How CMS-funded Transformation Networks help practices tap analytics to improve EHR data and care delivery
When caregivers and healthcare executives combine clinical data analytics with care process improvement methods, resulting enhancements to care delivery and outcomes can help physician practices transition more smoothly from fee-for-service payments to value-based reimbursement models, experts said.
This is the aim of work underway at the Consortium for Southeastern Hypertension Control Practice Transformation Network, an effort funded by the Centers for Medicare and Medicaid Services to help transform smaller, community-based physician practices to prepare them for value-based payments.
“There are 29 practice transition networks, which cover the entire country, that are funded by CMS’s Transforming Clinical Practices Initiative, which is responsible for reaching out and working with community practices,” said Debra Simmons, executive director of COSEHC and project director of QualityImpact at the COSEHC Practice Transformation Network.
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In the journey from fee-for-service to value-based reimbursement, medical practices must first examine how they deliver care today and which quality metrics exist. Then, a network like COSEHC can assist the practice through quality improvement consultancy and education so that within a four-year period, the length of the CMS’s Transforming Clinical Practices Initiative, the practice can ensure it is a high-performing quality provider with the ability to reach targeted goals the CMS has defined for performance, Simmons explained.
“Lots of practices see data from EHR systems, but then go, ‘What does this mean?’” Simmons said.
For instance, the Consortium for Southeastern Hypertension Control knows what hypertension control rates should be, so if a practice is not achieving these rates, the COSEHC Practice Transformation Network can step in and help the practice with education, resources and tools to achieve clinical improvement, which is the key.
The other key to the CMS-funded transformation effort is improving processes, Simmons said.
“So often when a patient arrives, a physician is trying to manage the patient and pull lab data and find out the dates of last vaccinations and so on,” Simmons explained. “But so many things can be done ahead of time by the care delivery team, so when a patient actually sees a physician, the physician can focus on the needs of that day, and everything else will already have been done.”
The COSEHC Practice Transformation Network also provides practices with a population health IT tool so care delivery teams at practices can view their entire patient population in a panel to see where patients are with, for example, immunizations, lab tests and so on.
“This tool provides an opportunity for the care team to reach out and prepare patients for a visit with a physician because it helps them understand where gaps in care are,” Simmons said.
Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
