Value-based care is a delivery and payment model that rewards providers who achieve a higher quality of care, better outcomes and greater efficiency than the fee-for-service model that has been in use for decades. Under the value-based care model, providers are responsible for ensuring their patients receive the services they need to produce the best results.
Current plans call for the federal centers for Medicare and Medicaid Services to put value-based care into widespread use in 2020.
Six Steps to Success
Adetutu Adetona, MD, knew that if she wanted to meet the demands of value-based care, she would have to change the workflow in her practice. One of the biggest changes she had to make was to ensure that she and her staff knew as much as possible about each patient before their appointment.
The Hixny, the health information exchange (HIE) serving the greater Capital District, provided Adetona with the information she and her staff needed when she needed it.
Adetona offers this advice to providers who want to duplicate her success:
1. Get friendly with patient data.
“Hixny bridges the gap,” Adetona says. “It gives you a global picture of what has happened with your patient outside your office. If you’re going to deliver good healthcare, you really need to know who your patients are seeing, what medications they’re taking, what tests they’ve had done.”
2. Get ready for tomorrow.
At the end of each day, Adetona’s staff uses Hixny to pull the records for every patient scheduled for the next day who has signed a consent form. They take time to discuss each patient and get on the same page. “Successful value-based practices spend time reviewing cases and discussing patient needs as a staff,” explains Adetona.
3. Use information to build patient compliance.
Adetona makes sure that upon check-in, her staff asks patients whether they followed her instructions for follow-up tests. That way, patients know the doctor is already aware that they failed to follow her orders, which helps build patient accountability.
4. Keep patient records on your screen.
During a patient’s visit, Adetona can quickly use Hixny to look up any information she might need that is not already in her records. “When someone comes into my office, I have their records on my screen, and I can see all of that. That’s one of the ways Hixny helps me,” she says. “You don’t know what test they had? All you need to do is hit a button, and the test is right there. You want to know what pharmacy they use. The doctors they’ve seen. It’s all there.”
5. Use Hixny to find records the patient doesn’t remember.
“Sometimes a patient will say they had a ‘very high’ blood pressure reading in the emergency department, but they don’t know what it was. I can find it through Hixny,” says Adetona.
6. Enter information into the system during the appointment.
Using the HIE allows Adetona to be more engaged with her patients. When speaking with them, she enters the information into the EHR instead of trying to look up older records. If the patient doesn’t have certain information, she can check the HIE.
Anticipate an Adjustment Period
Adetona says when she started using the HIE, neither she nor her staff were comfortable with the system. “The first patient took me almost two hours to find all the necessary records and input them, but I wasn’t going to quit,” she says.
She made sure to appear confident, even when she didn’t feel that way. And that made her staff feel more confident in the changes. Now that everyone in her practice is comfortable with the health information exchange, she says, “it makes our job so much easier.”
Ride the Learning Curve
Adetona says that she was hesitant at first to change her practice’s workflow and embrace value-based care. “It was a fear of the unknown,” she says. “I was comfortable with fee-for-service. I saw no advantage in changing.” Adetona took the journey into value-based care one small step at a time, easing her staff along with her. Now that everyone in her practice is comfortable with using the HIE, “It makes our job so much easier,” she says.
By using Hixny so effectively, Adetona has successfully adapted to the value-based care payment model. Not only that, she has also consistently earned top rankings for quality and effectiveness among more than 200 practices in the Capital District. One reason for the increased quality of care is Adetona’s ability to quickly check her patients’ medical records in Hixny to confirm if they have had needed screenings, and order then when necessary.
Given the results she has realized, Adetona encourages other physicians to make the change.
“I have been in their position,” she says. “But you have to embrace it. Would I do it again? Yes, I would, and I would do it sooner.”