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Last week we analyzed how to get the most value from population health data and facilitate communication between providers to improve population health management. In order to successfully manage the health needs of a community, providers require access to accurate, real-time data to address gaps in care as well as any new issues as they arise.
New medical technologies are making it even easier for providers to record and store massive amounts of patient data and transfer it securely. While these advances are useful for data tracking and analytics, physicians are being bogged down by the amount of patient information they have to record after every appointment. Overwhelmed by high reporting demands in addition to other occupational requirements, physicians and other providers are facing higher rates of burnout—particularly in emergency and internal medicine.
Fig 1 Top 5 Physician Specialties with the highest Burnout Rates. Data from Definitive Healthcare and the American Medical Association
Electronic Health Records (EHRs) have simplified the process of collecting and reviewing patient data for physicians, payers, and other providers. The prevalence of EHR systems means that providers have access to a patient’s entire health history wherever the patient seeks care. While this improves care connectivity and reduces the likelihood of repetitive or unnecessary treatments, entering and verifying EHR data can take so much time that physicians are forced to reduce the number of patients they see in a day.
Providers are still struggling with the best way to juggle data entry and patient engagement. If a physician is inputting data while they’re speaking with a patient, the patient may feel as though the physician is distracted and the doctor-patient relationship could suffer. How can providers learn to engage with EHR and other data collection systems in the most efficient way without sacrificing their rapport with patients?
To address this issue, practices and care facilities could set formal guidelines regarding technology use in the examination room, much like the unspoken social guidelines for other technologies. It is generally unacceptable to be texting while having an in-person conversation, so why would it be more acceptable to be typing on a computer? Nurses already aid in data collection during triage while they take a patient’s vitals, asking about symptoms and recording them before the physician arrives. Nurses or interns could remain in the room during examinations and take notes throughout the visit.
A counter to this method is that the nurse or intern is still taking notes rather than seeing a patient or performing another necessary task. Dictation services, though useful, are not always accurate and must be looked over before the information is entered into an EHR system or other note-taking platform. Alternatively, patients could take some responsibility over data entry. Before a visit, patients could enter basic information through a patient portal—such as recent symptoms, reason for visit, progress in treatment, etc. Nurses and physicians would only have to confirm this data during the visit rather than taking time to record everything during or after the appointment.
The best way to find a solution to the roadblocks providers face is to spend time in the field, witnessing firsthand where physicians are being inhibited. Seeing providers work first-hand offers more context than written testimonies or statistics. Are there any tasks that could be automated or done by an intern rather than a physician? Is communication clear and timely? Could the office be organized in a more efficient manner? These are all questions that can be more easily addressed in-person than through a survey or written communication.
Providers should also be aware of the information they are collecting and why the data is significant. In order to properly manage population health, a practice should have a clear goal in place so physicians aren’t wasting time gathering and analyzing irrelevant data. Similarly, the technology in place should serve a clear and useful purpose. If technology more difficult to use than it’s worth, consider an alternative. If desktops are time-consuming—with providers logging in and out continuously—consider using tablets that providers carry with them. It’s easier to engage with a patient while using a tablet than a desktop, and has the added bonus of built-in voice recording and dictation applications.
|IDN Name||Net Patient Revenue (M)||Technology Vendor|
|Catholic Health Initiatives||$16,574||Meditech|
|Providence St Joseph Health||$15,905||Epic|
|Community Health Systems||$12,927||Cerner|
|University of North Carolina Health||$11,169||Epic|
Fig 2 Data from Definitive Healthcare
Because data collection—for population health management, CMS reporting, or other reasons—can be overwhelming, it is essential to keep providers engaged to reduce the risk of burnout. The normalization of data collection and review makes it easier for nurses and physicians to integrate the tasks into their daily routines. Regular data collection also facilitates performance tracking and procedure analytics, ensuring that all care providers remain on-track with their goals and are held accountable for patient care.
Provider engagement can also be addressed through workshops, conferences, courses, and other continuing education opportunities. This could mean nurses getting re-certified in EHR data entry or attending a workshop in recognizing population health trends. Because nurses meet with patients before physicians, and ask the majority of initial health questions, they are able to spot trends in symptoms and illnesses first.
Data collected by a practice or care facility should be shared with other local providers in order to gain a comprehensive understanding of population health in a region or state. This is particularly true for facilities in the same network. Integrated delivery networks (IDNs) are uniquely equipped to address population health needs. Some IDNs do this by assuming the risk from patients through the use of bundled payments and relying on claims from payers through health information exchanges (HIEs). An IDN can also leverage its large size to negotiate lower purchasing prices for member hospitals, enabling facilities to deliver necessary care while remaining within a tight budget.
|IDN Name||Net Patient Revenue (M)||Technology Vendor|
|Universal Health Services||$8,333||Cerner|
|Cleveland Clinic Health System||$7,234||Epic|
|Mayo Clinic Health System||$6,048||Epic|
Fig 3 Data from Definitive Healthcare
While it is important to ensure continuous provider involvement, it is also necessary to include patients in their own care. This could mean asking patients to utilize patient portals to report symptoms and track their treatment. Providers could also offer an incentive for patients to participate in surveys regarding the quality of care they’ve received, or asking for input on what services they wish had been offered.
Technology has vastly improved care delivery, particularly for remote patients and those who have difficulty getting to regular appointments. By asking patients to regularly report their symptoms and other health measures, physicians have a more accurate view of how treatment is affecting a patient’s daily life. This is also more reliable than asking a patient how they’ve been responding to treatment every month or so, as patients may not remember little details that could indicate continuing problems or improvements.
Numerous studies have also shown that getting patients involved in their own care improves outcomes, reduces readmission rates, and allows patients to be more active in managing their overall health. Successful treatment relies on continual engagement from patients and providers—if a patient doesn’t understand their illness or treatment path, they can’t take an active role in improving their own wellness.
Once data has been collected and analyzed, it should be accessible to patients and other care providers. It is through sharing information—on population health, treatment methods, or other wellness initiatives— that providers can effectively and quickly improve care delivery and outcomes.
To view a sample Visual Dashboard on population health, visit our database and click on the “Population” tab.
Read the Definitive Blog for more information on How to Leverage Big Data for Patient Care Management.