Merging clinical and operational data to drive performance improvement
In this interview, Fiona McNaughton of IBM Watson Health discusses the importance of combining clinical and operational data so that providers can understand areas where they can improve.
FIONA MCNAUGHTON OFFERING MANAGEMENT, VALUE BASED CARE
Fiona McNaughton oversees offering management for IBM Watson Health’s Performance Management solutions focused on the cost and quality of care. She has been with IBM Watson Health and formerly Truven Health Analytics for 13 years.
Why is it important to understand the drivers of risk, cost, and quality care?
FM: I would say that the pressure to deliver high quality care at an affordable cost, or an affordable price, is not going to go away, nor should we want it to. It doesn’t matter whether you’re in a fee-for-service or value-based environment, or straddling both, which is what we see in a lot of cases. That pressure between cost and quality is always going to be there. Understanding the drivers behind what’s contributing to your cost, quality and risk becomes more intense as you’re looking at taking on risk. If you don’t know what’s driving your costs and outcomes, and you don’t understand where you have opportunities to improve, it becomes difficult to effectively assess risk and whether it would be appropriate to go into something like an alternative payment model or risk-bearing contract.
What comparisons are useful for extracting the maximum insights from these kinds of analytics?
FM: When you’re measuring how well you’re doing, measuring your performance alone just tells you what you’re doing. It doesn’t tell you how well you’re doing. It’s not until you start comparing your performance that you can really understand how well you’re doing.
When we’re doing those comparisons, you really need to do a comparison based off a level playing field. You should compare against other hospitals with similar organizational characteristics, or populations with similar patient risk and severity.
What technologies can help providers understand and assess their risk, cost and quality of care?
FM: I actually think it’s less about what tools are available, and more about how you discern between them. We frequently see hospitals and provider organizations supplementing their existing systems with additional technologies that meet very specific targeted needs around things like performance improvement, population management or clinical outcomes. That can get really confusing if your analytic insights aren’t coming from a consistent and reliable source, or if you don’t have a centralized analytic strategy. Providers need to bring together those actionable insights in a consistent way, so that they have a single, reliable source that they can use to make decisions.
How can emerging technology help providers succeed in both fee-for-service and value-based care?
FM: We’re really seeing that need to pull together the different dimensions of how you think about performance, and the drivers behind the performance, so that you get that more comprehensive picture, and you can see how things interact together. I would say that particularly, in the shift to value-based care, we’re seeing a lot more attention being paid to quality outcomes by stakeholders across provider organizations than may have previously been seen in years in the past. With that, we’ve found a lot more requests for quality and financial metrics to be available in an actionable, acceptable and consumable way for various stakeholders throughout an organization. •