Biggest obstacles to patient-centered care? Coordination and quality measurement

Michigan Health Information Network executive director Tim Pletcher says that effectively linking patients to providers starts with a dynamic health directory. 
By John Andrews
08:47 AM

A new model of healthcare means provider organizations need to mobilize and marshal their resources to develop a coordinated, more efficient process of care, according to Tim Pletcher, executive director of the Michigan Health Information Network.

Effective patient-centered care requires a clear understanding of which doctors, organizations and other care providers are actively involved in a person’s care, he added, and new approaches to care such as precision medicine further heighten the need for an effective process to link, or attribute, patients to providers, Pletcher said.

“The biggest challenge right now is that care coordination, performance measurement and quality measurement are completely separate, siloed activities,” he said. “As the industry moves increasingly toward advanced payment models, care coordination and quality measurement need to become a continuous and integrated process. This means that care coordination, performance measurement and quality measurement have to be closely related activities growing out of the same shared infrastructure, same foundation of master data, with the same 360-degree view of the patient and caregivers involved.”

It starts with an active, dynamic health directory, Pletcher said, because it captures which provider is part of a given practice unit, and in turn how that practice unit connects to any associated contracting entities such as physician organizations, accountable care organizations and patient-centered medical homes.

The next key resource required is robust patient-provider attribution showing that each individual provider is connected to a specific population of patients.

“Because health plans and those who pay for and regulate care use various kinds of attributions to make payments, the current process of care coordination and incentives linked to quality measurement aren’t well-aligned,” Pletcher said. “That alignment is actually very challenging now. Patients can often be attributed to providers they never see and providers don’t feel they should be accountable for those patients. It’s a constant source of friction and confusion.”

Developing a cohesive patient-centered care process enables providers to recognize gaps and the best kind of attribution to use, Pletcher said.

“It also helps us understand the dynamics of a relationship and make sure the right people get the information they need,” he said. “And it provides support to perform financial incentive calculations in a fair and consistent way.”

Pletcher will be explaining his patient-centered strategy in detail at his presentation, “The Future of Attribution: Who is Treating Your Patient?” on Thursday, Feb. 23, at 10:30 a.m. in Room 304A.

HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.


This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.


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