A 2018 survey of 100 health system executives adds to our knowledge about what EHRs are capable of delivering in value-based care – and what they aren’t.
Being in charge of a large system or ACO in this margin-sensitive, M&A-fueled environment is a difficult job, plain and simple. This survey provided a glimpse into how well executives are dealing with value-based care (VBC) models, and what technologies they’re using to achieve their goals.
The good news? All responding healthcare execs are participating in some type of VBC program and 75 percent are realizing a return on their investment.
The survey focused on EHRs and population health management (PHM) or analytics platforms. Who has what, what’s working, what’s not and what are the needs, all toward getting systems to move up the VBC contracting maturity curve.
You can read the entire survey here. Or, if your time is short, you can also view our infographic or watch a short video that summarizes the key findings.
The survey respondents were 100 executives operating health systems as IDNs, multi-specialty practices, hospital-based systems or ACOs. A full 87 percent of respondents were CEOs, CIOs, COOs or CFOs.
VBC efforts are paying off
We weren’t surprised to learn that about 70 percent of respondents were participating in ACOs. I’ve recently written about why it’s so important for the health IT industry to support ACO structures.
The survey reveals the limitations of EHRs and describes how execs are building on their EHR with data aggregated from a wide variety of other sources and systems. Sixty-four percent said EHRs alone are not delivering critical VBC capabilities, and less than 25 percent think EHRs can deliver on the six core needs KLAS has identified as essential to population health management:
- Aggregation
- Analysis
- Care management
- Administrative/Financial
- Patient engagement
- Clinician engagement
These numbers align with the most recent KLAS PHM report, in which EHR customers also cited poor performance across those verticals.
Third-party solutions bridge the gap
While EHRs are limited, 65 percent said they are not likely to pursue an EHR replacement in the near future. That’s good news because the high cost of ‘rip and replace’ is not essential today when third-party PHM and analytics systems can integrate data far less expensively and in far less time.
About the same percentage – 60 to 75 percent – are seeking a third-party solution to integrate with the EHR. That means a PHM/analytics solution to enhance the existing system. Some executives are waiting for their EHR vendor to deliver, some are finding current EHR upgrades lacking and some are looking elsewhere.
Disparate systems make data management a challenge
A major challenge is the number of disparate EHRs a given system may be operating. We have customers with more than 20 EHRS, causing them to seek a solution overcoming interoperability, data readability and other data management issues.
The survey notes that execs are turning toward agnostic analytics solutions purpose-built for aggregation, mapping and all the KLAS verticals. To be fair, the survey also notes that the PHM market is still evolving, as 50 percent with an analytics platform say they are likely to switch platforms within the next three years. This is precisely why vendors need to act like partners with customers and prospects, by drilling down into the specific needs matched to specific risk contracts and specific business goals.
Top VBC challenges
It was no surprise that EHR interoperability tops the list, with 42 percent citing it. This speaks again to the challenge of aggregating all types of data, reading and analyzing it, move longitudinal charts to where they are needed when they are needed, and ultimately serving as the engine for quality reporting. Other top challenges, which align with KLAS verticals, included:
- Patient engagement
- Stakeholder coordination
- Data analytics to support risk-based contracts
Seeking social determinants of health
And what makes this survey so timely is the area ranked as the second highest value-based care challenge – the need to incorporate social determinants of health data into our insights. This tells us that executives understand the important role social determinants can play in care gaps and planning. They are taking it seriously and seeking solutions.
This is an area we’ve been talking about for a long time, both in our white papers and webinars.
And Philips Wellcentive is excited to be bringing a social determinants integrated solution to market this year.
Segmenting analytics needs
Respondents also articulated where they see current platforms failing, and which capabilities they are seeking beyond their EHR. Seventy-five percent or more of C-Suite executives aren’t relying on their EHRs to deliver on the following capabilities:
- Risk stratification
- Aggregation from disparate EHRs
- Quality program optimization
- Patient engagement
- PHM analytics
Similarly, between 30 and 59 percent use non-EHR technology for the following functions:
- 59 percent – quality program optimization
- 45 percent – risk stratification
- 41 percent – data aggregation
- 44 percent – patient engagement
- 40 percent – analytics
- 32 percent – social determinants of health
It was surprising that 59 percent don’t use the EHR for quality program optimization. That’s a priority need of health IT technology in the value-based care era. This speaks to the need for vendors to increasingly collaborate with their mutual customers, or everyone in health IT loses.
Finding purpose-driven, modular solutions to address these challenges are critical components of future success, especially to meet the growing needs of health systems as they manage increasingly more risk-based contracts.
