Brown and Frazier agree that the benefits of the system and positive responses far outweigh the handful of patients who were called when they shouldn't have been.
Based on data from December to July, Riverside booked more than 13,400 appointments, and of those appointments, about 9,100 would not have been made without the intervention. In addition, those visits generated roughly $675,000.
Likewise, The Iowa Clinic, which went live with the system about nine months ago, successfully contacted more than 16,600 patients with gaps in care, and of those, roughly 8,500 appointments were made within 60 days. "We have also increased compliance with standards of performance that have been laid out for us by some of our payers for performance improvement," says Brown.
"It has a positive impact on the bottom line, but it is not disproportionately out of line with what it would have been before because those openings would have been filled by other services," says Brown. "But we are making sure that patients are getting more appropriate care for their needs."
Managing patient populations
Providers are still determining what accountable care organizations (ACO) are exactly and how they will be structured. But one thing is certain?technology will play a key role in helping organizations better manage populations of patients.
Today, when a physician tells a patient, "I want to see you back in so many months for follow-up labs," the responsibility rests with the patient, says Ed Brown, CEO of The Iowa Clinic.
But with so much emphasis being placed on patient-centered medical homes, P4P, meaningful use, and ACOs, "the bar is being raised so that there is responsibility on the provider to maximize the outcome of that patient's health," Brown says.
"That is the transition from a fee-for-service-based payment system to a global payment system," says Steve Schelhammer, CEO of Phytel, Inc. "To be successful, providers have to have capabilities to help them manage the entire population, not just the population that is actively seeking healthcare."
The idea of ACOs and complying with protocols that are set internally or externally will be enhanced by technology, agrees Brown. "As we establish protocols for various disease processes, we'll have within our demographics in our EMR the patient population that qualifies for the protocols," he says. Those patients need to be tracked closely, and "technology will enhance our ability to perform up to a high level of care based on the protocols that have been established."
In the future, Charles Frazier, MD, vice president of innovation at Riverside Health System, envisions technology solutions like Phytel enabling nurses to coordinate patient care more effectively. Rather than having patients call their physician practice, they can call a central number where nurses looking at the EMR can say, "Yes, I see where you do need follow-up for diabetes, and by the way, can I go ahead and make your eye appointment and order lab work that Dr. Frazier will need when you come in?"