On July 17, Modern Healthcare hosted a webinar called “Empowering Caregivers” that promised to educate listeners about how to optimize technology for better care delivery, provide lessons from health systems that drive physician-led clinical transformation, and lay out organizational changes that will foster collaboration between IT and physician leadership.
The presenters were Dr. Andrew Litt, Chief Medical Officer for Dell Healthcare and Life Sciences, Dr. Charlotte Hovet, Medical Director of Clinical Informatics for Dell Healthcare and Life Sciences, Dr. Michael Dobrovich, Chief Medical Officer at St. John Medical Center in Westlake, OH, and Christine M. Schutte, IS Director at St. John Medical Center.
(Note: Dell sponsored the webinar, and I work for Dell.)
The webinar opened with some sobering statistics:
- Almost 50% of U.S. healthcare spending is for the care of only 5% of the population
- Nearly 50% of U.S. healthcare spending—$1.13 trillion—is for the treatment of chronic conditions
- Medicare is facing the threat of insolvency by 2017
- Provider reform/value-based purchasing is not going away
The HITECH Act, Meaningful Use, and the PPACA are driving healthcare toward measurement and transparency, value-based purchasing, bundled payments, ACOs, and better outcomes, such as greater care coordination and improved population and public health.
To achieve these lofty goals, contemporary healthcare leaders must address an inherent dichotomy that exists between present and future realities:
- We currently pay for volume and need to pay for value
- Fee for service needs to transition to bundled payments
- Physician-oriented workflows need to re-center around the patient
A cornerstone of this transformation will be information-driven healthcare and an organizational culture shift toward true clinical integration: “Physicians working together systematically, with or without other organizations and professionals, to improve their collective ability to deliver high quality, safe, and valued care to their patients and communities. (Source)”
One example of a hospital that is well on its way toward bridging this gap is St. John Medical Center, a full-service community hospital with 182 beds and 540 active medical staff.
St. John’s leadership team approached clinical transformation not as an IT initiative, but as a partnership between IT and end users.* As a critical first step, St. John’s governance board and hospital administration team achieved consensus and committed to the transformation. The second key step was a call to action that involved engaging St. John’s medical staff and medical executive committee. The hospital created a roadmap to convert to an EHR by February 2013, and they understood that clinical transformation would be a continuous change in culture, not an epiphanic moment in time.
St. John shared some of their successes and lessons learned to-date:
Even though I usually write about the revenue cycle, today I wanted to offer perspective on the holistic healthcare landscape. Most of us already know that hospitals operate on low margins, that 1 in 3 physicians are likely to quit over the next 10 years, and that broad uncertainties such as Medicaid reimbursement and the Sustainable Growth Rate threaten providers.
That being said, I’m given hope by the fact that so many intelligent healthcare leaders are investing tremendous effort to find creative ways of curbing the rising cost of delivering healthcare and reversing the unsustainable shrinkage of reimbursement.
*Perspectives vary on the role IT plays in clinical transformation. During his time as Executive Vice President with Perot Systems, Dr. Kevin Fickenscher outlined a different IT approach in “Changing Healthcare Through Clinical Transformation.” It’s worth a read.