The extraordinary view
Martie L. Moore, RN, MAOM, CPHQ
"Transforming the views of healthcare by looking through the different lens of change"
(Part one of three)
The macro view of healthcare change
As an amateur photographer, I am in awe of those who can capture a glorious sunrise with the hint of fog kissing a river, just as a bear catches a fish. They are present at precisely the right moment, or perhaps they are just lucky.
Photography requires the ability to see the larger picture and decide if one should take a macro or micro shot. You must be ready to move and respond. If you think about what is happening in the healthcare setting, it is exactly the same. We must be ready to view the changes at both a macro and micro level, and move and respond accordingly to the moment.
The movement across the nation is a twofold action. The first is the utilization of data in decision-making. The second is alignment of services or networks based upon the data.
In 2013, Dale Sanders published “The Healthcare Analytics Adoption Model: A Framework and Roadmap.” In his model, he proposed that organizations move through stages of analytical adoption, such as using data for internal reporting to automate external reporting of data. His theory is that healthcare organizations will become more sophisticated in their utilization of analytics, and the data will drive population health management, clinical risk and predictive analytics to personalized medicine. His model rings true, as population health management has exploded across the nation.
Sanders then goes on to address the business aspect of how data would be utilized. Accountable Care Organizations, Value Based Payment, and bundles are the way of reimbursement, all based upon data. In today's environment, data now drives contracts and who is in/out of networks.
But is data more of an acute care phenomenon? Big data, which refers to collection of data sets so large that it becomes difficult to process using on-hand database management tools, has mainly been associated with EMR implementation and meaningful use, thus it is easy to see data through the lens of hospitals.
So I encourage you to change your viewing lens from a micro view to a macro. Depending on the market you are in and the level of sophistication of the health systems you are working with, healthcare organizations are — or soon will be — looking at data across the continuum of care. They also will be viewing data through the lens of transition, instead of episode.
How do you assure that you are ready for this change?
The first action is to become comfortable with the setting. Just as a photographer knows what is needed for the perfect shot, a healthcare leader should know what data is available and how to use it to achieve clinical and financial goals.
They must also know how the data informs actions of caregivers and leadership. Utilizing control and run charts to monitor key performance indicators provide an informed way of looking at outcomes. If utilizing data for quality improvement and clinical actions is unfamiliar, seek out additional education and training. A good resource for clinicians is a book written by Drs. Kimberly Glassman and Peri Rosenfeld, “Data Makes the Difference: The Smart Nurse's Handbook for Using Data to Improve Care.”
The second action is to set up the shot. Photographers have been known to move a log or even a blade of grass in order to take the perfect picture. Likewise, in this era of care transitions, you need to set up the scenario that aligns you with the right partners in this new era of care transitions. You must utilize your data to demonstrate the performance of your organization through exemplars. Be ready to show how you use the data for process and quality improvement.
As you align within networks of healthcare systems like ACOs or IDNs, you will need to align your facility's strategic goals with your partner's goals. For example, if one of the goals of the health system is reducing infectious disease, align your goals to theirs and demonstrate your organization's performance through the data. Negotiate contracts that allow for data and information sharing. It is through transparency that data can be used to inform patient care and outcomes.
The third action is to focus. In this case, align practice guidelines across the continuum of care. Utilizing data to reduce variation and provide a standardized approach to care can not only improve quality, but also drive down healthcare costs. This may be hard work, but it is the right work. As patients transition from one care setting to another, there should not be a change in the approach to care just because of a change in physical setting.
Think about all the possibilities that the lens of data offers us. In a world of fragmentation, this change is pushing healthcare delivery systems toward coordination and accountability. The same way a photographer uses a special lens to capture the image she intends, we must use the lens of data to capture the information we need to become stronger partners so we can understand what is occurring in our own facilities and how that impacts both our patients and our peers.
Data will help guide and inform us on best practices, evidence-based standards and thinking of care within a new frame, ultimately creating a better image of the healthcare landscape we wish to see.
Martie Moore, RN, MAOM, CPHQ is the chief nursing officer at Medline Industries Inc., the nation's largest privately held manufacturer and distributor of medical supplies and clinical solutions. In addition, she is a corporate advisory member for the American Nurses Foundation, the philanthropic arm of the American Nurses Association (ANA).