The Treatspace Referral Management Blog

Value-based care models are said to represent “policymaking at 80,000 feet.”

Healthcare leaders who were once optimistic about value-based reimbursement models are becoming doubtful after seeing the performance of several programs. Accountable Care Organizations (ACOs) are achieving modest gains and a meager 28% of Medicare Shared Savings Program (MSSP) participants have generated cost savings.

Image courtesy of flickr

Problems with handoffs are a big deal in clinical practice. Defective handoffs lead to patient harm, treatment delays, inappropriate treatment, and longer stays in the hospital. In a typical patient handoff between physicians, important patient information is often not given to physicians who take over care of a patient. In a hospital, “[s]hift changes, also known as handoffs, are prime opportunities for key information about a patient’s condition to get lost in the shuffle,” according to a recently released study about patient handoffs in JAMA Internal Medicine [1].

Electronic health record (EHR) rollouts are huge undertakings. It cost Massachusetts General Hospital $1.2 billion to shift towards Epic Systems’ EHR over the last three years. And the rollout has been complicated. They had to keep their old, homegrown systems running at the same time while they switched to their new EHR system. On top of that, they had to conduct extensive data conversions, testing and staff training.

Outpatient physician practices don’t fare much better with EHR rollouts. Outpatient EHR system implementations are estimated to cost $46,569 per physician. And one study of 49 PCP practices determined that the average 5-year return-on-investment of an EHR system was a loss of $43,743 per physician. 73% of the surveyed primary care practices demonstrated a negative ROI from EHR systems over 5 years.

Hospitals and Health Networks Magazine recently championed the concept of primary care physicians and specialists working closely together as partners, rather than continuing disconnected referral relationships.

Partnering with Primary Care

H&HN’s article touts the increased efficiency and improved patient care in organizations with tightly aligned specialty and primary care partners.

Healthcare practitioners want to provide the best care for their patients both during and after office visits. But one major stumbling block is that the majority of physicians in the United States aren’t capable of sharing information electronically outside of their practices. Data shows that the majority of primary care practices are struggling to seamlessly share patient information, efficiently manage referrals, and facilitate interoperable communication with specialist partners.

A recent article in technology and business magazine Fast Company heaped praise on user-friendly applications that go beyond electronic health record (EHR) systems. The beginning of the article detailed a number of the pitfalls of EHR systems:

1. EHRs were not set up for patient care

One pitfall of EHRs outlined in the Fast Company article is that they “weren't designed to help their providers treat patients.” The article states that EHRs are more geared towards meeting regulatory requirements, maximizing billing and avoiding liability. The Meaningful Use program was implemented by the government in 2011 to incentivize adoption of EHR systems, but Meaningful Use has been criticized for rewarding usage of EHRs rather than rewarding better patient outcomes.

Healthcare reimbursement is undergoing “the most dramatic shift in Medicare payments in the program’s 50-year history,” from fee-for-service to value-based care. But most physicians aren’t familiar with the important law that is establishing these changes for the future, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Proposed details for MACRA were released by the Centers for Medicare and Medicaid Service (CMS) a few months ago, in April 2016.

Journalist Fareed Zakaria is certain that those who prevail in tomorrow’s health care arena are the ones who figure out how to use the troves of data at their fingertips to distinguish themselves from competitors.

“[W]hat you do with that data will probably be the key differentiator going forward,” Zakaria explains at a recent healthcare conference, the Health Forum and American Hospital Association Leadership Summit.

Courtesy of Youtube

You may have seen the news that well-known infomercial psychic Miss Cleo, whose actual name was Youree Harris, recently passed away from colon cancer at the age of 53. She died while she was surrounded by her friends and family after entering into hospice care.

Here’s an old commercial of hers:

Entirely paper-based healthcare is going the way of the dodo bird. Since 2008, the number of office-based physicians who have adopted electronic healthcare records (EHRs) has doubled from 40% to over 80%. In fact, the number of physicians using EHRs has actually quadrupled in the past 12 years.

Poorly handwritten prescriptions are no longer a problem for the 70% of physicians who now prescribe medications for their patients electronically. The advancement of e-prescribing has led to a reduction in medical errors and prevents fraud, such as opioid abuse.

In addition, telehealth is booming, robotic surgery is more common, and robots are even roaming the hallways of hospitals to deliver food and transport trash.