Tackling value-based care head-on with athenaOne

Christine Fulton is the Director of Clinical Informatics of Southern New England Health Care Organization, a clinically integrated network organization. Read on to learn how athenahealth supports real-time data and reporting, helps close care gaps and manage patient panels, and strengthens value-based care operations through a unified platform and customer support.

Q: What is your organization’s mission, and what does success in value-based care look like?

A: We are really dedicated to helping the independent practitioner stay independent. Our goal is really to give the best quality patient care across all of our specialties, including primary care, pediatrics, cardiology, nephrology, etcetera.

We measure success in many different ways. We do utilize standard HEDIS and CMS quality measures, to gauge our quality performance, as well as financial success in terms of shared savings, but also physician engagement and keeping those practitioners independent, and be able to run their practice the way that they want to.

We measure our success really from a patient care perspective. Obviously, there's the total cost of care from a financial perspective, reducing unnecessary utilization, but also quality measures depending on your chronic diseases, diabetes care, and hypertension management. But also, preventative care, like bringing our patients in every year for annual wellness visits.

Q: How does athenahealth support your quality program goals?

A: athenahealth, from a real time clinical data perspective, has been invaluable to us. As we know, claims are lagged and so you could run generic reports on patients, whether it be a Care Gap list or of patients that need to be scheduled. And having those claims only reports really delays and overburdens the practice if they don't have the real time data at their fingertips.

Being able to really combine claims data and EMR data from athenaOne and from the Quality dashboard helps prioritize the patients that need the right care and helps to not overburden the practice to have to manually research each individual patient and make sure they're actually in need of that quality measure or that point of care.

Q: Why has athenahealth been a strong fit for your reporting and data needs?

A: You know, we have practices across multiple specialties. We have independent practitioners. We have an employed group. This allows us to – one, from a best practices standpoint – implement standard documentation so that everyone's capturing data in the same way across all patients specialties and groups. But then also being able to report on that level.

It's important for each individual provider to be able to see the reports on their patient panel. It's important for the groups to be able to see data on their groups level, but it's important for SoNE to be able to run reports on a network-wide level. And athenaOne allows us to be able to run reports at different hierarchies and really achieve all of our operational goals, depending on who you are in the organization and what your priority is.

Q: How are you using athenahealth to help close care gaps and engage patients?

A: The first thing we did was build our Quality dashboard and we picked our key performance Quality measures across our contracts from a network perspective, to be on the Quality care tab so that every provider, when they bring up their patient's individual chart, they can see that. That was step number one, is to be able to just really communicate the key measures that the patient is eligible for or is in need of at the time of the visit.

And then individually sort of working with the practices to create processes and reporting around on a higher level, bringing patients in, utilizing appointment ticklers, all of those things, the patient outreach, the portal to be able to communicate outside of an individual encounter and manage your panel 24/7, 365.

Q: How does athenahealth help improve operational efficiency?

A: Having that real time, Quality dashboard and reporting dashboard within athenaOne is really helpful to balance against those more lagged or claims-based reports. And as we grow in athenaOne, being able to integrate more. With every release comes a new capability from athenaOne, to be able to better integrate that data, so that you're not manually merging, but you're able to pull in data from outside sources and communicate that one-stop-shop for your providers. And so that's been key for us.

From an annual wellness visit perspective, being able to have that data in athenaOne and be able to run reports to show, hey, you're at an X percent compliance rate with annual wellness visits, but you have another 25% already scheduled. And this is the actual key group that you need to work on. These are patients who haven't been in this year or for an annual wellness visit, and who also aren't scheduled. So, it's really allowing us to better prioritize which patients need to be seen and really help the practices understand who they need to call and what they need to do that specific day, rather than do a lot of manual work to figure that out.

Q: What value does athenahealth provide beyond the technology itself?

A: The CSM relationship has been key for us, especially being newer to athenahealth. So having our CSM has been invaluable in meeting on a monthly basis, reviewing those individual practice reports, and identifying opportunities so that we have speaking points with those providers and with those practice managers to be able to help them optimize their workflows and their office operations.

There are always things that come up, that maybe require a ticket or maybe require some athenaOne support, and certain things need to get escalated. So having that CSM relationship who really understands our business operations and the way that we like to function as an MSO helps escalate certain things in a timely fashion. I've had really great success with our CSM and building that relationship.

I have learned early on to just bounce any idea off of the CSM, because they can help us navigate the correct way. She really does help us navigate who to talk to, what things to get enrolled in to optimize and achieve our success.

The coaching calls have been invaluable. There are Quality, there are value-based care ones, there are clinical ones. We've used them multiple times. Before you're even fully live, they have met with us. And really I was able to sort of explain our programs, whether it be clinical value based programs or day to day operations from the providers, and really be able to help us set up our programs right on day one, of go live to achieve what we are setting out to do.

With any EMR implementation, you have some roadblocks, you have some providers that need that extra help. That [support] has been invaluable. And the implementation team as well, was invaluable to us and really set us up for success.

Q: What barriers still create friction, and how is athenahealth helping address them?

One of the biggest barriers, is the integration of information. athenahealth is doing really great things with us. Between your health payer data exchange program and being able to bring in sort of outside data sources and utilizing APIs, which is something that quite honestly drove us to athenaOne. Because anyone who's in the value-based world or the ACA world or the MSO world knows that you get information from tens of different places, payers, health information exchanges, other EMR, the actual EMR.

A big topic has really been around, panel management and real-time data. There are opportunities to manage our panels outside of a 15-minute appointment and being able to integrate multidisciplinary care across one patient chart. All of our providers set out to provide the best quality care. We just need to give them the information and the tools to do that. But again, athenaOne has been really great. And utilizing the tools and the reporting to be able to drive that quality clinical care and bring in some insights from outside sources has broken down that barrier a little bit.

Q: What stands out most about the athenahealth experience overall?

A: Some of the biggest things that we love about it is the frequent updates and upgrades, the ability to participate in alphas and betas. I've worked in multiple institutions with different EMR, and I've never had a support community so robust where you kind of have ideas and upload ideas and participate in User Groups and come to Thrive. And so, [it’s valuable to] really be able to communicate with other customers and get best practices from other people.

The ability for an MSO to manage their instance of athenaOne has been hands down, such a benefit for us. And it's allowing practitioners to manage their own business, but also for us to implement standard best practices, documentation and quality reporting across independent and employee groups. So that's been just such a success for us. And it's been really a really great year.