1. Scott Helt noted the emergence of patient resource centers that help people learn more about their own health. | 2. Brian Stewart said that accountable health care had to include accountability for both the insured worker and his company. | 3. Gary Stanton cited the high costs of training as an issue for medical offices incorporting new technologies.

 

“I think we’re going to see more standardization,” said Frank Devocelle, president and CEO of Olathe Medical Center. He sees the industry “headed toward best practices.” Although Devocelle thinks this will be good for the patient, he sees a need for a definition of what “best practice” means. “I don’t know if that lies with the insurance companies or government,” he added, “but I think there needs to be some direction given.”

According to Evan Peters, one of the services Cigna has been rolling out across the country is known as a “collaborative accountable-care organization.” With these integrated arrangements, said Peters, “It can’t just be the unit cost you’re looking at. It has to be the outcomes. It has to be the quality. It has to be the patient satisfaction.”

Danette Wilson addressed the evolution of patient-centered medical homes, now in their fourth year of operation in Kansas City. Basically, those are health-care settings that create partnerships between patients and their personal physicians and, at times, the patient’s family. The concept depends on information technology, health-information exchange, registries, and other aids to ensure that patients get appropriate care when and where they need it.

“One of the things we are doing through that model,” said Wilson, “is paying for care coordination, paying for things that carriers have not paid for in the past.” Wilson contended that most carriers recognize that the traditional fee-for-service arrangement will not be sustainable in the future.

Consumer Expectations

Danette Wilson worries about those patients who think the Web is the “source of truth.” She wondered how access to medical information had changed the way doctors approach bringing care to patients.

“Our job,” said Mark Laney, “is to provide the sites that we think are evidence-based and are excellent sources of information.” He added that the health-care industry could not achieve what it hoped to unless it had engaged patients.

Danette Wilson believes, in fact, that patients have been getting more and more engaged. She told of hearing a good deal from consumers about issues like transparency and access to information. She asked her colleagues what providers were doing to prepare for increased customer demands for access to information.

The University of Kansas Hospital, said Scott Helt, vice president of contracting, has already set up patient resource centers with plentiful literature and easy Internet click access to good, trusted information. “This makes it easier for the patients to get information that is validated and is evidence-based,” said Helt, “as opposed to ‘Uncle Harry had the same thing 50 years ago.’”

Evidence-Based Medicine

Christine Wilson, president and CEO of the Mid-America Coalition on HealthCare, sees a constant improvement in the development of evidence-based care. One reason why is that employers in Kansas City are watching its progress very closely. That much said, Wilson acknowledged a substantial lag time between a given innovation and its widespread adaptation. Still, she has been encouraged by the collaborative effort of Kansas City-area providers in sharing information.

Brian Stewart, chief marketing and clinicians officer for the Athletic and Rehabilitation Center in Overland Park, spoke to the issue of collecting information from employers to improve overall service delivery. He cited three reasons for this effort.

One is to create a model of an “accountable consumer” and an “accountable provider.” Two is to review the data
internally to see which clinicians are doing the best job and to partner them with clinicians who could use their assistance. Third is to be able to make planning decisions that are truly “objective.”

Rick Kahle asked his colleagues how they could leverage information to get the best outcomes. Ian Chuang, medical director and senior vice president at Lockton, expressed some caution about the use of data at this stage. Given the inevitable inconsistencies, Chuang suggested that providers define a standard, practice it, analyze it, and figure out if there is a way to do it better by looking at the data. The challenge now, he said, is to tie the clinical data with group data from some of the higher-level employers and assess the impact.