How a Texas ACO saved $50M through an IT partnership

Christopher Crow, MD, is the president of Catalyst Health Network, an ACO based in Dallas, Texas.

The ACO is focused on providing value-based care to members. In May, it added Strive Clinical Network, a group of more than 100 primary care physicians in East Texas, and now has around 650 primary care providers with 220 offices serving around 1 million patients.

Here, Dr. Crow discusses patient data management and making care delivery more efficient for providers.

Question: What are the top data management challenges you hope to solve in the next 12 to 24 months?

Christopher Crow: As a clinically integrated network of 650 independent primary care providers and 85 care team members spread across 220 office locations, our goal at Catalyst Health Network is to always ensure high-quality, affordable care for our patients. However, as an ACO, one of the biggest challenges we face is coordinating care across the continuum, or, put another way, ensuring that we have complete visibility into claims data and patient referrals.

Like a lot of large healthcare organizations, we historically struggled to connect the dots. We didn't know if patients were receiving the care they needed because, believe it or not, a lot of the communication between doctors offices is still being done via fax machine. By the time we received the claims data from the patient's insurance company, it was typically too late; the data was no longer actionable, or reliable. To truly provide our patients with the best care possible, we knew we needed full visibility into our network and that providers needed a more efficient way to communicate between offices outside of the EHR.

To solve this issue, we've been working with the Austin-based healthcare IT company, LeadingReach. All of our providers and staff are part of the LeadingReach Network and use the company's Patient Pipeline Management software to coordinate and communicate about patient care transitions. In the first three years of using LeadingReach, we saved over $50 million in healthcare costs, in part by ensuring patient referrals were kept in network. In the next 12 to 24 months, we hope to drill down further into the patient journey to gain a deeper understanding of the level of care our patients are receiving and identify any bottlenecks in that process.

Q: What is your organizational approach to clinical or patient data registries, and how do you make sure you are getting the right data input?

CC: As I mentioned above, our patient referral management system, LeadingReach, functions much like a LinkedIn-style network; our providers are able to easily and securely communicate with other doctor's offices and can see exactly where our patients are along the continuum. When sending a care referral, providers can easily attach EMR and medical records, insurance information, etc., or can request missing information from the referring provider. This allows PCPs and specialists to play a larger role in shepherding patients along their care journey. It's not just on the patient to follow-through on an appointment referral; providers are accountable as well. Having all of the pertinent information we need in one, integrated platform allows us to easily ensure that no patient falls through the cracks.

Q: As healthcare organizations partner with more vendors and collect an increasing amount of patient data, how do you ensure patient data is secure?

CC: As an ACO, we have many reporting requirements in order to demonstrate that we're providing our patients with the best possible care, while simultaneously controlling costs. Of course, this means we use a lot of technology and security is a top priority for us. We are on track to be HITRUST certified by mid-year 2020. When we're considering a new technology, whether a be an EHR, CRM or other patient engagement solutions, interoperability and security are among our top considerations. We make it a point to ensure that all of the technology and tools that we use are HIPAA-compliant and essentially, trustworthy. We have a lengthy, thorough vetting process.

Q: What do you think are the most interesting opportunities for partnering with big tech companies currently or in the future?

CC: I think big tech companies moving into the healthcare space hold a lot of potential, but currently, a lot of it is still hype. For example, there's no doubt artificial intelligence has the potential to transform patient diagnosis and enable individualized care. But there is still a lot of low hanging fruit to pick now. While most industries abandoned the fax machine in the 90s, it’s still alive and well in healthcare. We need to focus on fixing our communication and care coordination challenges first, so that patients can actually benefit from the new treatments and technologies being developed.

Put another way, while Uber's partnership with Cerner to improve patient access to affordable transportation is certainly a step in the right direction, it's all too likely that only a fraction of the patient's medical history will make it to the appointment, as it's likely stored piecemeal in multiple EHRs that can't communicate. We must accept that EHRs aren't working to coordinate care, but also that they aren't going away. Through our use of this configurable platform, we've proven that increased coordination, communication and visibility into the patient journey not only lowers healthcare costs, but also improves patient outcomes, which is the most important thing we can do for our patients.

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