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As of January of this year, one in five Massachusetts residents are being treated by doctors working under value-based contracts. In February, United Healthcare announced a fee overhaul and the prediction that an estimated 50 to 75 percent of its 26 million commercially insured members will be covered under value-based contracts by 2015.As the national reimbursement system shifts to value-based care it will drive the wide-spread adoption of electronic medical records (EMR) and the web-based disease registries and data collection systems needed to collect the quality metrics on patient care that will be required.
A web-based disease registry will play an integral part in the future success of Holy Cross Physicians Partners (HCPP), a physician-led clinically integrated network in Fort Lauderdale which began enrolling physicians earlier this year.
There are four main reasons we have selected the web-based data collection system we have chosen.
1. It requires no hardware investment for physicians.
2. It draws data automatically from many sources including: computerized billing systems in physicians’ offices; lab data from Quest, Labcorp and other relevant labs; EMRs used in physicians’ offices; and pharmacy data from the centralized Surescripts pharmacy repository.
3. Examples of data that it can collect, store and analyze include blood pressure readings in hypertensives, glycohemoglobins in diabetics, LDL cholesterol levels in ASHD, immunizations for pediatrics and cancer prevention screening measures. Other measures may include patient satisfaction, patient safety and hospital metrics such as re-admission rates and ER visits.
4. Physicians can use the system on all patients in their practice, not only patients in the network. Day to day it will improve the ability to track patients making sure they get the proper testing at the right time. Written reminders or phone lists can be generated to improve patient compliance with the involved disease states and metrics.
The disease registry will generate reports on how HCPP follows and improves on patient care metrics individually and as a network enabling it to go to the community and the insurance companies and share the results.
Eventually the system will collect enough information to enable the network to determine the cost of care of its patient population. It can then take more financial risk for patient care, which will lead to higher proportion of any shared savings involved.
By using EMRs and web-based disease registries, we can collect quality metrics on patient care in order to measure how well we take care of individual patients and disease states within our community. All metrics rely on evidence-based studies that show that if we first are able to properly and timely measure and, later, if we improve on these metrics, we will improve quality of patient care and clinical outcomes.
A secondary effect of measuring and improving on metrics is that cost of health care to the system decreases by keeping patients healthier, preventing over-utilization of services and better communication through improved IT.
