Providers are facing an avalanche of changes in healthcare in the next few years, with the meaningful use program and the transition away from fee-for-service payment models expected to alter the way they operate. Participants in the Beacon Community Cooperative Agreement Program offered some advice on how healthcare organizations can continue managing change in healthcare settings.
In a May 22 webcast, titled The Beacon Community Experience: Illuminating the Path Forward, National Coordinator for Health IT Farzad Mostashari, M.D., said the healthcare industry faces a number of challenges and it will be difficult for providers to make the necessary changes. It can be hard to get data out of EHR systems to allow physicians to collaborate on care and to apply advanced analytics, and such barriers can impede progress toward payment reform. Even so, the experiences of Beacon Community participants could help other providers deal with these difficulties, he said. "Now those lessons are relevant to a lot more people who are trying to navigate this transformation," he added.
Data empowers leaders and allows entities who might not otherwise be able to collaborate to share common goals.
director of government programs, Rocky Mountain Health Plans; program director, Colorado Beacon Consortium
As part of the Beacon Community program, the ONC awarded $250 million in grants to 17 providers across the country. The goal was to demonstrate that the use of IT could make care more patient-centric and advance the so-called "triple aim": better health, better care and lower costs.
Collecting data is key to pursuing these goals, said Patrick Gordon, director of government programs at Rocky Mountain Health Plans and program director for the Colorado Beacon Consortium. This step allowed his organization to collaborate with others and measure quality. Measurement has to take place in order to improve quality, he said.
"Data empowers leaders and allows entities who might not otherwise be able to collaborate to share common goals," Gordon said. Building an effective workforce is essential to pursuing these goals, he said. Providers shouldn't get too focused on the specifics of technology implementation if it comes at the price of creating human capital. Strong staff will be able to find new ways of doing things, which will support the organization as it moves through the stages of meaningful use or toward payment reform, he added.
Healthcare providers typically are risk-averse, and that presents another challenge to the successful implementation of IT and the pursuit of cost and quality improvement. Asaf Bitton, a physician at Brigham and Women's Hospital in Boston, and a researcher at the Harvard Medical School Center for Primary Care, said hospitals typically don't want to do anything that's too risky. This means they are more likely to make incremental changes that are sure to deliver results.
For Bitton, however, the problems of high cost and poor health outcomes are so great that this incremental approach is inadequate. He feels that organizations should take on bigger challenges. This doesn't mean providers should act carelessly. Instead, they need to learn how to "fail successfully," he said. They can experiment by continuing demonstration projects for longer than the standard six months, learning from the experience and making changes as necessary. "The value of having a standardized, sequential method throughout the organization about how to succeed includes learning how to fail," he said.
Dealing with meaningful use and payment reform will be most challenging for smaller hospitals and physician offices. Mark McClellan, M.D., director of the Engelberg Center for Health Care Reform and a senior fellow at the Brookings Institution, said many small providers are looking to form accountable care organizations but they are struggling with meaningful use. Without the technical infrastructure in place, providers have a difficult time connecting with other medical offices, and that limits their ability to collaborate on patient care.
This is a challenge providers will need to figure out soon, regardless of their size. The push for payment reform is strengthening, McClellan pointed out, as consensus grows around the idea that the industry must move away from fee-for-service payment models.