MACRA: The Yardstick for Quality that Health Systems Need

yard stickThe number of quality initiatives is rapidly rising in the healthcare industry as stakeholders shift their focus toward the value of patient care. In addition, with the recent implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), the rules surrounding healthcare reimbursement are being rewritten, incentivizing healthcare providers to prioritize the quality of patient visits over the quantity.

Historically, it has been difficult to achieve consensus on defining quality; therefore, it was not consistently measured. MACRA provides tools to assess quality of care, and lays the foundation for a future in which payers and providers must collaborate in new ways driven by patient data.

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Reflecting on IT’s Transformation of Healthcare

health it week pictureAs we celebrate National Health IT Week, it is incredible to realize how health technology tools are transforming every facet of patient care. From telehealth, to 3D printers to artificial intelligence, the explosion of personalized health devices redefines the dynamics of patient treatment and interactions.

However, we still fall short in comparison to other industries, particularly in terms of consistent patient information access, and the lack of incentive for industry collaboration to achieve smooth, interoperable data transfers. This week, we strike a balance between applauding our progress, yet refusing to rest on our laurels.

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Turning Data Into Action by Leveraging ‘Low-Hanging Analytics’

data-o-nscreenIn healthcare, we constantly seek new ways to deliver and improve care. Countless ideas have already been tried and tested, and people often think that coming up with the next great innovation requires thinking ‘outside of the box.’ This notion has been instilled in most of us from a young age, and those in all industries – not just healthcare – often strive to show their creativity through this approach. However, in my experience, thinking outside of the box doesn’t always lead to the best new ideas. Sometimes, we need to focus on thinking better inside the box.

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Using Technology to Stop Hemorrhaging Data

health-records-digitizationIn healthcare, we talk a lot about how we can use data to improve patient care. We discuss the importance of interoperability, the need for more data to be available to physicians, and how data can help physicians spot an issue with a patient they otherwise may not have caught.

What we don’t often discuss is the degree to which care settings can impact the need to effectively capture and make sense of data.

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Patient-centric Approaches to Data are Great…Except When They’re Not

infrastructureIn a variety of recent private and panel discussions with health and policy leaders, I’ve heard encouraging talk around interoperability through open and available application programming interfaces (APIs). Public comments by Health and Human Services Secretary Sylvia Mathews Burwell and Centers for Medicare and Medicaid Acting Administrator Andy Slavitt indicate there is sincere commitment to making this a reality.

While this momentum seems promising, when Meaningful Use Stage 3 is mentioned – particularly its requirements for making data available to patient facing applications – I see the potential for unintended and terrible consequences for clinician workflows.

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Telehealth Brings Non-Stress Tests to the Home

Non-stress tests (NSTs) are the current standard of care for monitoring high-risk pregnancies. Intended to reduce the risk of stillbirths, these tests are for those who have one or more risk factors, whether they be maternal, fetal or obstetric complications.

Currently, these tests can be very time-consuming for patients. NSTs involve attaching the mother to fetal and contraction monitors to watch the fetal heart rate tracing and uterine activity. However, many rural and remote areas don’t have ready access to NSTs. Consequently, mothers sometimes travel up to several hours each way to get to our facility for their NST appointments once or twice a week. Once they arrive, there’s the usual wait time, the 30-60 minute testing process, plus an additional wait time for the test to be interpreted by a staff member and a clinician. These appointments, on top of any additional prenatal visits the mothers have scheduled, can therefore add up to a considerable amount of time, even for patients who live nearby.

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Creating a Friendly Environment for Adoption of Clinical Decision Support

In recent years, our ability to stream large amounts of data in real-time has improved dramatically. This enhancement can transform how clinicians offer care by sourcing unprecedented opportunities for clinical decision support. However, the capability to process, store, and display data in and of itself does not transform care. Rather, it is how the clinicians adopt and apply decision support that will make all the difference to patients. However, the current environment must be altered to create a clinical decision support-friendly climate.

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