ONC Annual Meeting: NY providers share impact of health IT

Costs for delivering diabetes care dropped 17 percent per patient at Crystal Run Healthcare in Middletown, N.Y., thanks to the implementation of health IT-enabled quality measures, said Gregory Spencer, MD, chief medical officer. He spoke during a panel discussion on health IT’s impact on care delivery for New York-based providers at the Office of the National Coordinator for Health IT’s Annual Meeting on Jan. 23.

When Crystal Run Healthcare shifted its payment model to the Medicare Shared Saving Program, the impact was dramatic, he said. For the first time, Crystal Run clinicians received more granular information on its cohort of patients, including per patient charges and which providers within the system spent the most on patient care.

Equipped with that information, the clinicians decided to reign in diabetes costs and improve care.  “The physicians, nurses, IT people and endocrinologists decided on best evidence-based practices and what we should be doing better. They developed quality measures and tracking through a dashboard kind of capability for the manager,” he said.

The adoption of standardized practices for patients with diabetes, which included specific follow-up plans, led to real results. Charges decreased by $4.2 million, he said. “Although quality scores went up, we were able to save more than 3,000 visits which is about the full-time equivalent of a position’s worth of access.”

Michele Reed, MD—who runs an independent practice in New York—said that though EHR adoption was no easy task, it has proven beneficial. She credited the New York City Department of Health and Mental Hygiene’s Primary Care Information Project with assisting her practice with EHR adoption and Meaningful Use certification.

While Reed’s practice still uses the fee-for-service model, she credited health IT with the ability to better track patients, remotely access the system and run meaningful registry reports.

Adoption of health IT also has improved patient engagement. “I like that my patients are educated,” said Reed. “I like that I can e-prescribe to patients and that they can make appointments online, and I like that patients come in prepared and are as educated as I am.”

She encouraged government stakeholders not to forget the small practices in New York as there are independent physicians who do not think Meaningful Use dollars still exist. “Please approach us.”

Health IT also can help practices, particularly small ones, access their own data and close gaps in care, said Paul Ryder, CP of product management for the New York eHealth Collaborative, a nonprofit working to help practices develop health IT systems and strategies.

He recalled a cardiology practice that suddenly acquired information on which patients’ lipids were in control. “You could see data creating measurable change in the quality of the healthcare of the patients.”

Information exchange plays a crucial role, he says, and especially is beneficial to smaller practices. “I firmly believe health information exchange is a democratization of healthcare and helps physicians decide if they want to be independent or not.”

He said access to data across systems help healthcare organizations better understand readmissions, as they may learn that their patients go outside their systems for emergency care.

Ryder also commented that more works needs to be done in refining HIE-generated alerts. He said alerts need to be pared down so hospitals can meaningfully act on the data and avoid fatigue.