How Health Systems Can Elevate Performance with the Right Technology and Implementation Strategies
An Honest Perspective from Scott Sears, MD, MBA, Chief Physician Executive, Honest Health
Part 3 of a 4-part series guiding readers through the complexities of the transition to value-based care.
In the first two articles of his four-part series, Dr. Scott Sears outlined the challenges of value-based care and shared how executives can be champions of change. In this third installment, he explains how technology and effectively optimizing the data it generates are pivotal enablers of value-based care and explores essential technology selection criteria and implementation strategies.
Successfully transitioning to a value-based care model requires more than readiness awareness and a commitment to change; it demands a careful selection of technologies and effective use of data. However, selecting the right tools and using them to garner meaningful, actionable insights can be challenging.
Health system leaders should prioritize these considerations when making their decisions.
Key influences for choosing value-based care technology
Two questions are central to ensuring the right tools are in place to support successful value-based care arrangements:
- Does the technology provide timely, accurate, and actionable information?
- Can it enhance the accuracy of clinical diagnosis and documentation integrity (CDDI) to drive improved outcomes?
The need for timely, accurate, and actionable information
Healthcare often suffers from significant delays in information flow. A physician sees a patient, documents the visit, codes diagnoses, and submits the claim. It’s not unusual for several months to pass — sometimes up to six months — before payers process these claims, leaving practices without crucial insights they could have used immediately.
Adopting technology that delivers real-time data is critical to overcoming this lag. Such tools enable providers to access actionable insights at the point of care, empowering them to make informed decisions in the moment.
CDDI as a driver of better outcomes
CDDI is essential for better outcomes, and turning data into meaningful insights for physicians and care teams ensures short- and long-term success in the transition to value-based care.
A common pitfall during this shift is treating CDDI as a tool solely for optimizing documentation and reimbursement. In reality, it’s much more than that — it’s about ensuring that every aspect of a patient’s health is accurately identified, documented, and managed.
In traditional fee-for-service models, care often focuses on immediate, visible concerns. In value-based care, CDDI shifts the focus to uncovering and addressing underlying or overlooked conditions.
Physicians should consider two primary goals to maximize the benefits of CDDI tools:
- Identify undiagnosed conditions. Are there lab results or data from other physicians indicating an active condition that hasn’t been diagnosed or documented? CDDI helps ensure these conditions are diagnosed, documented, discussed with patients, and appropriately managed to improve health outcomes. Without these efforts, conditions in early stages can remain unidentified until complications arise, making management much more difficult and much more expensive.
- Proactively managing known conditions. Are documented chronic conditions routinely discussed, or do acute issues overshadow them? Are conditions that are not deemed to be chronic or are no longer present removed? CDDI tools help physicians maintain a continuous focus on chronic disease management, preventing gaps in care and promoting better, more empowered patient care.
By prioritizing real-time information and leveraging CDDI as a comprehensive tool, organizations can align technology investments with their value-based care goals.
Turning data into action, not overload
The transition to value-based care can feel daunting, but the data generated by modern technologies shouldn’t add to the burden. Instead, it should be straightforward, accessible, and actionable for physicians and care teams.
The days of paper charts and handwritten notes are gone. Today’s medical records, if printed, could span thousands of pages — far too many for any physician to effectively sift through. The right technology, however, can efficiently process this information and present it in a way that drives informed decisions and meaningful changes in patient care.
For example, some technology platforms, like those we utilize at Honest Health, analyze large data sets, extract meaningful insights, and deliver them to providers in an intuitive format with specific, targeted questions for providers that address both chronic and preventive care needs. Examples might include:
- “This patient, who is at high risk for breast cancer, had a mammogram 18 months ago. Should they have one today?”
- “This patient’s blood tests show poor kidney function in two separate occurrences, but there is no formal kidney-related diagnosis. Do they have chronic kidney disease?”
- “This patient’s blood pressure is above target in spite of three medications. Do they need a work-up for secondary causes of hypertension?”
Effective technology that generates actionable data delivers three meaningful insights physicians require to succeed in a value-based care environment:
- Prevention: What conditions need to be prevented?
- Management: What known conditions exist, what is their status, and are they appropriately managed?
- Discovery: What hidden conditions can be uncovered within the patient’s medical record?
When data is presented in a clear, actionable way, it becomes a powerful tool to support providers in delivering the highest quality of care while meeting value-based care goals.
Aligning clinical outcomes and financial goals
Clinical outcomes and financial goals work hand-in-hand in value-based care models. While there may be a perception of tension between them, they are deeply interconnected and cannot be addressed separately.
Technology can bring balance.
Value-based care is effectively delivered when expenditures to care for patients stay within the confines of allocated resources, which makes having a clear financial picture essential. The right technology provides real-time information to guide critical clinical and operational decisions and enable your understanding of:
- The amount of funding available to manage a specific condition for a patient
- How that funding can be used to achieve the most impactful outcomes
Technology bridges the gap between clinical priorities and financial constraints, helping organizations maximize care quality and financial sustainability in value-based care.
Overcoming common technology challenges
Technology is essential in value-based care, but, like many well-intentioned solutions, it comes with its challenges.
Integration with existing tools can be complex and they may not immediately deliver as expected, requiring adjustments and fine-tuning. Executives may also face hesitation from teams when implementing new technology. The following actions can establish a sound value-based care foundation for your organization, physicians, and care teams and mitigate some of the complexities you may face as a healthcare leader.
1. Don’t delay critical choices
Choosing the right technology early in your value-based care journey lays the foundation for measurable success.
Providers must have the proper technologies to do their jobs effectively and see measurable results. Asking providers to change their behavior without equipping them with the right tools sets them up for frustration and failure.
2. Evaluate technology for real-world impact
With so many technology platforms available, the selection process can seem overwhelming. Every tool promises seamless integration and real-time data delivery, often demonstrated through polished sales pitches and demos. Don’t settle for theoretical best-case scenarios. Instead, focus on practical applications and real-life results to confirm the technology will meet your needs and support your goals in value-based care.
3. Embrace a flexible mindset
Successfully navigating a technology transition requires adaptability. Challenges are inevitable, but maintaining an open mind helps you address them effectively. Remember, technology is continually evolving, maturing, and improving over time.
As you introduce and implement new technology, incorporate feedback loops for end users. These mechanisms allow you to understand how changes impact daily workflows and make adjustments along the way.
Engaging your teams throughout the process creates a sense of collaboration. When teams feel involved, they’re more likely to see the value of the new technology and view it as a resource rather than a mandate. Instead of “pushing” technology onto your teams, you’ll find they’ll begin to actively “pull” it from you.
4. Enlist the support of an experienced enablement partner
A trusted partner like Honest Health can make a significant difference, guiding you through these vital decisions and saving you time and resources. An experienced partner uses technology effectively with diverse provider partners and across multiple electronic medical record systems — ideally, one that matches your own. They will demonstrate a commitment to innovation that drives impactful results and leverage that innovation to support your organization’s goals for continued success.
The transition to value-based care requires thoughtful technology choices, actionable insights, strategic implementation, and a partner who understands your goals. By prioritizing these areas, health systems can deliver better outcomes, reduce costs, and thrive in a value-based care model.
Don’t miss the final installment in Dr. Scott Sears’ four-part series, “Steering Clear of Setbacks: What You Can Avoid in Your Journey to Value-Based Care.” In this conclusion, he examines common missteps organizations make during the shift to value-based care and shares practical advice on avoiding these pitfalls, overcoming setbacks, and ensuring a smooth, effective, and successful transition.