Executive Outlook: Rhonda Medows, M.D., on expanding the reach of meaningful use data

Rhonda Medows, M.D., and executive vice president of Population Health for Providence Health & Services joins State of Reform’s Executive Outlook guest column. The not-for-profit Catholic health care organization has 34 hospitals, 600 physician clinics, a health plan and more than 83,000 employees across five states – Alaska, California, Montana, Oregon and Washington – with its system office located in the Seattle area.  

Recently, Providence Health & Services submitted performance reports for our 34 hospitals and more than 2,100 employed providers who qualified for the meaningful use data program in 2015.

For the 2015 performance period, Providence achieved 100 percent compliance for our hospitals and 99 percent compliance for our providers – the industry average for providers was 54 percent (HealthIT.gov).

This was an important achievement for a large organization like ours. We quickly realized how new opportunities were available. The new infrastructure and methods Providence developed to meet meaningful use goals were also applied to help an organization of our size begin to collaborate around data.

So far, Providence has been able to take an integrated approach with meaningful use data – using it in other areas within our Population Health Division, such as payer contracting and our accountable care organizations. This is key for us as we focus on knowing our populations and improving their health outcomes.

Key lessons learned in the early days of data collection

Rhonda Medows, M.D., and executive vice president of Population Health for Providence Health & Services. Source/ Providence Health and Services

Rhonda Medows, M.D., and executive vice president of Population Health for Providence Health & Services. Source/ Providence Health and Services

The effort to collect and analyze data began five years ago. We developed an internal scorecard in order to track specific meaningful use measures. In a simple snapshot – green, yellow and red – coding quickly alerted executive leaders when their hospitals were on target and where they were off target.

A scorecard concept proved useful with the transition to Stage 2 meaningful use, so we could track the percentage of records providers were creating electronically. The reporting benchmark was 10 percent of provider records being created:

  • Hospitals in our system that fell below 10 percent in reporting were coded red
  • Hospitals with reporting at 15 percent were yellow, and
  • Hospitals that exceeded 15 percent were green.

Ray Manahan, our director of government programs, says it well: “When it comes to achieving certain quality health measures, oftentimes hospitals leaders need a high-level view before diving into detailed analysis. They want to cut through the weeds and first understand ‘Where am I coming up short and what do I need to do to fix it?’”

This high-level color coding system has translated well to 300 patient care quality measures, which are now being tracked across our multi-state organization of hospitals, clinics, and caregivers (all employees).

During the process of this data coordination project, our leaders also realized the value of clarifying ownership of specific improvement goals that emerged from the data so that regions could learn from each other.

“When we see that Oregon is doing well with this goal and Washington isn’t, we can ask Oregon what they’re doing differently to get those good results. Having that discussion at a granular level was very useful to us, but in order to get there, we needed a good analysis of the data,” says Manahan.

At Providence, performance reports for all hospitals and all providers are run biweekly to carefully monitor trends and address areas of risk.

What health systems of the future will need to do

Completing one of the largest interoperable electronic health record installations in the country was important. However, it’s only one digital tool among many needed for the future to fundamentally change the way we provide care to those we serve.

Providence is investing now in other technologies that will enable us to focus more on prevention and wellness. We will be using software to promote collaboration between multiple care delivery locations (inpatient, outpatient, home health, retail) to provide more coordinated, connected care.

And, we will continue to refine our data coordination methods. Our scale gives us advantages that we can use to improve care. We are being nimble in sharing best practices and reducing variation to drive safety, quality, and affordability to ensure access to the most advanced, high-quality care.

The ultimate goal of the federal government’s meaningful use EHR incentive program is to optimize performance on three dimensions of care: population health, affordable services and patient experience. At Providence, everything we do, including data analysis and reporting, is informed by our strategic goals to improve health and well-being for entire populations. In this journey, we have found health systems of the future will need to do more than merely meet data reporting benchmarks to achieve these goals; we must continue to innovate in the ways that provide the right data at the fingertips of our providers, which makes proactive, connected care possible.