Whatever may happen to the Affordable Care Act, one thing is certain: The evolution that it created toward accountable and more integrated health care will continue onward, and the collaboration between different types of health care providers will only intensify in the coming years.
Information technology (IT) continues to be central to this effort, but what kind of technology? Certainly systems that store, manage, and easily retrieve patient data have become state-of-the-art, but a new challenge emerges: turning data volume into value. Business intelligence solutions that affect both quality of care and costs will soon become the bridge across care settings.
It is because data aggregation, data exchange, and analytics are so central to value-based care and to collaboration across care settings that I was surprised this past February when I scanned the audience at the HIMSS conference, considered by many to be the world’s leading gathering of health IT professionals, and saw so few representatives from the long term/post-acute care (LTPAC) profession. Of the 40,000-plus attendees that gathered over the several days of the program, not very many represented LTPAC providers.
While technology has been a latecomer to a field traditionally focused on the human touch, I certainly don’t believe the numbers are reflective of the LTPAC community’s commitment to leveraging IT solutions to advance quality and deliver superior outcomes. Those of us in attendance were highly motivated and eager to demonstrate to the broader health care universe the vast number of improvements skilled nursing has made thanks to technology adoption.
Post-acute care providers understand that IT has never been more important to the profession—influencing decision making at not only the bedside, but also in the boardroom. To anyone tempted to think technology innovation is exclusive by care setting, look no further than hospital readmissions.
In June 2016, just one year after the American Health Care Association (AHCA) introduced the AHCA Quality Initiative aimed at reducing the number of hospital readmissions within 30 days during a skilled nursing stay, one-fifth of AHCA member centers had achieved a 30 percent reduction in hospital readmissions or lowered their rehospitalization rate to below 10 percent. These numbers are reported based on our PointRight® Pro30™ measure, a National Quality Forum-endorsed risk-adjusted rehospitalization measure that includes all SNF admissions regardless of payer, rather than Medicare-only data tracked by CMS.
The federal Hospital Readmission Reduction Program (HRRP), created under the ACA, makes lowering readmission a priority, as it penalizes hospitals with readmission rates that exceed the national average. HRRP shines the light on the interdependence between acute and post-acute providers, a relationship that goes far beyond avoiding readmissions.
As hospitals and health care systems work on improving population health while strengthening their connection to patients and families, having a strong post-acute network in place is pivotal. This means hospital administrators must have a very strong sense of the quality of the post-acute providers upon which they rely.
Data help tell the story about provider quality. Hospitals can use analytics to better understand the post-acute facilities in their area that may be most adept at serving certain types of patients. A patient being discharged with a respiratory diagnosis has vastly different needs than a patient recovering from a knee or hip replacement.
Understanding which facility is right for a particular patient will greatly decrease the likelihood of readmission.
Hospitals and post-acute providers, in many respects, have the same IT challenge, and that is leveraging the data in their EMRs to meet the new challenges of our value-driven health care system. What is even more interesting is that each provider segment can learn a lot from the other’s data.
Establishing an integrated care continuum will depend on technology-enabled partnerships where data are shared and analytics are used to better serve patients as they move across diverse environments of care.
Steven Scott is President and CEO of Cambridge, Mass.-based PointRight, which provides predictive analytics solutions to thousands of post-acute providers, hospitals, ACOs, and payers.