Clinical integration is a comprehensive, aggregated record of patients’ medical histories – and a perfect example of the value of shared clinical data.
Yet the thought of clinical integration is as perplexing as it is inspiring. Many providers struggle to manage data in their own electronic health records (EHR’s), let alone to integrate data from other systems.
Clinical integration has numerous meanings in health care circles. Some think it means that all providers will use the same EHR. Many think it represents interoperable methods of data sharing among many different systems. Others equate it with the requirements and goals of a clinically integrated network (CIN), such as improved value, physician leadership, best practices, performance improvement, and data sharing.
The gateway to MACRA success lies in integration.
The 2017 introduction of the Medicare Access and CHIP Reauthorization Act (MACRA) reporting requirements provided greater significance to the concept of clinical integration. From the Merit Based Incentive Payment System (MIPS) to Alternative Payment Models (APM’s), it’s evident that leveraging clinical integration provides a springboard for quality improvement and reporting efficiency. Furthermore; CIN’s with a proven track record of clinical data management have demonstrated a strong foundation upon which to build an APM, such as an Accountable Care Organization (ACO).
We observed these clinical integration advantages first-hand among our customers at Clinigence. Whether reporting for MIPS or ACO measures, our clinically integrated customers had higher quality scores than those performing manual data collection. Even more intriguing was the fact that 100 percent of our clinically integrated ACO customers achieved shared savings.
All providers using one EHR is a myth.
These groups had multiple EHRs (and multiple instances of the same EHR). Thus, having a greater number of providers using the same EHR did not ensure better quality scores.
This caused us to take a closer look at the common denominators of these groups’ achievements. We observed two key factors that contributed to their success:
1) The process of mapping to data in the EHR improved their scores because ACO stakeholders became more aware of the measurement requirements and the correlating documentation workflows.
2) Scores were improved when data was automatically extracted from the EHR throughout the year. They were impacted by two primary benefits: real-time progress reports for filling gaps in care, and reducing the likelihood that data would be “missed” during annual reporting for clinical quality metrics.
Common themes we observed in non-clinically integrated projects included charting inconsistencies, more gaps in care, and an increase in the time and efforts of reporting.
Clinical integration and improved workflow turns clinical data into your superhero
These observations helped prove our hypotheses that unleashing the value of clinical integration hinges on an understanding of EHR workflows, an accurate data-mapping process, and engaging providers in real-time quality performance. Shifting all providers to the same EHR platform might not achieve the desired results of clinical integration. An example of this is when there are multiple locations in the same EHR to document information, and all of these possible locations are not mapped into the data aggregation and reporting scheme.