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Mar 27, 2018

Insightful survey shows the new health IT pain points, gains and desires of health system execs

We see a lot of surveys in the healthcare information technology industry, and I always lean in on those from the health system C-Suite level.
 

If you’re in charge today of a large health system in this margin-sensitive, M&A-fueled marketplace, be it a large IDN or CIN, a hospital-based system or an ACO, it’s hard, plain and simple.
 

And when it comes to the health IT sector, more transparency, more collaboration and a lot more of a partnership approach is needed to fill either the big picture or the more gap-specific or mission-critical needs of systems trying to navigate through value-based care and risk, long-term technology investments they can trust and the holy grails of integrated workflows and real interoperability.
 

There’s some real encouragement in the survey in that execs are realizing some goals, contrasted though with some results that simply make me sad because I know from customer experience all things are possible.

 

But gee, let me wipe away the tears here and examine and relay some key findings.

The technology/respondent landscape

The heart of this survey is around EHRs and what are called PHM or analytics platforms. Who has what, what’s working, what’s not and what are the needs, all toward getting systems up the value-based care contracting maturity curve.
 

And before I get too far, the entire survey can be found here.
 

The survey respondents are 100 executives operating health systems as IDNs, multi-specialty practices, hospital-based systems or ACOs. A full 87 percent of respondents are CEOs, CIOs, COOs, CFOs, etc. It’s a geographically diverse group as well.

VBC is a viable, achievable goal

Great news in this survey in that 100 percent report participation in some type of a value-based care or risk-based contract. Better yet, 76 percent have realized ROI.
 

Of the VBC programs, no surprise that just more than 70 percent represented here are participating in ACOs. I’ve recently written about how it’s so important for the health IT industry to support ACO structures.
 

Where the survey gets tricky is how technology is or is not helping, and the smart choices being made to overcome challenges:

  • 64 percent say EHRs alone are not delivering critical VBC capabilities, and less than 25 percent think EHRs can deliver on the six core needs KLAS has identified as essential to population health management. Those six core capabilities are:
  • Aggregation
  • Analysis
  • Care management
  • Administrative/Financial
  • Patient engagement
  • Clinician engagement
These numbers do align with the most recent KLAS PHM report, which also found EHR customers citing poor performance across those verticals. (I’m happy to note that the Philips Wellcentive platform was rated as a top-10 solution across all six verticals by our customers.)

How to reach that goal

But moving on, some credit to EHRs in that 65 percent said they are unlikely to pursue an EHR replacement in the near future. That is good news because taking on that cost and migration and implementation process is really not necessary these days.

 

Why? The survey says it all as just about the same percentage – 60 to 75 percent – are seeking a third-party solution to integrate with the EHR for VBC success. That means a PHM/analytics solution to enhance the existing system. Some executives are waiting for their EHR vendor to deliver, some are finding current EHR upgrades lacking and some are looking elsewhere.
 

The crux of the problem is the number of disparate EHRs a given system may be dealing with. We have customers with more than 20, causing them to seek a solution overcoming interoperability, data readability and other data management issues.

Here’s a quote from the survey:
 

“EHR data has inherent problems. First, when you’re pulling data from 29 EHRs, it’s coming to you in 29 different ways.” – Rick MacCormack, CEO, Northwest Physicians Network of Washington

 

Yes that’s scary given legacy architectures and data language in the EHRs, but the survey’s movement toward agnostic analytics solutions purpose-built for aggregation, mapping and all the KLAS verticals, are being turned to.

 

Here’s another quote:
 

“As no one-size-fits-all EHR exists, while I hate stacking systems on top of each other, I think that’s the most viable solution to achieve interoperability today.” – Casey Crotty, CEO, San Juan IPA, New Mexico

 

The trick here is turning “hate” into a less anxious word. And to be fair, the survey also notes that the PHM market is still evolving, as 50 percent with an analytics platform say they are likely to switch it out within the next three years.
 

This is precisely why vendors need to act like partners with customers and prospects, by really drilling down into the specific needs matched to specific risk contracts and specific business goals.

C-Suite top VBC challenges

No surprise again that EHR interoperability tops the list, with 42 percent citing it as the top challenge. This speaks again to being able to aggregate all types of data, read it, analyze it, move longitudinal charts to where they are needed when they are needed, and ultimately be the engine for quality reporting.
 

At the same time the new frontier in data exchange is what we call consumeroperability, as patient-generated data from remote monitoring, API-driven third-party apps and even wearables must be accounted for within innovative solutions.
 

Other top challenges, which again align with KLAS verticals, included:

  • Patient engagement
  • Stakeholder coordination
  • Data analytics to support risk-based contracts

Seeking social determinants of health

And what makes this survey so timely and prescient is the area ranked as the second highest value-based care challenge, the desire for a way to incorporate social determinants of health.
 

This tells me several things. One, these executives are very enlightened about the role social determinants can take in real-world care gaps and planning. They are taking it seriously and seeking solutions.

 

This is an area we’ve been talking about for a long time, both through white papers and webinars.

I’m also very pleased to note that we are bringing a social determinants integrated solution to market this year.

Segmenting the pursuit of analytics needs

To wrap up the highlights of the survey, respondents went on to carve out where they see current platforms failing, and which capabilities they are seeking elsewhere.
 

Overall, less then 25 percent of C-Suite executives said their EHRs can deliver:

  • Risk stratification
  • Aggregation from disparate EHRs
  • Quality program optimization
  • Patient engagement
  • PHM analytics
Likewise, between 30 and 59 percent say they use non-EHR technology for the following functions:
  • 45 percent/risk stratification
  • 41 percent/data aggregation
  • 59 percent/quality program optimization
  • 44 percent/patient engagement
  • 40 percent/analytics
  • 32 percent/social determinants of health

Wow, 59 percent don’t use the EHR for quality program optimization. That’s a priority need of health IT technology in the value-based care era.

That’s no great surprise to me, but let that sink in for a moment. This again speaks to the need for vendors to increasingly collaborate for their mutual customers, or everyone in health IT loses.

 

All of this is the very point of where health IT needs to go, especially in terms of population health management and VBC. Today, solution offerings need to be à la carte. As flexible and modular and purpose-driven as C-Suite executives want it to be.
 

Need it to be.

About the author

Niki Buchanan
Niki Buchanan, 
General Manager & Business Leader, Philips
Niki Buchanan is General Manager & Business Leader for Philips PHM. A dynamic and versatile healthcare executive, Niki uses her distinctive customer satisfaction and product optimization methodology to lead improvements across the Health IT spectrum.

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