As the new Center for Medicare and Medicaid Innovation gears up to begin operations as a driver of more efficient models of delivering health care, various providers have been describing for it the improvements they made to better their systems' quality, many of which rely on electronic health records (EHRs), health information exchange and other technology tools.
The Centers for Medicare and Medicaid Services formally launched the innovation center, which the health reform law called for, last month. The CMMI will direct its efforts and funds toward supporting models that deliver better quality while at the same time reducing costs, according to its director Dr. Richard Gilfillan.
Noting the Institute of Medicine's estimate that there is 30 percent waste in the healthcare system, Gilfillan said the CMMI want to take that waste "and put it to work in other ways."
"We want to do all the things we know we can do to make patients' live better and change the cost curve," he said at a Dec. 16 conference sponsored by the journal Health Affairs.
Dr. Craig Blackmore, scientific director of health care solutions for Seattle's Virginia Mason integrated healthcare system, explained how his organization created treatment paths or value streams to deal with common minor conditions such as low back pain or headache, that nevertheless take up a lot of resources, so that patients could move through the system efficiently and get back to work.
For example, the knee pain value stream takes the best medical evidence and translates it into a standard care pathway. The EHR offers templates, which the physicians contributed in developing, that supply the information for that path.
"You simply can't order an MRI of the knee or the back or the head at Virginia Mason if you don't meet one of the limited sets of evidence-based indications," Blackmore said.
Another provider, Robert Margolis, MD, CEO of HealthCare Partners Medical Group of Torrance, Calif., described what his group has done with information contained in a disease registry on its 70,000 diabetics.
For instance, a provider or payer can identify the diabetics who have heart failure, chronic kidney disease, or poor kidney function and who are not on correct medications, he said.
"The ability to probe at that level and to actually customize care and then tie it to your personal health record and your outreach" is a tremendous capability, he said.
