As more payment models shift towards value-based reimbursements, healthcare executives have become even more dependent on providers taking ownership of improving outcomes.
In order to compete and survive in today’s value-driven economy, organizations must:
- Reduce variation in care to deliver consistent quality
- Engage with and collaborate around evidence based best practices
The transition from volume-driven reimbursements to value-based payment models relies on successful change management for care providers. Thousands of providers now directly impacting financial viability must adjust their practice behaviors, and they need reliable, targeted data to do so. Effective change management involves:
- Clear personalized performance plans
- Accountability to results
- Performance feedback designed to effect change
The Path to Better Outcomes
Relias Analytics automates these necessary change management concepts through a personalized performance improvement application developed in partnership with leading physicians. By pairing advanced analytics with proven change management, Relias empowers you to promote accountability and results across your entire provider community.
Giving providers ownership over their performance data motivates their efforts to accelerate change in their own care practice, and aligning those gaps with evidence-based best practices closes the loop of what change is needed. Enabling smart, caring physicians with transparency, focused performance improvement paths, and personal accountability ensures better outcomes system-wide.
Applying powerful performance management to every physician across your community leads to systemic transformation as providers work to improve their own uniquely attributed outcomes.
How Does It Work?
Physicians are already assessing their own practice, often building their assessment based on criteria such as:
- Response to treatment (“Did it work?”)
- Verbal cues and testimonials (“Do my patients and colleagues like and respect me?”)
- Repeat visits in a busy practice (“Do they come back?”)
What is lacking is data-driven performance insights aligned with value-based care goals. Relias empowers physicians by bringing together individual performance data with organizational goals and empirically-based recommendations.
When initially presented with data, physicians often respond with denial, disbelief, or possibly anger, which quickly morphs into resistance. However, physicians are curious, analytical diagnosticians that love nothing more than solving a tough problem.
“Enabling smart, caring physicians with transparency, focused performance improvement paths, and personal accountability ensures better outcomes system-wide.”
Resistance is not unexpected, and our team encourages physicians to explore, analyze, and prove their data wrong. During this exploration phase, physicians will review their patient metrics and EMR data, assess their outliers, and seek to discredit or invalidate the data.
Providers often discover they missed a step through this focused discovery. They may even identify other missed opportunities and before long, they recognize they have room to improve their practice. The pressure to improve outcomes, combined with the inherent devotion to care quality, can make this a difficult realization. Changing performance metrics and technology demands fail to empower physicians’ evaluation of their individual performance, and closing this feedback loop surfaces gaps in care that providers may not have anticipated.
Support and guidance through this transition to data-driven performance insights empowers physicians to change their practice and deliver optimal care. Personalized paths accelerate innovation and collaboration as care teams seek to change the data rather than question its validity.
When first presented with his performance data, Dr. X’s response was a swift denial, followed by stern resistance, and then absolute fury. Outraged by the results, he refused to believe that he was at a 30% compliance rate with mammography screening for women in his practice. He was offended by the implication that he did not practice good medicine. In his words, he knew how to care for his patients and when to order a mammogram. As he reviewed his patient outlier list, the names of 25 women he had seen in the previous month were listed in red, indicating he had not ordered mammograms for them.
While he debated the validity of the outlier list, he noticed his compliance rate was also below his peer average. Noticing one of the providers’ names in his peer group, he acknowledged that she used the same EMR he did. Still refusing to accept the performance data, Dr. X combed every record from his outlier list, only to find he had in fact missed 25 mammography screenings.
After asking his nurse to schedule the 25 outliers for mammograms, Dr. X called Dr. Dimaggio, one of his peers that the data had revealed was above the peer average. Dr. Dimaggio willingly shared how she was ensuring mammography screenings were ordered, and Dr. X implemented her process the next day.
Dr. X will freely share this journey. One of his patient outliers that month discovered a mass in one of her breasts. A biopsy revealed Stage II breast cancer. The early diagnosis allowed the malignancy to be excised before it spread. This discovery cemented his conviction to promote the review of patient outcomes to every provider in his group. He believed the use of Relias Analytics made him a better doctor.
When first presented with his patient outcomes, Dr. Z’s response was disbelief and outrage. He knew the data was wrong. He cared deeply for his patients, and took great pride in his work and leadership over two rural practices.
The data revealed that his outcomes were less than optimal when it came to managing his diabetes patients. Exploring the outliers and questioning how performance scores were calculated only revealed the patients were his.
Determined to prove the data wrong, Dr. Z printed out the list and started checking his documentation. He was astounded to find there were critical steps missed with his diabetic patients. These were important, well-supported, known diabetes screenings, which he was fully capable of managing. He wondered how they could be missed and wondered what he would tell his group. His partners respected him as their medical director and group leader, and these were not the scores of a leader.
Dr. Z was compelled to take action. He developed a focused plan to improve his diabetes metrics and overall composite for the next 6 months. Changing this trend in his scores would prove he was skilled in managing his diabetic patients. He was empowered to improve.
His targeted plan measurably improved outcomes across his patient population. With the upward metric trend in hand, he met with each of his partners individually to review their results. He anticipated their reactions, and came prepared to coach them through the discovery process.
Data was validated, outliers reviewed, and process changes discussed. Eventually, the entire practice evolved from an individual focus to a group process improvement, armed with the data from their unique patient panels.
The entire group celebrated their success of an overall composite score for Diabetes, and Dr. X became known in the region and across his peers and colleagues as a medical expert in Diabetes Care Management.
With Relias Analytics, organizations give every physician the power to improve their practice and create better outcomes.
Ready to learn more about how Relias can assist your organization?