HCI3 Update from the Field – Newtown, CT
Turning data into actionable information is hard but essential in the effort to transform practices – and many times, it doesn't take a huge organization to do it. A case in point is the work Dr. Brenner did in NJ to identify "hot spots" – areas in the community that were responsible for the majority of ED and other hospital admissions. Similarly, our continued work with practices across the country to achieve Recognition, and our work in pilot sites with hospitals and physicians to adapt to value-based payment always comes back to having effective feedback loops. There are thousands of physicians across the country that have achieved Recognition from a base of a few hundred when we started in the early 2000s, and there is a growing number of hospitals and physicians involved in value-based payment. And every time they submit a new batch of data, we see improved scores and performance. Getting to these data wasn't easy and took time initially, but it takes less and less time in every new implementation and almost no time for the second submission. There are important lessons in this for all of us.
What this means to you – We've rarely, if ever, witnessed the transformation of a practice or seen the implementation of new operational processes take less than 18 months. And that's after the design of the implementation, the data requirements, and the specific transformation have been agreed to. The 18 months get you to some level of stability and repeatability, and help work most of the kinks out. But after that, the acceleration of the transformation is far greater than simply linear because the feedback loop gets to be faster and faster. In addition, toolkits (like the one we've assembled on episode of care payment) can greatly reduce the 18 month cycle time for implementations, and the associated frustrations.There's always a tendency to look for shortcuts, and sometimes it makes sense, but most of the time it doesn't. Because taking shortcuts is what has gotten us to our current dead end. If Dr. Brenner had taken a short cut, he wouldn't have found Camden's hot spots. And if we collectively take shortcuts, we'll never find a stable and repeatable way to improve the system. It's a hard road, but the thousands of physicians who have already become Recognized, and the thousands more who are hard at work today to transform their practices are paving it. Employers and plans that are deploying the right incentives are helping to fuel the drive. For all the others, step aside, because the person who says it cannot be done shouldn't interrupt the one doing it.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.