- A successful transition to value-based care will require effective partnerships between healthcare providers and health IT developers as well as among providers themselves to ensure that current and future EHR and health IT infrastructure lead to improved care delivery.
That was the message delivered by the keynote speaker at last week’s Value-Based Care Summit in Chicago.
“Technology is a critically important driver of value-based care. If we don’t have functional systems in place — technology that is connected, easy to use, provides a free flow of information across systems — then it will be impossible to effectively migrate to a value-based care model,” said American Medical Association Board of Trustees Secretary Jesse M. Ehrenfeld, MD, MPH.
While the health IT tools and capabilities necessary for success in value-based care are clear, Ehrenfeld detailed a reality that is far from meeting this end. “There continues to be a stark, dramatic lack of interoperability which hinders patient care coordination,” he added.
Part of the problem stems from the focus of federal EHR certification programs not geared toward the needs of providers shifting from volume to value.
“While federal electronic health record certification over the last five years has done some helpful things, it’s done very, very little to ensure the usability and interoperability of electronic records and patient data going across practices,” Ehrenfeld maintained. “In fact, I would say that many of the regulations that have been brought forth by CMS and other entities have had unintended consequences for the design of electronic health records.”
In his role as Associate Director of Vanderbilt University School of Medicine’s Anesthesiology & Perioperative Informatics Research Division, Ehrenfeld knows firsthand the limitations of current EHR and health IT systems in serving the needs of a value-based care environment.
“Improving interoperability and promoting the ease of communication between systems is truly critical for the value-based care model to deliver on the promise of lower costs and improve patient outcomes,” he stressed. “As a physician, if the systems I’m forced to use can’t provide me with timely, reliable data that tell me how I’m doing, what my quality scores are, in a way that’s automated, easy to use, simple, then it’s going to further complicate my day, frustrate me, and ultimately impact the time that I’ve got with my patients.”
According to Ehrenfeld, a two-pronged approach is required to ensure that providers are equipped to meet the goals of value-based care.
First, health systems and practices must actively engage their technology partners to focus on delivering EHR and health IT systems and services that address their unique needs as providers of care.
Based on research conducted by AMA, physicians want tools that support improvements to clinical productivity, fit into their current workflows, and reflect their input as end-users.
“We discovered that the majority of research and investment in digital health is focused on patient outcomes and controlling costs despite clinical efficacy being the primary concern of practicing physicians. So there’s a bit of a disconnect,” said Ehrenfeld.
At a more specific level, Ehrenfeld and AMA have called on value-based health IT to meet eight criteria:
“If we get these things done, we’ll be in a much better place to make the shift to value-based care,” added Ehrenfeld.
The second prong calls for providers to work with their counterparts with fewer resources to have access to technology necessary for succeeding at value- rather than volume-based care.
“For many physicians who have already purchased electronic health records, more needs to be done to help maximize the value of the systems that are already in place,” Ehrenfeld argued. “This is particularly important for the small community health clinics that often don’t have frankly the resources to build technology to address these challenges.”
AMA is calling on larger providers to help community practices customize, configure, and implement EHR features and functionalities efficiently and effectively.
“We know that community clinics often really serve as the lynchpin for care coordination in our local communities, and healthcare systems have a deep bench of knowledge — including best practices, lessons learned — that can improve the flow of information out across our smaller clinics,” Ehrenfeld observed.
Additionally, the provider association seeks collaboration among practices to make key value-based data available across the care continuum.
“Physicians in large organizations and physician practices also need help frankly integrating the different kinds of information, the data needed to succeed in alternative payment models and value-based care arrangements. Quality information from clinical data registries and utilization and cost data from claims have to be integrated within EHRs to help practices improve their healthcare delivery,” said Ehrenfeld.
“Sharing best practices, pooling resources will serve to strengthen each member of the medical community by improving interoperability and usability and ultimately safety in improving patient care,” he continued. “That is how we will bring to life the vision of a healthcare system that works for everybody.”