When comparing a private practice with a larger healthcare system, Linda Bosserman, MD, assistant clinical professor and staff physician, City of Hope, said that the challenges can run across the system. These include structuring the clinic to collect the right information from the patients, running the clinic visits, using an electronic versus paper trail of data, among others. “I think the advantage of a larger system is they may have more funding or research grants or other ways to pay for it,” Dr Bosserman said.
She said that team work among the providers should allow physicians to focus more on the patients, rather than spending time entering information in the computer. “I think patients’ biggest complaint is that the doctors are staring at the computer and don't have that eye contact one on one I'm really focusing on your care and your health interaction that's important to patients. How do we balance that?” Dr Bosserman asked.
Clinicians, and now health systems, are interested in best practices, but this requires additional data capture. “How do we balance who is going to pay for this extra data capture that may help us actually take much better care of patients, particularly in cancer, where treatments have gotten so expensive?” Bosserman asked. This makes it essential that we not only avoid futile care, but also ensure the right care to the right patient to improve outcomes, she added.
For health plans, it’s important to have systems that work across all clinical settings, said Jennifer Malin, MD, staff vice president, Clinical Strategy, Anthem. “Even if every practice did have an EHR, the hookups to getting data from EHR are monumentally expensive,” she added. In her opinion, healthcare exchanges would be the best way for a health plan to easily access meaningful data.
What Anthem did was to use its existing data system, used for prior authorization, in tandem with its Clinical Pathways Program, to assimilate data for quality measurement. “They're standard business procedures, and we're able to leverage those programs to get the quality data. It doesn't end up being different for a practice who doesn't have an EHR or a healthcare system because everyone goes to the web portal,” Dr Malin explained.