PwC: Knowledge culture key to successful clinical informatics programs
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“Outcomes-based reimbursement is the future of the health industry,” read a February report published by the New York City-based consulting firm. “To improve patient outcomes, proactively identify chronic and high-risk patients in this new environment, and effectively manage their financial performance, healthcare organizations must be able to provide analytics at the point of service and rely on historical and longitudinal data to manage patient populations.”
To evaluate the current state of clinical informatics, researchers surveyed more than 600 professionals representing providers, payors and pharmacists to learn how organizations are using clinical informatics and what their efforts have produced.
More than half of the respondents reported having a formal informatics program at their organization, with providers the most likely to report a formal program. Integrating data from multiple sources was the top goal of 73 percent of respondents, 56 percent reported that data standardization was a goal and 86 percent reported that data standardization was a challenge. Survey results also indicated a lack of faith in health information exchange (HIE), with only 17 percent of provider respondents and 16 percent of payor respondents saying they were very confident that their HIE vendor will meet their informatics needs in the next two years.
Based on the survey results, researchers made three key observations: informatics programs face a choice between compliance and innovation; collaboration has resulted in improved informatics abilities; and connecting with patients through informatics has shown mixed results.
Approximately two-thirds of provider respondents said their clinical informatics programs supported their organization’s top goals, such as reimbursement reform, and approximately three-fourths of payor respondents said their clinical informatics goals include product development and new business models. However, a majority of provider respondents said that their informatics staff were preoccupied with compliance, like meaningful use requirements, and they didn’t know what to prioritize.
“With so much more to accomplish in the next several years related to IT and informatics, providers are wondering where they’ll find the funding to comply, let alone compete,” researchers wrote.
Researchers observed more and more data exchange partnerships are developing among healthcare’s various stakeholders, noting vendors are establishing data warehouses and healthcare organizations are beginning to share clinical data across networks. While data exchange should be a feature of all clinical informatics programs, researchers suggested organizations think carefully about the partnerships they develop.
“Before pursuing any potential partnership, all health sectors need to understand the motivations of their counterparts within the industry so they collaborate for mutual benefit,” they wrote. “Healthcare organizations should understand their first motivations in data sharing partnerships might not be IT-related. Most likely, it will be an investment in developing relationships grounded in trust.”
While many believe patient engagement will play a large part in reducing healthcare’s costs and clinical informatics will facilitate their involvement, few respondents reported that they believed their informatics program was affecting patient behavior.
Only 13 percent of providers and 15 percent of payors reported changes in patient behavior. Almost 60 percent of providers and 91 percent of payors reported that improving patient compliance was a goal. In addition, 43 percent of providers and 40 percent of payors said this goal would be difficult to achieve.
Based on their findings, researchers suggested that cultural challenges are preventing healthcare organizations from freeing up their data and they should begin dedicating more resources to informatics, measuring performance, promoting changes in workflow and empowering informatics staff.
“Healthcare organizations must find ways to free their data,” researchers concluded. “Having the right culture in place is critical for organizations to realize the benefits of informatics. This culture ranges from technical when dealing with data integration to clinical when focusing on quality improvements. At the core is a knowledge culture that promotes learning, sharing and innovation.”