Dear Healthcare Intelligence Network Client,

While electronic communications in clinical care might appeal to medical leaders and especially patients (No commuting! No waiting time!) physicians aren’t as likely to welcome it unless different payment models emerge, according to a study from Weill Cornell Medical College.

Considered efficient and cost-effective, enabling doctors to email test results to patients or manage clinical conditions without a time-consuming and costly visit, doctors are still unwilling to adopt e-communications until patient workloads are reduced or they are paid for the time they spend phoning and emailing patients, both during and after office hours. Their biggest complaint? A work day that never ends, with anywhere from five to 50 emails to respond to daily. Physicians are looking for compensation for e- communications in ways other than traditional fee-for-service (FFS); more details inside.

We highlight another cost-effective method this week: the use of electronic health records (EHRs) to automate reporting of quality measures. According to a new study from Kaiser Permanente, the method reduced reporting time by nearly 50 percent in surgical care improvements.

Of the six Total Joint Commission measure sets — acute myocardial infarction (AMI), emergency department (ED) patient flow, immunizations, the surgical care improvement project (SCIP), pneumonia and VTE prophylaxis — Kaiser Permanente observed a 50 percent reduction in reporting time for the surgical care improvement project (SCIP), a national quality partnership of organizations interested in improving surgical care by significantly reducing surgical complications.

Given this improvement, researchers say that time savings are likely achievable on a broader scale. Like electronic communications, automated quality reporting allows for immediate access to data, which can more quickly lead to improved care for patients.

Improving the quality of healthcare for all in the United States isn't about finding the right mix of rewards (“carrots”) and punishments (“sticks”) for patients and clinicians, according to a new report from the Health Care Incentives Improvement Institute, Inc. (HCI3®), in conjunction with the Robert Wood Johnson Foundation (RWJF). It is about finding an approach that allows each party to make good decisions on their own about healthcare.

Contrary to conventional wisdom, external incentives designed to change simple behaviors, like improving productivity in rote tasks, do not work for more complex behaviors. In fact, they can actually be harmful, undermining assets like creativity and drive, which are essential to the success of health professionals and workers in other fields.

Instead, the researchers argue that healthcare reform should focus on finding internal motivations that doctors and patients share when delivering or seeking the best care. Most health professionals enter training with the same goal that their patients enter the doctor’s office with: to improve patients’ health. But, as doctors begin to practice and patients begin to pay, they encounter a whole host of conflicting external forces that distort their once shared goal, explained in this issue.

Improving patient care is also the goal of Aetna’s recent accountable care agreements with five major health systems in Maine. Under each agreement, the providers will become part of a coordinated healthcare network and receive information about medical care and medications a patient may be receiving. By having access to information about the patient’s range of healthcare interactions, providers can better coordinate their patient’s care, reducing duplicate testing and appointments, and making the healthcare experience simpler for the patient.

This care will be supported by changes in the way these hospitals and providers are reimbursed for care with certain payments based on the achievement of mutually agreed upon measures of quality, efficiency and patient outcomes.

And lastly, are you participating in an accountable care organization (ACO)? As the number of public and private accountable care organizations nears 500, participants and pundits alike are looking more closely at the ACO model's structure, challenges and benefits. Take HIN's third annual survey on ACOs by September 6, 2013 and receive a free executive summary of the compiled results. Your responses will be kept confidential.

Your colleague in the business of healthcare,
Cheryl Miller
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to [email protected].

August 12, 2013
Vol. XV, No. 30

Sponsored by:

marcus evans Healthcare Executives Summit

The National Healthcare CXO event is an invitation-only event held for approximately 90 attendees and is closed to the public. Delegates include CEOs, CAOs and COOs. The topics include: thoughts on the transformation of our healthcare system, cultivating a healthy hospital-physician relationship, quality measurement, techniques and redesigning the care process for improved results, patient satisfaction and experience programs to boost engagement and communication, and reducing costs by investing in outpatient care.

Click here to visit the conference Web site.

This week's industry news:

1. Patients Welcome Widespread Electronic Communications Use; Physicians Wary
   
2. Guide to Physician Engagement
   
3. Improved Care Coordination, Patient Engagement Key to Aetna’s New ACO Agreements in Maine
   
4. Population Health Management Tools for ACOs
   
5. Healthcare Business White Paper: Medication Adherence in 2013
   
6. EHRs Save Up to 50 Percent of Time in Quality Measures
   
7. New Chart: What's the Greatest Challenge Posed by a PHM Approach?
   
8. 2012 Benchmarks in Patient Registry Use for Accountable Care
   
9. New Report Challenges Basic Assumptions About Healthcare Payment Reform
   
10. Blueprint for Bundled Payments
    
11. Videoconferencing, Virtual Visits and Smartphones Lead Telehealth Use
    
12. 2013 Healthcare Benchmarks: Telehealth & Telemedicine
    
13. Infographic: Realizing the Value of Health IT
    
14. A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings