Op-ed: Actionable data emphasis needed in national healthcare reform debate

Karen Ferguson is the Practice Administrator at Arthritis Northwest and co-founder/CEO of Discus Analytics, Inc., a healthcare company specializing in the capture, analysis, and application of actionable clinical data. Ferguson wrote the following op-ed on the national health care debate from a medical technology & rural clinical perspective

Without a course correction, access to our nation’s healthcare system will become out of reach for many American families. While constructive legislative efforts over the last decade have brought about reforms that prioritize patient access, choice in coverage options, and preventative healthcare services, we still have work to do to ensure quality, affordable outcomes are the standard for healthcare delivery moving forward. And right now, the national debate is missing the point on how to deliver real-world fixes for patients and providers.

Arthritis Northwest, the largest rheumatology clinic northwest of Denver, created a digital monitoring platform to track patient outcomes during their course of care. They set out to transform their practice by improving clinical care, care coordination, and outcomes of patients by simplified documentation, simplified administrative burden and standardization protocols.

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This allows physicians to send actionable notifications or messages to the care coordinator to follow the patients closely. There is little doubt that if outcome-based performance becomes the new gold standard by which payment is allotted, a new commitment to tracking and analyzing data (that is, outcomes) is necessary. At the national level, this shift was spurred on by purposeful changes in how Medicare and Medicaid reimbursed healthcare providers. Recalibrating the system meant tracking patient progress across different clinical settings to improve accountability and coordination.

The American Reinvestment & Recovery Act of 2009 catalyzed this shift by requiring healthcare providers to modernize their medical records-keeping systems and leveraged government funding to do so. The Affordable Care Act of 2010 incentivized data coordination between healthcare providers to achieve better outcomes at a lower cost.

We shouldn’t roll back the clock on these important gains. Communities are now better equipped to manage patient populations through increased collaboration between providers. This is an important foundation to build on, but many challenges remain that can and should be addressed through careful policymaking at the national level.

Clinicians are working hard to be part of the solution but struggle to balance the demands of system-wide change with keeping their clinics open and their employees paid. The ACA required enhanced data reporting and collection from providers but failed to provide reimbursement for increased administrative costs as these high value services were implemented.

While this data collection is important, the future of healthcare is really centered around how we glean insights to make recommendations that improve patient outcomes at the individual, community, and regional level. Just like in 2009 when we made an initial investment in electronic medical records, the next round of reforms should allocate additional resources that allow us to use data intelligence to help people get the care they need faster.

Currently, physicians trying to redesign the way they deliver healthcare find few resources available to support this kind of innovation. For many rural or critical access clinics this creates an unfair choice between providing better outcomes and remaining financially solvent.

The next round of healthcare reform must address the gap between legislative intent and on-the-ground reality.

Finally, we have to let go of unrealistic policy efforts being championed by the loudest voices on both sides of the aisle in the other Washington. I believe that Americans want a healthcare future which promotes innovation, inclusion, and more empowerment for patients. What’s more, these Medicare for all style proposals are irrelevant unless systems cost is truly reduced – and new federal initiatives proposed often increase clinical demands while reducing reimbursement for each patient seen at the practice. The outcome I hope we can achieve is a healthcare future that puts patients first and provides higher quality care at a lower cost. To accomplish this, politicians on both sides of the aisle need to put their differences aside and focus on practical solutions that serve their constituents and the community of caregivers around them. By working together and putting the needs of patients first, I believe we can leave the next generation with higher standards of care and better coordination between providers.