the patient?
At our annual User Summit last month, big data was the big topic of discussion. While our users recognize there can be very real benefits to elements of meaningful use, there is a lot of friction surrounding its integration into medical practices. It often feels like the data we are being asked to capture—the data that is supposed to make everything more productive—interferes with what we are trying to accomplish. Physicians can find themselves required to ask questions that make no sense, that take up valuable office visit time, and that possibly cast a little doubt in the patient’s eye. Where is the ROI on that?
Medical professionals need more, because that’s what MU is asking of them. HCIT companies have to provide more than technology—they have to provide expert guidance to help navigate the MU waters. Together, technology and expertise can help physicians satisfy government regulations while also achieving their industry and business goals. From strategic planning through product execution, we must provide more predictable solutions. This goes beyond “certified solutions”—this is about creating working solutions that allow medical professionals to be compliant without interfering with their practice goals.
It all comes down to ECR: Efficiency . . . Care . . . and Revenue. The right HCIT solutions will:
- create efficiencies, allowing doctors to spend more time with more patients;
- improve care, providing flexible solutions that don’t interfere with the doctor–patient relationship; and
- increase revenue, helping doctors earn more by reducing malpractice risk and insurance, creating additional revenue streams, and more.
We heard it loud and clear at our User Summit: increased data requirements cannot be accomplished at the expense of patient care. EHR solutions aren’t real solutions if they slow you down—they have to capture data with minimum interference while ensuring maximum productivity.
At SRS we’re working even harder to help our clients navigate government and industry demands and translate them into meaningful products that will satisfy more than MU: they’ll satisfy your patients. And they’ll satisfy you.
People talk about client satisfaction as if it were a static thing—something that never progresses or evolves. I believe the “action” in satisfaction means we must continually measure it and make adjustments as necessary. Our world is constantly changing; what made a customer happy three months ago may have nothing to do with his or her needs today. We must check in on a regular basis through a variety of channels in order to create a multi-dimensional living model of what our clients really want. Only then can we understand whether we are truly satisfying our customers. In order for any company to innovate, they must know what is important to clients today—as well as have a sense of what will be important tomorrow. Insights are discovered in many ways, and I believe we should use a variety of tools to determine the most accurate picture. Here are a few:
- Industry Events – Be present to check the pulse of your industry, hear about issues and trends, and speak to others as an authority and a colleague. Events are already in place for these purposes, so get out there and learn.
- Focus Groups – Drill down to specific insights that allow you to ask new questions and test ideas that may not yet be ready for a larger forum. Modern focus groups can provide nearly instantaneous feedback and insights at a very reasonable cost, so consider upping the frequency.
- Social Media – Sometimes it’s the informal comment or question that can trigger a breakthrough innovation. Social media can be the next best thing to actually talking with clients—and sometimes even better, since it gives people a place to share their thoughts in real time.
If you’re really committed to knowing (instead of assuming) what your customers are thinking, why not create a whole experience dedicated to discovering just that? Right now I’m at our annual User Summit, where my team and I will be spending three days with our clients, listening to what only they can tell us. This is the ultimate forum for the pursuit of knowledge, and we look forward to learning how to continue to evolve our company to best serve our customers. Each customer interaction reveals different insights; enabling and acting upon that ongoing dialog is what we consider to be the action in customer satisfaction. It’s what allows us to innovate with purpose. The most significant question our clients ask right now is, “How can I successfully meet government requirements and achieve my practice’s goals without having to sacrifice one to serve the other?” I’ll be sharing more about our answer to that in my next blog post, so stay tuned . . .
I believe that 40% of past attesters will give up on meaningful use. To understand the troubling trends that lead to this conclusion, read my Readers Write column on HIStalk.