Building on Meaningful Use: Three Opportunities for High Performance

Four-fifths of the nation’s hospitals, and 41 percent of office-based physicians intend to take advantage of federal incentive payments for adoption and meaningful use of certified electronic health records (EHR) technology, according to a January 2011 survey released by the Office of the National Coordinator for Health Information Technology.¹

The imperatives are clear, and the bandwagon is chock-full with believers of meaningful use. But does the value stop at incentive payments and avoiding future penalties?

Those who see meaningful use as a burdensome IT exercise, or an opportunity to reap windfall profits from the federal government, will find themselves left behind. High performers are exploring new opportunities to get to value. By using the journey toward meaningful use as a mechanism to drive operational and clinical value, hospitals will actively engage in shaping the future of their industry. Furthermore, those who better understand that the road ahead is long and meandering will strive to stay agile, adapt to the pipeline of changes and actively pursue long-term opportunities to improve return on investments.

¹http://www.hhs.gov/news/press/2011pres/01/20110113a.html

As a follow-up to the 2011 research Accenture conducted with CIOs from select US health systems with advanced EMR use, Accenture reconnected with the CIOs interviewed to see how they have progressed along the meaningful use journey. Accenture found that leaders are hunting for value catalysts as they take further steps to embrace and adopt meaningful use. One CIO said: “Meaningful use is one of the lower bars that hospital organizations need to hurdle in the coming years.”

To prepare for the increasingly competitive and cost-conscience marketplace, leading hospitals are making key investment and strategic decisions to better succeed in the new regulatory environment, drive down operating costs and improve quality of care.

Accenture’s 2011 research into the key items necessary to achieve meaningful use revealed several opportunities to operate more efficiently, at a lower cost and to serve patients better than ever before. These include:

Value-based purchasing: Beginning in October 2012, Medicare will reward hospitals that provide high-quality care for their patients through the Hospital Value-Based Purchasing Program. In FY 2013, it is expected that this program will distribute an estimated $850 million to hospitals based on their overall performance on a set of defined quality measures linked to improved clinical processes of care and patient satisfaction.² To prepare for the changes in calculation of diagnosis-related group (DRG) payments, hospitals have begun benchmarking certain quality measures to start tracking their relative performance.

ICD-10: The October 2013 deadline to replace ICD-9 code sets used to report medical diagnoses and inpatient procedures with ICD-10 code sets is fast approaching. Most healthcare providers are not ready for the change and do not have plans to pilot the changes until 2013. Forward-thinking organizations are preparing now and have accelerated preparation efforts to help address anticipated organizational, system and process changes.

Alternative care delivery models: On October 20, 2011, the Department of Health and Human Services (HHS) announced that by choosing to become Accountable Care Organizations, providers will be able to share in savings by better coordinating patient care, providing high-quality care and using healthcare dollars more wisely. The higher the quality of care providers deliver, and the greater the effectiveness of their care coordination, the more savings they earn. Federal savings could reach $940 million over four years.³

Technology outsourcing: Many healthcare providers have made colossal investments in implementing new infrastructures. While these investments are critical, the related expenses continue to deal a blow to the bottom line. Those seeking to reduce operating costs are finding ways to lower the cost of infrastructure maintenance. Some are opting to push system upkeep back onto the vendor.

Revenue cycle management: With integrated, automated revenue cycle management, hospitals can improve financial performance and capture savings by remedying lost charges, delayed payments or underpayments. Leading hospitals are going one step further and using the business intelligence yielded through the integration of financial and clinical information to gain more insight into operating costs so see where they are making or losing money.

Healthcare 2.0: Leading healthcare organizations are shifting toward Web-based delivery models to deliver services faster and cheaper. Hospital organizations and leading vendors have indicated a 3- to 5-year timeframe in developing robust Web-based, thin delivery models. Regardless of the timeframe, applications will continue to be pushed to the cloud with thinner, customer-friendly devices for providers to deliver care.

Analytics and reporting: Enhanced analytics and reporting tools better enable real-time clinical decision-making and drive operational efficiencies and insight-driven health. Leaders are building metrics for specific business units within the organization to track and quantify progress through one aggregated picture. Scorecards and dashboards illuminate information so it’s reported in a consistent way to the correct audience in the correct timeframe.

Patient-centricity: Comprehensive, patient-centric, user-friendly consumer portals are helping clinicians to better coordinate and delivery higher quality care across the continuum. By tracking the end-to-end healthcare experience, providers have a more comprehensive picture of the patient at every checkpoint. This information can guide decisions about medications to prescribe, treatment plans and preventative measures that will help patients live healthier and avoid relapse or readmission.

Connected health: Connected health goes beyond the management of patients’ clinical data to encourage communication and collaboration among the various stakeholders involved in a patient’s health. Ambitious providers are using connected health to help seamlessly connect to a healthcare delivery system so that critical health information is generally available when and where it is needed.

Data interoperability: While there has been a shift away from best-of-breed solutions, hospitals recognize that a single EMR system is not an end-all solution. There is a need for cross-EMR system data interoperability that will enable population-based healthcare.

²http://www.healthcare.gov/news/factsheets/2011/04/valuebasedpurchasing04292011a.html
³http://www.healthcare.gov/news/factsheets/2011/10/accountable-care10202011a.html

Accenture’s 2011 research into the key items necessary to achieve meaningful use revealed three primary opportunities to operate more efficiently, at a lower cost and to serve patients better than ever before.

Opportunity 1: Winning in the new regulatory environment

Legislation established to support affordable, quality care for patients not only aims to help the overall patient population, it can help providers. Leading healthcare organizations are moving beyond meeting the baseline mandates to maximizing value from these new guidelines for delivery of care. The necessary investments to operate in the new regulatory environment are unavoidable costs, so leading hospitals are thinking ahead and understanding how to drive additional revenue, improved outcomes or lower costs from the same investments.

Accenture learned in its research follow-up that to understand the requirements of operating in the new environment, a leading southwestern hospital has aimed to “understand the criteria of next-generation care delivery models,” identify the common IT requirements and determine organization-specific IT investments for winning in the long run.

Opportunity 2: Reducing operating costs

In today’s strained economy, what provider is not striving to do more with less? Healthcare organizations worldwide are seeking new ways to cut costs or work more efficiently, using technology as a key enabler.

Opportunity 3: Improving clinical outcomes

Every healthcare organization is focused on delivering the best patient care possible. Technology and new tools for integration help clinicians to make better decisions, deliver better care and, ultimately, drive better outcomes.