Becker's Hospital Review

24 Executive Briefing comprehend a date when it is spelled out with the month — Dec. 12, 2020 — versus numerated as 12/12/2020. Simple issues with alignment, like a desktop with off-center tabs, can slow users' reading and comprehension rates. Even use of color matters. When we visually read signs with colors, we need positive contrast between the foreground and background. Poorly contrasted colors result in unnecessary cognitive burden. Allscripts spends a great deal of time assessing how products are used, and its technicians aim for products to be actively helpful instead of passively useful. This distinction inspires other relatively straightforward yet meaningful adjustments for the user. Dr. Teague highlighted several, including strategic icon placement that reduces the amount of time it takes users to research treatment options. The Allscripts team makes these changes knowing that the communication of dates, placement of icons or use of color individually do not significantly move the needle on burden but the collection of these design alterations can positively change the user experience. The team also knows these modifications alone will not solve clinician burnout. Rather, it's users' collective experience that makes these adjustments worthwhile. "Users don't review us on our features; they don't care about the features," said Dr. Teague. "They instead evaluate us on how these features help them achieve their goals. Are they spending more face-to-face time with patients? Can they go home to enjoy dinner with their family?" Population health and creating a smart healthcare community The goal of population health is to create a smart healthcare community, in which care is safe, timely, efficient, effective, equitable and patient-centered. A single hospital will likely define several populations for which it aims to improve health outcomes and behaviors, and the work of maintaining a healthy population is not limited to any one care setting. "Historically, we waited for patients to come to the hospital — it was sick care," said Michael Blackman, MD, medical director of population health for Allscripts. "But if you are responsible for an entire population, you have to care for the people who don't come into the hospital." Rural residents' physical proximity to care is a primary challenge community hospitals face in their pursuit of population health. This obstacle is added to an existing series of economic and demographic shifts that all healthcare providers must account for when executing their population health strategy: 1. Patients are living longer, and they will continue to live longer, which poses challenges to healthcare access and clinicians' time. Clinicians are ill-positioned to care for patients beyond their presenting problem when they only have several minutes for each visit, for instance. 2. Costs are on the rise. The U.S. spends about twice what other high-income nations do on healthcare, largely due to steeper prices for drugs, medical devices, physician and nurse salaries and administrative costs. At the same time, the country has the lowest life expectancy and the highest infant mortality rates, studies have found. 3. CMS is moving to a value-based model, which overhauls how care is reimbursed and how hospitals are funded. Hospitals must know their data to properly assess performance-based contracts and protect their revenue from risk. 4. Healthcare accounts for only 20 percent of a patient's outcomes, while health behaviors, social and economic factors and the physical environment comprise the remaining 80 percent. No one believes population health is achievable through the EHR alone, noted Dr. Blackman. Healthcare providers must account for major socioeconomic, demographic shifts that span well beyond software and health IT. But even still, technology can do more now than it has in the past to bridge the gap in care for these populations. EHRs and other technology solutions have delivered an ample amount of data; now the question is whether organizations are using this data effectively and in alignment with their population health goals. Hospital needs tools that turn available data into information clinicians can use to direct care for patients while also refining the data over time. "You have to take every opportunity you have with the patient," said Dr. Blackman. He noted that every office visit is an opportunity to deliver more complete care, such as ensuring patients are up to date with their preventive care services, such as vaccines, mammographies or colonoscopies. From its position in the health IT environment, Allscripts believes four major components of population health combine to ultimately result in the care outcomes patients experience. These are: 1. Aggregation and interoperability. Is the data combined and normalized? How is the data pulled and analyzed? Is the care team able to discern, from the data, whether the patient has already received the same care at another facility, for instance? 2. Analytics. Is the data leveraged to inform decisions at the point of care? Does the data create actionable information for clinicians? With the right data, hospitals can design interventions based on risk factors and identify patients who need to be monitored. 3. Care coordination. Are high-risk, high-cost patients effectively managed? Optimal care coordination ensures patients do not undergo unnecessary, duplicative administrative work and medical care. "The chances that a patient is only receiving care from a single provider are very slim," said Dr. Blackman. "That's why you hear patients ask, 'Don't you people talk to each other?'" 4. Patient engagement. Are patients involved in their care? When they are, clinicians and care teams are much better positioned to take a holistic view of care and better account for the 80 percent of health determinants outside of the clinical setting.

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