Integrating Research and Practice Health System Leaders Working Toward High-Value Care: Workshop Summary (2015) / Chapter Skim
Currently Skimming:
5 Creating the Conditions for Sustainability
5 Creating the Conditions for Sustainability
Pages 57-70
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 57... ...
• Being an organization known for research aimed at improving care can help grow market share, Garthwaite said. • A critical piece of a sustainable research enterprise, Garthwaite added, is the ability to estimate impact, which not only pro vides feedback to physicians but also offers justification to management.
|
From page 58... ...
• One model of sustainability has a value proposition of what can be called reasonable value at acceptable cost, Lewis Sandy said, while another creates an environment in which research activities pay for themselves through continuous learning and improvement and are positive contributors to a return on investment. This session, moderated by Lewis Sandy, executive vice president for clinical advancement at UnitedHealth Group, explored the business and financial issues and opportunities presented to organizations by moving toward continuous learning and improvement.
|
From page 59... ...
Intermountain Healthcare then uses what James characterized as 20 different tools for blending that 1. Rapid impact on care delivery performance (best medical result at lowest necessary cost)
|
From page 60... ...
Because of these outcomes, Intermountain Healthcare has used this knowledge system as a foundation that has enabled it to make clinical quality its core business strategy, James explained. Beginning in 1996, I ntermountain conducted a key process analysis of more than 1,400 clinical processes, with each process being a way that a patient experiences care.
|
From page 61... ...
"This is the only area where I can justify spending Intermountain patient care dollars," James said. Priorities for Level 1 research are set by Intermountain's clinical development teams, and no external funding is required, James said, although he added that once this type of data-driven research effort is established, it starts to attract significant amounts of external research funding.
|
From page 62... ...
He closed his remarks with an old Yiddish proverb: Better has no limit. EVALUATION AND IMPROVEMENT OF CARE DELIVERY In his remarks, Thomas Garthwaite spoke about how to conduct and sustain the type of research that James discussed in health systems that are not at Intermountain's level of development, which would include doctors and community hospitals that are not part of a system.
|
From page 63... ...
This study, using HCA system data, showed that babies born at 37 and 38 weeks had a significantly higher risk of requiring admission to the neonatal intensive care unit. HCA published the results of this study (Clark et al., 2011)
|
From page 64... ...
64 FIGURE 5-2 HCA's dashboard links performance and outcome. SOURCE: Reprinted with permission from Thomas Garthwaite.
|
From page 65... ...
The fundamental question that PatientsLikeMe tries to answer for patients pertains to this issue: Given my status and data, what is the best I can hope to achieve, and how am I going to get there? Okun explained that basing decisions on the patient-centric value equation does not imply that clinical data should be shared with patients so that they can make informed decisions and get some outcome.
|
From page 66... ...
it, collect it, learn from it, and then ultimately we have measured it in such a way that we can then apply it broadly." Okun suggested that it would be powerful indeed if it was possible to bring together patient-generated data and clinical data in a systematic way that would inform decision making for individual patients. Referring to the last part of the equation -- shared accountability -- Okun said that too often the expectation is that patients cannot rise to the occasion when it comes to accountability.
|
From page 67... ...
There was an infusion of capital associated with the economic stimulus and passage of the Health Information Technology for Economic and Clinical Health, or HITECH, Act, which charged the agency to work with the private sector on building an infrastructure that would allow for standard data capture across the health care environment for certain eligible providers. Money was also made available to build the workforce that would manage this system and help utilize the resulting accumulated data.
|
From page 68... ...
Let's be careful with how we are using this data." She also said it is important to be thoughtful as the PCORnet infrastructure is being developed about not over-burdening the frontline health care professionals because, at the end of the day, it is a health care system and its foremost responsibility is to care for patients. "We certainly want to make sure that we are not over standardizing and structuring data in such a way that we lose context and narrative or prevent that care environment from being the rich place that patients and providers so enjoy," DeSalvo said.
|
From page 69... ...
He said that the system's chief financial officer set a goal that its learning activities should produce enough return on investment so as to limit the health plan's rate increases to no more than 1 percent above the consumer price index by 2016. Intermountain nearly met that goal in 2013 and has likely surpassed it in 2014.
|
From page 70... ...
Bray Patrick-Lake, the patient representative on the PCORnet coordinating center executive leadership committee, asked James if Intermountain involves patients in setting the priorities that determine which research projects are approved and which are rejected. James replied that each of the clinical development teams, which set the research agenda, involve patients directly.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.