Whether you send invoices to patients or claims to Medicare, you will soon be judged by how healthy and happy your patients and clients are, not by how many hours you spend with them or how many visits you do. Payers from John Hancock to Anthem to Humana, whether they are MCOs or operate under names like Medicaid, TennCare, or Medi-Cal, they have options. To be more specific, there are so many of you, they have multiple, virtually unlimited options as to which post-acute care organization they will take on as a partner.
Why would a payer decide to send its premium-paying, covered customers to you instead of to your competitor across the street? On the day "patient outcomes" becomes their answer to that question, if it hasn't already, these payers will be looking for your ability to send patient data to them and receive it from them, either directly or through an established network. The technology you must acquire is called "Interoperability." The minute you admit to a hospital or physician group that your EMR cannot send and receive patient diagnoses, medication lists, ICD-10 history, and payer information is the day your census begins a decline that will, inevitably, arrive at zero.
Nick Knowlton is Brightree's Vice President of Business Development. He is also one of healthcare's leading interoperability experts. He spoke to us about his five years on the board of the CommonWell Health Alliance and his successful efforts to bring his company aboard as one of the first post-acute members.
CommonWell is a not-for-profit trade association that was formed in 2013 by a handful of competing EMR software companies. They set aside their differences to focus on promoting improved patient care through data exchange standards that would break down silos and facilitate communication among healthcare providers. It has grown since its founding to include most major healthcare technology companies and thousands of care providers, from large hospital systems to local county nursing services.Brightree, a wholly-owned subsidiary of ResMed (NYSE: RMD, ASX: RMD), recently announced plans to make CommonWell's network available to users of its home health and hospice EMR systems. (See "Brightree Announces Access to CommonWell Health Alliance Network," 5/8/19)
Bringing in post-acute EMR members is a key CommonWell development, Knowlton told us. The openness to admit other than hospital and physician software companies, he said, "represents an important opportunity in bridging the gap between out-of-hospital care providers and the broader care ecosystem." Too often, he explained, providers at all levels lose visibility into their patients' care when they enter a post-acute care setting. Bringing post-acute companies like Brightree into the network, with all their home health and hospice clients, makes it possible for hospital and private practice clinicians to know what happened to their patients in their homes as well as at other facilities.
The case for interoperability begins and ends with patient outcomes, Knowlton believes. "Yes, the use of data exchange standards for point-to-point interfaces has evolved into the use of data exchange standards to enable a national, technology-powered network, but its purpose is patient-centered. It enables the unrestricted flow of data that makes each care locale better able to serve its patients. Without a national network to manage all the policy, governance, patient identity and other issues historically inherent to health data exchange, the technology alone cannot solve for patient-centric interoperability."
Knowlton knows Brightree is not the only home care and hospice software company committed to interoperability but he is committed to keeping it in a leadership position. One of the steps toward that goal is to build CommonWell connectivity into Brightree’s EMR.
"When a patient moves from care setting to care setting, their experience is harmed if the clinician on the receiving side does not have easy access to their complete history," he told us. "This escalates to life-threatening when it comes to medication management. Home health nurses are accustomed to scouring a home, looking for medications, vitamins, and herbal remedies that were not on the hospital discharge sheets. But if there is a readmission, or even an ED visit, that nurse's updated, accurate list rarely travels back with the patient. Networks such as CommonWell solve this issue."
Interoperability, therefore, is more than a mere convenience for hospital, rehab, SNF, hospice and home health clinicians. It amounts to a smoother journey for patients moving from care setting to care setting and, on occasion, it saves lives."By including CommonWell connectivity within our home health and hospice EMR, our customers have the tools they need to provide a better patient experience more efficiently, which can only lead to improved outcomes. By including this service in Brightree's EMR offering, we are helping create a better future for our providers and patients."
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org