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Embracing a Holistic Approach in Care Management

Healthcare of Tomorrow

The health care industry is evolving, thanks to policy changes, societal shifts and technological advances. Healthcare of Tomorrow from U.S. News & World Report examines the challenges facing health care, and how it must change to face the future. See more U.S. News special reports.

Health care providers need to think like their patients.

At least, that's what leaders of accountable care organizations said during a panel session at the U.S. News Healthcare of Tomorrow conference Nov. 2 in Washington.

"We need to transform the way we've done case management in the past," said Julie Bietsch, vice president of population health management at Dignity Health. "You have to get people to think about the other side of the bed that the patients are on."

 

Population Health Management

 

Bietsch, Dr. Robert Fields of Mission Health Partners ACO and Kevin Ban, chief medical officer at Athenahealth and moderator of the panel, discussed how the future of health care management will rely on the engagement of patients and providers in a more interpersonal, holistic approach to improve care beyond hospital walls.

There is no a single silver bullet that will get great outcomes, Ban said.

"There is no one population that you need to focus on," he continued. "What you need to do is focus on the entire population and do something."

In doing so, health care organizations will change the relationship between public health and health care from one of inverse to one of concurrence. But there are multiple factors that go into a holistic accountable care structure, and the panelists weighed in on what they consider the most integral components to a successful, value-based system.

Take Big Data, Growing Technology and Make it Actionable

Accountable care organizations rely on the latest health data to accurately treat each patient.

Therefore, making electrical medical records and data on admissions, discharges, and transfers accessible not only within a hospital or network but also among competitors enables healthcare systems to keep patient demographic and visit information synchronized. In doing so, healthcare providers can provide more qualitative care to each patient if problems persist.

And, Fields said, don't neglect human behavior.

"It’s not a coincidence that behavioral economics are huge and we grossly ignore them in healthcare design," Fields said. "I think we can take way more advantage of that to be successful."

That means, Fields said, take advantage of the new generation of analytics that incorporate artificial intelligence to discover social determinants and drive treatment.

Provide Incentives for Health Care Providers That Go Beyond the Wallet

While money is a great incentive, the panelists said primary care physicians in their networks are additionally motivated by natural competition and a better work-life balance that comes with changing the focus from quantity of patients treated to quality and patient engagement.

“The dollars paid are symbolic gestures, but they don’t actually drive the change," Fields said.

"Some of it is doing the right thing for our patients," Bietsch said. For others, having scribes or physician assistants in the office to do the repetitive tasks under the physician's oversight tremendously helps to manage workflow while also cutting down on time in the office.

Providing transparency of care that holds each physician accountable for their quality of treatment is a further motivator for physicians, Fields said, as it drives natural competition.

"As soon as you form a club and have expectations of the club, now you’re holding them accountable in ways they weren’t before to stay in the network," Fields said. "And if you’re not in the network, you aren’t going to be in contracting care. If you’re going to play, you’re going to play by the rules we have in the network."

And, for nurses, create a system in which they are the CEOs of their patients, Bietsch said. Doing so enables nurses to work at the top of their medical licenses while also providing a more gratifying experience for the work they do for each patient.

Create a Network That Engages Patients

“Data's important, all the other stuff is important, but a fundamental skill you need to have is building relationships with people," Fields said.

It's not about buying every tool in the shed, Bietsch said, but instead focusing on how to engage patients and physicians with the available social services outside their primary care appointments that address other social issues in their homes and communities.

By providing physicians with care teams that can address outside factors that a patient is facing, Bietsch said, it keeps everyone on the same page and provide more efficient, qualitative care.

Understanding patients' needs and where they are coming from further enables providers to better address existing social gaps, Fields said.

"We might want to handle their heart problems or their diabetes, but what they want to fix is their transportation needs,” he said. Addressing those social factors first and creating ongoing relationships with patients may make them more likely to stay with the health care network in the long term.

 

Source: U.S.News

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