Data’s the key to gauge the potential for change that aids care
The success of a wide range of initiatives depends on whether data can easily be collected to serve as a platform for improvement.
Improving care delivery and reducing healthcare costs represent a sizable portion of responsibility on the full plates sitting before healthcare executives.
After all, those two lofty targets represent 40 percent of the Quintuple Aim. And the symbiotic relationship between these two Aims means they get a lot of attention – especially for organizations that have the primary mission of improving care.
There’s so much going on at healthcare organizations, so it’s understandable that maintaining focus on these two crucial goals is challenging. This is well-described in a recently published piece by Janet Henderson at NextAct Strategy. A variety of pressures can lead to strategic fragmentation, she notes.
Making progress on care quality and cost containment requires good data that can accurately measure the delta that occurs when new approaches are tried. “You can’t improve what you don’t measure,” is a relevant maxim, attributed to both Peter Drucker and W. Edwards Demming (although there’s doubt that either of them said it, but that’s another topic for another day).
Recent announcements and developments in the industry show growing interest in measuring how programs and technologies can impact care. Despite that evidence, policy and care decisions hinge on whether that information is accepted and then incorporated into standard practice within an evolving care industry.
Hopeful examples
Careful research, backed by data, shows promise in directing policy makers looking for improved care at reduced cost.
For example, the Accountable for Health’s Kidney Care Coalition, representing more than 95 percent of participants in the kidney-specific models established by the CMS Innovation Center, has released two studies with data that back continued support of accountable care models for Medicare beneficiaries with chronic kidney disease and end-stage renal disease.
The coalition says the data demonstrates that the Comprehensive Kidney Care Contracting model “shows stronger savings potential than early evaluations suggest while delivering significant quality improvements.” The group says CMS needs to act to ensure continuation of the contracting model to ensure “long-term stability for patients and doctors participating in accountable kidney care.”
“The early evidence shows that accountable kidney care is improving quality, and these independent analyses show that the model’s financial story is stronger than headline evaluation results suggest,” says Mara McDermott, CEO of Accountable for Health. “CMS should continue to build on this important progress.” A research paper and policy roadmap are available for review.
Another similar data-based study looks at the value of how best to address musculoskeletal disorders, intending to measure the value of physical and occupational therapy. The study involved a partnership between researchers from Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Medicine, working with American Specialty Health, a provider of musculoskeletal health solutions.
Findings from the research is meaningful because musculoskeletal conditions are one of the top leading causes of healthcare costs, with these issues affecting more than one in three individuals in the U.S. Data supports the efficacy of therapy-based interventions for reducing pain and restoring function across a range of conditions. In addition, data finds that early, appropriate therapy can help reduce reliance on expensive procedures such as surgery and imaging, as well as ongoing medication use.
And downstream, the research indicated that early engagement in physical therapy is associated with faster return-to-work timelines and shorter durations of disability, which reduce overall costs to society.
Tackling impediments to care
Other evaluation work is in the early stages, delving into how technology can be applied in specific disease specialties.
For example, accessing meaningful data for research purposes can be challenging, and that accessibility significantly impacts the ability to apply artificial intelligence to research and enable finer clinical decision support.
That’s been a challenge for addressing specific diseases, particularly serious gastrointestinal diseases like inflammatory bowel disease and metabolic dysfunction-associated steatohepatitis. To facilitate AI’s ability to extract all relevant data for this class of illnesses, Phoenix-based Arizona Gastrointestinal Associates, one of the largest independent community GI practices in the country, is partnering with Century Health, a technology provider that gives clinics the ability to use their own clinical data to support research.
The partners say they will work together to create detailed real-world datasets, from which AI can extract meaningful patterns to support evidence generation and life sciences research for patients with GI conditions.
Collaborating on care
Finally, when technology has enabled better care for patients with specific needs, efficacy needs to be demonstrated when it’s widely deployed and to see if patients are comfortable using it.
For example, The Center for Cancer and Blood Disorders, a large community oncology practice in Texas, is expanding efforts to support patients receiving advanced cell therapies, including CAR-T therapy, through a deeper collaboration with Reimagine Care, a virtual oncology care platform.
The tech vendor’s platform provides a clinical and operational model that supports outpatient post-infusion monitoring and management for CAR-T and other advanced oncology therapies. This capability post-discharge enables The Center to support patients during the critical weeks after infusion, “when toxicities can escalate rapidly and ongoing clinical visibility is essential,” a news release suggests.
The technology company contends that patients are comfortable using the technology and engage with it for several months; the company can independently manage 90 percent of encounters without escalating incidents to The Center staff. That enables quicker response and appropriate follow-up action to avert serious complications when issues occur.
"This collaboration allows us to extend our reach beyond the walls of the clinic and maintain close visibility into how patients are doing between visits,” says Barry Russo, CEO of The Center for Cancer and Blood Disorders. “That's increasingly important as advanced therapies become more common in community oncology."
Through the program, patients receive structured monitoring during the highest-risk post infusion period, including symptom assessments, vital sign tracking, neurocognitive evaluations and rapid escalation support coordinated between Reimagine Care and the Center’s oncology care team.
In all these cases, data is crucial in determining new paths for whether suggested changes in delivery truly provide measurable benefits to both patients and the healthcare organizations that care for them.
Fred Bazzoli is the Editor in Chief of Health Data Management.