As healthcare providers work to improve patient outcomes under growing cost pressure, keeping patients out of hospitals and managing their long-term care in lower cost settings is imperative. However, many postacute care providers are trying to manage care transitions, avoid duplicative testing and procedures and adjust care plans without a full, longitudinal view of the patient's medical records.
This content is sponsored by Option Care.
The more post-acute providers begin to see data as an asset and work with other stakeholders across the care continuum, the better the entire system will be able to control costs and outcomes, which ultimately optimizes the patient experience.
The following executives from Option Care, the nation's largest provider of home and alternative treatment site infusion, gave their perspective on using data from across the care continuum to drive superior outcomes in the post-acute setting:
- John Rademacher, CEO
- Brenda Wright, Senior Vice President, Clinical Services
- Matt Deans, Vice President, Business Development
Editor's note: Responses have been edited for length and style.
Question: What are some macro and micro ways data is being used to drive value for patients?
John Rademacher: As Option Care continues to push forward and look at data as an asset — both as an organization and in healthcare more broadly — there are a lot of indicators that allow us to drive better care and outcomes through the capture and analysis of data. On a macro level, it's looking for pattern recognition in like groups of patients to align care paths more appropriately. At the micro level, we are looking at additional factors that may influence outcomes for a patient — such as socioeconomic factors or comorbidities that may affect their ability to recover — so we can customize their care.
Brenda Wright: In our technology platform, we can develop personalized care plans for each patient centered on clinical evidence-based protocols. We capture results and use that information to improve their plan as care progresses. Through this process, we will create reportable and repeatable outcomes, utilizing that information to continue to refine our care pathways.
Matt Deans: A lot of what we do on the front end is identify trends in patient care and outcomes on a macro level. It could be looking at the impact of the amount of hydration support for a patient with short bowel syndrome, examining innovative therapies to reduce dependence on that support or studying historical utilization and then measuring the impact of our interventions on those individual patients. For example, when we introduced a breakthrough therapy called Gattex®, how well did those patients do weaning off parenteral hydration or nutrition?
Q: What do you see as the greatest untapped opportunity when it comes to using patient data to drive better outcomes?
JR: The greatest untapped opportunity is using data to its fullest. Historically, healthcare — and even within our company and the industry — we've sat on terabytes of data and didn't really make actionable information out of it. We're data rich and information poor in healthcare. Our ability to use pattern recognition and anticipate care trends by looking at data and interrogating it in different ways is going to be where the power is.
BW: The biggest opportunity I see is using those reportable and repeatable outcomes in predictive modeling as we embrace AI. Perhaps, even identifying patients that may require additional monitoring and support, utilizing that information to continue improving our care paths.
MD: With the goal of expanding the use of precision medicine in patient care, we want to understand what therapeutic intervention would be the most appropriate for a patient based on a comprehensive clinical assessment. Unfortunately, we don't always get all of the clinical information we need at admission to use predictive analytical models. For example, today, we are doing routine lab work after initiation of therapy to modify antibiotic dosing for patients— quasi-precision medicine — but it can go beyond anti-infective therapy to other disease states, helping us understand what patients and therapies might be most effective for them in the home or alternate site setting.
Q: What are the biggest barriers to using data to its full potential in patient care, and how can providers begin to work around these challenges?
JR: The biggest barrier is interoperability. A lot of our patients come from an inpatient setting to the outpatient setting. There is a lot of information in their personal health record about the care delivered in the acute setting. The ability to share data and follow that patient on a longitudinal path is a barrier today and also an opportunity. The walls are starting to come down between partners — health systems and payers — as we begin to think differently about how to drive better outcomes and create higher quality care at a more appropriate cost.
BW: Truly our biggest barrier today is obtaining complete data and capturing it in a timely manner. This is a challenge across the entire healthcare continuum, whether you are looking at hospitals, health systems or the post-acute setting. We can successfully overcome this by developing efficient data capture processes and integrating it into the care process, which provides the training clinicians need to understand the value of this information.
MD: The biggest barrier is aggregating and synthesizing data from the different potential sources we may have. That's a healthcare issue not unique to us. How do we integrate, within the entire spectrum of care providers, to have one record, one view of the patient? We need to establish strategic partnerships, exchanging data and building platforms to ensure we are working collectively. We cannot do this in a silo.
Q: How can acute and post-acute providers better support each other in terms of data collection and sharing?
BW: The first step is to make certain the definition of the data is consistent. How we define certain data points is different from one home infusion provider to another. Having that common dictionary across the acute and post-acute environment is important — anything we can do to make communication simpler and not require duplicate entries. At Option Care, we have developed a secure texting and scanning platform so providers can quickly exchange data in a safe manner, however, the ultimate solution would be to have our systems become integrated and able to communicate directly.
JR: The ability for bidirectional sharing of information is the biggest opportunity for Option Care as we look forward. For any of us to spend time retyping information or collecting paper and trying to make it digital doesn't make sense. The more we can find ways to electronically transfer data in a safe and effective way, the more both acute and post-acute providers will benefit.
Q: How can providers be sure they are collecting "the right data" today that will help drive insights tomorrow?
JR: It's starting with the end in mind. Option Care is spending a lot of time right now thinking about how to look at data as an asset. How do we develop a master data strategy and think ahead about some of the data elements we will need to continue to push ourselves forward? It's also having scalable systems along with the ability to expand and add data components as information becomes available. You can't close off and have a hard-walled system that prevents you from adding elements as the market evolves.
The other thing we are doing is working with innovators, in both pharmaceutical and service areas, to get a good sense of how they are trying to build data into their business. The more we can have those collaborative conversations and work together around driving better patient outcomes, that's where we collectively win.
MD: We have a cross-functional team — clinical, operations, technology, business intelligence and analytics, and customer facing teams — really trying to pull together a comprehensive view of what data is both meaningful for our customers as well as what data we need to improve our ability to execute predictive modeling and patient care. We are trying to get at this with the internal cross-functional teams as well as interfacing with health systems, physicians, health plans and drug manufacturers to ensure we are addressing the needs of the future.
Q: How does Option Care's new technology support optimization of patient outcomes?
MD: With Option Care's ability to collect and digitize clinical notes, we will develop and refine care pathways. For example, when we launch a product for patients, we can collect specific data on patients' responses to that therapy at the point of care. This will help us assess our ability to keep patients persistent to that therapy and decide if that therapy is delivering the desired outcomes while managing the underlying disease. Our technology allows us to capture, track and report that data as well as understand the patient's response to therapy. If patients aren't being persistent, what interventions do we need to do, and when? We can assess that data and create other pathways to get to the desired outcome.
JR: We are replacing our entire core technology infrastructure with the idea that data is an asset and we need to keep the end in mind. We are building out a business intelligence and data analytics capability set, which will allow us to do more in-depth data interrogation and pattern recognition, ultimately getting to a point where we have predictive modeling. If we can look at things with predictive modeling and identify where an intervention by one of our clinicians is going to drive a better outcome, that's the future of medicine. It's about utilizing your knowledgeable workers and clinical expertise to its fullest.
Coupled with that, we are doing a lot of work to understand the patient journey. We have a journey map exercise going on to understand those touch points at a patient level, even before they get to us and potentially after they leave us. It's really important to understand what we are passing back to patients, their referring physicians, hospitals systems or pharmaceutical manufacturers. We are looking at all those stakeholders as we design that infrastructure.
Option Care plays a small but important role in the overall way healthcare is delivered in this country. We also recognize that if we can connect with and understand the stakeholders' unmet needs as well as how to work more efficiently with them, we all win.