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Briefing Congress on the importance of interoperability

Editor’s note: On June 7, 2016, Allscripts client Stephen Nuckolls, CEO of Coastal Carolina Health Care (New Bern, North Carolina, U.S.A.), was a panelist at a Congressional briefing on interoperability hosted by the EHR Association. This blog post shares some of his comments at the briefing, which covered successes and areas for improvement with health information technology.

It’s an honor to share with Congress a first-hand account of how we’ve used electronic health records (EHRs) to reduce spending and improve quality. Our medical group, a practice with 45 physicians mostly specializing in primary care, operates a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) that has about 11,000 attributed beneficiaries.

Our ACO has accomplished several positive outcomes since being accepted into the program in 2012, including:

  • Earned recognition as the top performer in the program for cancer screening rates
  • Achieved top 2% for patients rating of their doctor, pneumococcal vaccination rate, and influenza immunization rate, and top 3% for blood glucose control for patients with diabetes
  • Lowered hospital admissions by 22%*
  • Reduced emergency department visits by 13%*
  • Decreased number of hospital readmissions by 9%*

We would not have been able to attain this level of quality and reduction in avoidable spending without a robust EHR. The features in our EHR and dashboard are useful because we obtain information from multiple sources, including clinical laboratories, community pharmacies, radiology providers, major payors and specialists outside our group. Our organization is fortunate that we have good system linkages in place to acquire the vast majority of this information automatically.

“If doctors don’t use it, nothing else matters”

A number of years ago, Allscripts leadership used to say, “If doctors don’t use it, nothing else matters.” To justify the cost of interfaces and integrations, we must always ask ourselves, who is using the information and how actionable is it?  What benefit does that investment offer to our clinical staff?  To our patients?

Fortunately, our EHR and dashboards, powered with data from multiple sources, has provided our clinicians with powerful tools to provide better care for our patients. I believe this type of success was the return Congress envisioned when it passed the American Recovery and Reinvestment Act in 2009. And now, MACRA and other value-based payment reforms are beginning to provide the “necessity” that the Greek philosopher Plato stated was the mother of invention. The technology is advancing, the number of people with necessary skills is growing, and prices are dropping.

Thanks to Congress for helping shape a positive impact on patients’ lives. At this point, in my view, the market seems to be taking over and responding to the incentives now in place, and I think that will be even more the case in the coming years.

* Numbers per 1,000 Medicare beneficiaries from 2014 (the most recently completed year with final performance results), compared with 2011 (the year before starting the MSSP ACO). You can read more about Coastal Carolina Health Care’s success in 6 tips for achieving Meaningful Use Stage 2.

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