It has long been said that information is power, and if that is the case, actionable information is even more powerful. For members of independent physician networks, such data are the linchpin in achieving alignment with hospitals, leveraging relationships, attaining preferred status with payors, and more.
Michael Repka knows this all too well. Repka is executive director and CEO of Independent Physicians Network (IPN) Inc (Milwaukee, Wisconsin), a consortium of about 1,000 primary-care and specialist physicians providing services to patients throughout Wisconsin. Primary-care physicians constitute about 30% of IPN’s members; specialists, about 60%. IPN member physicians currently are engaged in data sharing at the emergency-department level, with the help of one health information exchange (HIE).
This strategy, Repka says, has led to a reduction in the delivery of duplicate services because it allows decisions about patient care to be formulated with all of the necessary facts at hand. It also boosts the potential for suggesting and executing alternative, more cost-effective treatment, in many cases.
IPN, however, has bigger information-sharing goals in mind. RadAnalytics recently interviewed Repka to discuss IPN’s plans.
RadAnalytics: How does IPN intend to proceed, in terms of sharing actionable information?
Repka: Our first order of business will be to build a complete infrastructure for sharing actionable data among all providers caring for patients, from primary-care physicians to specialists to hospitals. The first step will center on moving our physicians into the electronic medical records (EMR) world. Some have already migrated to EMR systems, but there have been challenges.
Once this step has been completed, we will need to look at establishing additional interfaces—for example, adding HIEs to the mix and/or adopting another technology platform. This is not going to happen overnight; it will involve several years of work.
RadAnalytics: What have been the challenges of EMR implementation?
Repka: Three or four years ago, some of our physicians implemented EMR technology, only to learn that the consolidation among vendors was hindering support for these systems and that it would cost them a considerable amount of money to upgrade their technology to operate with the new owners’ platforms. Fortunately, this is becoming less of a problem now; the market is more stable.
RadAnalytics: How will actionable data culled from EMRs help IPN’s members to achieve alignment with hospitals?
Repka: In addition to eliminating duplicate services, the sharing of real-time information among, for example, emergency-department physicians, primary-care physicians, and specialists will make it easier for hospitals to do a better job of managing patient care.
RadAnalytics: What about leveraging relationships with payors?
Repka: This is where running historical data on patient treatment and outcomes will have very significant value. We need to be able to show payors how well we are managing the patient with diabetes, the patient with chronic obstructive pulmonary disease, and the like. By sharing data with them, we can prove that we have a better handle on a given case or cases, thereby reducing hospital admissions and readmissions, improving outcomes, and reducing costs.
The optimal end result is better patient care, of course, but it is also demonstrating why payors should designate us preferred providers. Physicians are now graded based on claims data, but adding the clinical piece and proving that there was a better (and perhaps less expensive) outcome yields leverage. In addition, historical data will permit us to meet the requirements of CMS, which has set forth 62 different quality measures to be tracked on a historical basis.
RadAnalytics: How will actionable data assist with disease management?
Repka: We will be able to harness data on outcomes to see whether a less costly treatment is warranted. We will also be able to create predictive models to identify those patients who will probably, at some time, require high-cost episodic treatment for their diseases. By predicting the need for such treatment in advance, we will be able to intervene earlier, driving down costs (or, at least, slowing cost increases)—and proving our value to payors.
Julie Ritzer Ross is editor of RadAnalytics.com