By now we all know that transitioning to value-based care (VBC) offers tremendous benefits to healthcare organizations; what many are still grappling with is how to get there. Successful implementation of technology to support VBC initiatives first requires a strategic plan from business operations. From there, an effective IT plan can be structured to support VBC initiatives, current and future.
In the first article, we presented an overview of the current state and value-based instruments (products) that help with defining that strategy. There is no one right path; however, there are some basic premises that organizations need to have in place to succeed in this journey.
A framework for strategy must be established within the organization so that IT can be adequately prepared to develop and/or buy and support the efforts. A clear business strategy is key, as it can be challenging for IT to remain nimble and responsive to the changing climate; for example, changes from the new administration may require IT systems to make modifications changes to support newer frameworks. However, there are some tenants for supporting value-based care that remain consistent regardless of the current plan or administration.
Framework of a Value-Based Strategy
Each of the strategy components has technology implications, many of which must be integrated to create the continuum of care necessary to support diverse populations. Solutions must be seamless, support data from multiple sources, and drive toward consumerism and patient centered integration. Data is the key in any IT value-based strategy; therefore it’s important to understand where the data sources exist, and how to get them, integrate them, and manage them in a meaningful way.
The graph below was developed as part of a strategic effort we are pursuing at UMass Memorial. It demonstrates how data feeds the other premises of value-based efforts, such as data analytics, care management, patient engagement, and business systems support (i.e., Customer Relationship Management system) to manage outreach efforts to clinicians.
This framework is important because it establishes the population health conceptual model in regard to what data sources are needed and the intended outputs from that data. From this point, an evaluation can be made to review current systems, perform a gap analysis, and determine how future systems can create a framework for supporting population health and VBC.
The Impact of Consumerism
Consumerism in healthcare has led to patients taking an increasingly active role in their care. The fact that they are more empowered than ever before to choose alternatives cannot be overlooked as part of the strategy. Patients want — and will need — access to all sorts of information regarding their care. That means data from many sources, not just their doctors’ offices, which then must be delivered in a meaningful and accessible way. What that means for IT, is that any strategy must contemplate how to make that data accessible; therefore, interoperability is vital.
Interoperability across networks and systems has been slow due to a variety of reasons. However, there is light at the end of the tunnel, and signs show that we are headed in the right direction, although we still have a ways to go. Creating a framework within your network and then extending out beyond it is an important critical step in strategy development. Identifying key touch points and access to data sources — for example, health information exchanges — and then making that data accessible along with other data collected from the EMRs being used by payors, the hospital, the clinicians, and other sources.
The Vendor Management Factor
One aspect of the IT strategy for VBC that is often overlooked is vendor management. The market is currently saturated with vendors who purport to provide population health technology from soup to nuts. Beware, however, because that is not always the case; some have strengths in given areas such as analytics but are branching into care management, while others are better at care management but are branching into data analytics. The market moves quickly and there are many organizations merging or being purchased by larger vendors who prefer to buy established technology rather than develop it themselves, and so careful assessment and engagement of any vendors are required. Some key pieces include:
- Holding them responsible for participating in the strategy process;
- Having active discussions about future development, how they are supporting population health, and how will their developments now an in the future support the organizations effort to transition to VBC;
- Participating as a partner who is fully invested.
Consider that it may not be one vendor but several that help with VBC, and they all must cooperate and integrate with one another.
From a leadership perspective, realize that creating organizational awareness and offering support are key components to an effective strategy. Without them technology efforts will be difficult, as they are often looked at as a line item in the expenses rather than viewed as a value-add to the organization. Be an advocate, and help management understand what the strategic advantage will be for the organization that can offer technology that attracts and maintains the networks and patients.
Finally, remember to build a certain level of flexibility in your plan, and revisit often to ensure you are adequately prepared for the future.