INTELICHART looks forward to showcasing HealthyOUTCOMES, the company’s platform for patient engagement to outcomes, at the upcoming 2018 NACHC Community Health Institute (CHI) and Expo in Orlando. Taking place on August 26-28, NACHC CHI is the largest annual gathering of health center clinicians, executives, and consumer board members, along with State/Regional Primary Care Associations and Health Center Controlled Networks. The conference focuses on emerging public health issues, new technology for delivering care more effectively and efficiently, and setting the stage for sustainability.
Emerging public health issues: Patient complexity and costs
The United States spends $10,348 per person per year on healthcare. This is the highest in the world and 31 percent more than the next wealthy country in this ranking. Chronic illness is driving much of these costs. In fact, five percent of Americans – 15 million with multiple chronic conditions – account for 45 percent of healthcare spending—$1.2 trillion. Medical spending and lost productivity attributed to chronic conditions is expected to reach $42 trillion by 2030.
Reducing these costs and improving patient outcomes is at the heart of the shift from fee-for-service reimbursement to the value-based care payment models that government and commercial healthcare payers are introducing at a rapid pace. In this environment, healthcare organizations must operate more efficiently while continuing to deliver optimal care.
High-quality care inside the four walls of a healthcare organization is only a portion of what delivers better patient outcomes. Driving stronger patient engagement and helping patients adhere to their personalized care plans involves overcoming patients’ behavioral, economic and physical environment, in addition to other social obstacles. One study estimates that more than 80 percent of outcomes are influenced by these social determinants of health.
Population Health Management: delivering care more effectively and efficiently
Many providers are discovering Population Health Management (PHM), a new, growing movement in healthcare delivery that enables organizations to gain deeper insights into the best and most effective ways to manage patients and their care plans. PHM technology integrates with a provider’s EHR – along with clinical and financial information systems – to deliver reliable, timely insight into patients’ health status and trends.
PHM offers a new breed of clinicians the ability to efficiently and effectively manage populations by leveraging not just electronic health record and claims data, but also comprehensive data aggregated from throughout the care continuum and beyond. Deeper and broader information sets about patients’ social determinants of health, behaviors and non-clinical activities, combined with medical information, deliver a complete and insightful perspective to guide care decisions and interventions.
A holistic view of patients includes information about their physical environment, such as air and water quality, housing type, transportation, parks or walking access, or proximity to grocery stores. Behavioral information may be included in the EHR, but clinicians at the point-of-care need reliable insight such as care-plan adherence behavior, healthy attitude, or behavior modifiability to optimize care plans. Social data is also crucial and may include information about the patient’s education, literacy, employment and financial history, family and social support.
These social determinants offer a view of patients that enable more relevant care before, during, and after visits. A better understanding of a high-risk patient’s social determinants of health also helps care managers overcome obstacles that may be affecting more than just one patient.
Proactive engagement sets the stage for sustainability
Supported by integrated and automated data analytics technology, PHM helps organizations track and intervene with high-risk and potentially high-cost patients. Proactive, preventive intervention can divert patients from high-cost emergency department visits that may lead to an even costlier, and potentially unnecessary, hospital admission and associated inpatient care. Modern PHM strategies also help increase engagement to support patients in managing their conditions to drive better outcomes.
Even with automated patient data capture and analytics, PHM can still be highly labor-intensive with manual report creation, data searching, and patient outreach. Sophisticated PHM platforms, however, are taking automation a step further by instantly generating real-time dashboards showing performance on key metrics. Platforms are also automatically initiating patient outreach from healthcare organizations through text messages, phone or secure patient-portal messages, based on pre-determined criteria and patient preference.
Automated communication from the healthcare organization is designed to remind, notify or encourage patients to adhere to their care plan and take positive action. The goal is the same: to modify behaviors and overcome social determinants of health that are driving them away from optimal outcomes. This reimagined workflow allows clinicians to manage lower-risk, lower complexity patients and devote more valued time to the highest-need, highest-risk patients.
As health centers across the U.S. are being called upon to deliver care more efficiently and effectively, the way provider organizations operate must evolve from episodic and isolated to holistic and year-round. Consistent and relevant outreach and communication yields strong engagement from patients who likewise feel more connected to providers demonstrating concern about their health throughout the year. PHM, combined with clearly defined clinician roles and insight-driven workflows, empower organizations to optimize patient outcomes and maximize reimbursement across their enterprises for many years to come.
HealthyOUTCOMES: See the Power of the Platform at NACHC
INTELICHART knows the importance of integrating with your EHR, and that’s why we started our company in 2010 by building APIs. Our employees innovate every day to stay ahead of the continually changing healthcare curve. We listen to our customers and build enhancements designed to fill their evolving needs. Through this innovative process, we created HealthyOUTCOMES, a powerful suite of solutions that you can access from one platform with all data syncing back to your EHR. HealthyOUTCOMES includes PatientPORTAL, PatientSURVEY, PatientNOTIFY, and PopulationHEALTH.
Our platform helps health centers:
• Maximize reimbursement
• Reduce no-shows
• Streamline staff efficiency
• Achieve healthier outcomes
With INTELICHART, your organization works in harmony with one vendor for all your solutions, as opposed to the cumbersome burden of working with numerous vendors and applications that don’t mesh. Our dedicated training and support teams further facilitate seamless implementation.
INTELICHART welcomes NACHC’s CHI attendees to stop by booth #901 to learn how HealthyOUTCOMES can help your organization stay vibrant and viable in this realigned world of care management.
(1) Cox, Cynthia and Sawyer, Bradley. “How does health spending in the U.S. compare to other countries?” Peterson-Kaiser Health System Tracker. February 13, 2018. Accessed May 15, 2018. https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/?_sf_s=health+spending#item-start
(2) Partnership to Fight Chronic Disease. “What Is The Impact Of Chronic Disease On America?” Fact Sheet. 2016. Accessed June 11, 2018. http://www.fightchronicdisease.org/sites/default/files/pfcd_blocks/PFCD_US.FactSheet_FINAL1%20%282%29.pdf
(3) Hood, Carlyn M. et al. “County Health Rankings: Relationships Between Determinant Factors and Health Outcomes.” American Journal of Preventive Medicine, February 2016. Accessed June 12, 2018. http://www.countyhealthrankings.org/sites/default/files/Hood_AmJPrevMed_2015.pdf