“So every year a patient should have their symptoms assessed, if it's not. Then the provider has a ranking of where they fall and how many of their patients have had symptoms assessed. And then, it's a step-wise algorithm, and each time they'll get an alert saying, ‘Hey, your patient's still not well-controlled. It's time to titrate their medicine, think about this medicine next.’
And so, we will help them titrate their medicine. Giving them clinical decision support at the time of a visit is very, very important, instead of just saying you have to do this right, but you're not sure what's right, and you don't have time to look it up. I think providing that clinical decision support just in time is a really important tool for doing that, but still, it's hard to get people engaged.
So you've got carrots and you've got sticks. You can look and see how you compare to everyone else. You can reimburse based on measures, which sometimes works, sometimes doesn't. Or you can provide the clinical support. And so, coaching models – there are primary care coaching models where you can send coaches into practices and help them figure out the best flow to make those things happen. I think it’s a really important aspect of primary care and helping them do the right thing at the right time.
You can do population health, so setting aside time, like you were saying, for the DME, but set aside time for a primary care doctor. You've got one day – one clinic day every month – where you're going to just look at your panels and do panel management, where, you say, who's missing this rescue inhaler – this person should be on an LAMA.”