Pars­ing data to im­prove re­sults

Modern Healthcare - - INNOVATIONS - By Beth Kutscher

Most health­care providers re­al­ize they need to get bet­ter at data an­a­lyt­ics to be suc­cess­ful un­der pay­ment mod­els that will re­ward them for im­prov­ing out­comes.

But know­ing where you stand within a group of peers is just part of the equa­tion. The other is be­ing able to use those met­rics to ac­tu­ally get bet­ter re­sults over time.

In some ways, Chicago-based Iclops was a com­pany ahead of its time when it was formed in 2002 with the goal of us­ing prac­tice data to im­prove the health of chron­i­cally ill pa­tients.

Theresa Hush, former di­rec­tor of the Illi­nois Med­i­caid pro­gram, co-founded Iclops with Dr. Tom Dent, a fam­ily medicine physi­cian, to work with physi­cian hos­pi­tal or­ga­ni­za­tions. They brought on board de­vel­oper Ge­orge Her­nan­dez to hone the tech­nol­ogy side of the busi­ness.

By 2008, Iclops re­ceived CMS ap­proval as one of the first 12 clin­i­cal-data reg­istries that could report for the physi­cian qual­ity-re­port­ing sys­tem, the CMS ini­tia­tive that links physi­cian pay­ments to qual­ity met­rics.

Its CMS des­ig­na­tion as a qual­i­fied clin­i­cal­data reg­istry al­lows it to do more-so­phis­ti­cated data anal­y­sis, such as track­ing trends over time. Iclops has pa­tient-level data, which al­lows it to fac­tor in vari­ables such as a pa­tient’s med­i­cal his­tory, life­style and so­cioe­co­nomic sta­tus.

Data reg­istries aren’t new, but Iclops aims to pro­vide the tools to al­low physi­cians to make changes that af­fect out­comes.

For in­stance, it’s good to know that your read­mis­sions are in­creas­ing, but that won’t nec­es­sar­ily help you iden­tify why, Hush noted. “You at least need to know if it’s a sys­temic is­sue or a se­ries of one-off prob­lems,” she said. “What we try to do is pro­vide a mech­a­nism to make that avail­able to them.”

Many pop­u­la­tion health pro­grams fo­cus on get­ting pa­tients in the door and track­ing a sin­gle mea­sure, such as A1C blood-glu­cose lev­els in di­a­bet­ics, Hush said. But they don’t pro­vide the lon­gi­tu­di­nal in­for­ma­tion nec­es­sary to see which in­ter­ven­tions are work­ing, such as whether a par­tic­u­lar care-man­age­ment pro­gram has been ef­fec­tive.

“When you start look­ing at those out­comes, you don’t see im­prove­ment; you see a steady, flat line,” Hush said.

One study Iclops cites is a 2014 pa­per in JAMA that looked at out­comes for a med­i­cal home pi­lot. The med­i­cal home did lit­tle to re­duce the uti­liza­tion of hos­pi­tal or emer­gency room ser­vices and did not lower costs, the au­thors found.

“The data in health­care is just now com­ing to the cusp of ma­tu­rity,” Hush said. “We’re look­ing at how we use out­comes over time to ac­tu­ally ef­fect change.”

Bene­fis Health Sys­tem in Great Falls, Mont., be­gan work­ing with Iclops in 2013 as it was form­ing its own med­i­cal group and look­ing for ways to align more closely with com­mu­nity physi­cians.

The sys­tem has been us­ing Iclops’ bench­mark­ing tools to de­ter­mine which qual­ity met­rics to report to the CMS un­der the physi­cian-qual­ity re­port­ing sys­tem. Providers that report PQRS data through a reg­istry like Iclops are al­lowed to pick and choose which met­rics to in­clude—al­low­ing them to share only the mea­sures where they’re per­form­ing well.

But the soft­ware also al­lows Bene­fis to iden­tify ar­eas where there’s room for im­prove­ment.

One ex­am­ple was smok­ing ces­sa­tion. “What we found is that the nurse or nurs­ing as­sis­tant would ask about smok­ing,” said Julie Wall, Bene­fis’ di­rec­tor of nurs­ing and in­pa­tient spe­cialty providers. “But the provider never took it to the next step in coun­sel­ing the pa­tient. With our elec­tronic health record, we couldn’t re­ally cap­ture that. But Iclops can.”

Another was med­i­ca­tion rec­on­cil­i­a­tion, or mak­ing sure that the drugs pa­tients are tak­ing match what’s in their med­i­cal record. Iclops’ tech­nol­ogy al­lowed it to de­ter­mine which providers were meet­ing the mark and which weren’t. “It’s just a great tool to drill down and do case re­view,” Wall said.

The typ­i­cal Iclops client is a med­i­cal group with about 200 physi­cians em­ployed by a health sys­tem. But the com­pany also works with free-stand­ing physi­cian prac­tices.

Iclops is pri­vately funded and does not dis­close rev­enue.

This year, the com­pany’s clin­i­cal-data reg­istry will be el­i­gi­ble to col­lect Medi­care claims in­for­ma­tion, pro­vid­ing it with even more data. Its tech­nol­ogy also will ful­fill the pub­lic health re­port­ing re­quire­ments un­der mean­ing­ful-use stages 2 and 3.

“There’s a feel­ing among providers that if you sim­ply show them the data, they’ll self­cor­rect,” Hush said, adding that what Iclops is able to do is get “un­der the hood.”

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