KANSAS CITY, Mo. – At Advocate Health Care, a sprawling, Chicago-area hospital system with about 6,000 affiliated physicians, computerization isn’t just about modernizing charts and swapping information electronically.
“We are all about measurements,” aimed at improving health outcomes, said Mike Englehart, president of an Advocate subsidiary, during opening remarks at the Population Health Summit held here last week at the InterContinental Hotel.
For example, physicians in the 12-hospital system, he said, are scored on a dozen to two dozen performance metrics depending upon their specialty. The scorecards are available for all their colleagues to see.
But the bigger point, Englehart said, was to make good use of all the data Advocate collects. And the rest of the industry should be doing that, too, he said.
“The play is sitting out in front of us,” he said. “What are you going to do with the information? Can you take the information and leverage it? That is really where we believe the industry needs to go.”
Cerner Corp, a health information company based in North Kansas City, Mo. organized the summit, which lasted a day and a half. Representatives of about 300 Cerner clients from around the country attended.
Among Englehart’s key points:
- Medical providers must extend additional supports beyond the most expensive, chronic patients to those that seem headed toward diabetes or other chronic ailments. “If you catch them, that is where you move the meters,” said Dick Flanigan, an executive with Cerner’s population health group.
- A spike in prescription drug costs is not necessarily cause for alarm, if it means patients are adhering to regimes that avoid more expensive emergency room visits or hospitalizations.
- The concept of hospital discharges should be discarded. Englehart said Advocate uses the word “transition” to signify that care does not end when the patient leaves the hospital. “That is really the key,” Flanigan agreed.
Cerner officials said the newest version of a Web-based patient referral system, which the company piloted with nine Kansas City-area safety-net clinics, would have an analytic component to it.
The product is called Cerner Direct, and the nine clinics currently use it for about 3,000 secure message exchanges per month.
Building in a drop-down menu of specialties into the Cerner Direct system is high priority for the company, said Derek Zaun, a senior engagement leader working on the project. That would allow those on either end of a patient referral to track disease prevalence.
A breakout session at the summit featured representatives from three of the organizations that participated in the Cerner Direct pilot, which began in January 2012.
They were from Truman Medical Centers, Samuel U. Rodgers Health Center, and MetroCare of Greater Kansas City, a nonprofit that finds free care for uninsured patients in Jackson, Clay and Platte counties through a network of about 850 physicians.
The pilot with Cerner Direct began as a previous system, KC Carelink, which had been in place since 2001, was ceasing operations.
But the goal of paperless medical administration remains elusive.
Even today, the Cerner Direct panelists said, many providers still make patient referrals via fax machine, which can leave the referring party in the dark about whether the referrals went through while burying the receiving party in a blizzard of paper.
That’s why the paperless Cerner Direct system is a “godsend for us,” said Lisa Millerd, director of health information and systems management for the Samuel Rodgers clinic.
She said Cerner Direct allowed staff to track the status of each referral, resulting in fewer unresolved cases and expedited care for patients. Also, she can monitor the status of referrals and if she sees cases on hold too long due to an outstanding issue she can make it a high priority for the staff.
The evolution of Cerner Direct had been interesting, Zaun said, because the new product essentially evolved out of a stopgap solution Cerner suggested to Truman in 2012 for secure messaging.
The referral function grew out of that initial need.
“It is not like we had this grand plan,” he said.