In our VitalBlog we frequently share our thoughts and opinions on healthcare-related topics.
A VitalHealth PHM Road Trip to HIMSS | Stop #3: Time as an asset
It seems as though the most valuable thing we have is time. Workdays for health care providers are increasingly stressed by the burden of administrative work related to reimbursement or documentation for regulatory purposes. Given the fact that these functions are necessary for a provider to remain in practice it is no surprise that providers feel squeezed for time and patients sometimes feel that their provider is spending more time looking at a computer screen than at them. At the same time new care models are recognizing the importance of patient reported outcomes (PROs) and are even basing a portion of reimbursement upon PROs. What is a provider or health care system to do to address this problem of time?
While clinical outcomes measurement has been a central part of the evaluation of new treatment modalities for decades, the use of PROs has only recently been recognized as a central part of the transition to value-based reimbursement models for health care. Given the issues related to the time available for a patient encounter providers and patients alike have embraced using ePROs (electronically delivered tools to collect PROs) as a potential solution. ePROs can be delivered automatically via the internet using email, automated telephonics or downloadable apps. Many providers have implemented ePROs in a way which complements their current workflow and facilitates incorporation of the PROs into the patient’s visit with their provider. Some have chosen to use the time before a patient is ‘roomed’ to collect PROs via iPads. Others have chosen to utilize email functionality to automate the collection and evaluation of PROs between visits. Solutions which use native apps have also been developed so that PROs can be collected even when a patient is not connected to the cloud. All of these approaches can automate the collection of PROs and help ensure that the time the patient spends with their provider is focused on their major concerns/questions.
PRO evaluation and follow-up
However, automating the collection of PROs is only part of the solution. Having systems which utilize rules to evaluate results of the initial PRO and send additional (non-)validated survey instruments to clarify the issues identified are also a critical part of solving the time problem which providers face. For example, using individualizable rules to reflex to such additional surveys may identify patients who need to be contacted to schedule an office visit or referred to a specialist for care. The ability to identify such situations in the interval before the next regularly scheduled office visit can potentially improve the clinical outcome and the PRO. It also can potentially lower the cost for the patient’s overall care on the basis of identifying and treating complications before they result in a readmission to hospital. The automation of PROs is not only important to address the provider time problem but also to improve clinical outcomes.
Philips VitalHealth has developed ePRO solutions which automate the delivery and evaluation of validated and non-validated survey instruments. The solutions have been shown to save time for providers and are valuable tools from the patient’s perspective as well. These automated solutions don’t replace face-to-face interactions between patients and providers but rather ensure that the time spent in the face-to-face interaction is valued by both the patient and provider.