January 30, 2018 | Written by: Watson Health
Categorized: Blog Post | Value-Based Care
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Q&A with Health Quest’s Kowsilliya Ramnaresh, PhD, Assistant Vice President, Practice Transformation
According to the 2016 HealthLeaders Media Value-Based Readiness Survey, 94 percent of providers say they are currently on a path toward some form of value-based care.
One such organization is Health Quest Systems, Inc., a 501 (c)(3) nonprofit healthcare system located in New York’s Mid-Hudson Valley and Northwest Connecticut. Health Quest is currently participating in value-based care programs offered by the Centers for Medicare & Medicaid Services (CMS).
Kowsilliya Ramnaresh shared some steps her organization has taken to speed its transition to value-based care.
IBM Watson Health: What is your approach to quality, and what are some of the programs that you’ve started to reach your quality goals?
Ramnaresh: We believe in a patient-centric continuum of care. We’ve been addressing quality by guiding our patients, from making an appointment to utilizing specialists within our system and/or the surrounding area. This guidance ensures we have continuity of care.
To do that, we’re in the process of participating in various value-based, quality improvement programs such as Patient-Centered Medical Home (PCMH), Merit-Based Incentive Payment System (MIPS), Comprehensive Primary Care Plus (CPC+), and some of the Healthcare Effectiveness Data Information Set (HEDIS) requirements with insurance companies. Additionally, we’re engaged in other quality initiatives such as the American Medical Group Association’s Together 2 Goal® to improve outcomes for our diabetes population.
IBM Watson Health: What are some of the challenges you’ve faced?
Ramnaresh: We’ve struggled with getting access to data that was both timely and accurate. We’ve also been looking for a partner to help us improve patient care and physician satisfaction. We believe the IBM Watson Health team and the IBM® Watson® Care Manager solution will be able to help us.
One of the reasons that we selected IBM Watson Health as a partner is the ability to get the data in near real time. Other vendors have a one to six months’ delay obtaining quality data, but with IBM Watson Health, the very next day we are able to see reliable data on how our patients are doing.
Another powerful element of the IBM Watson Care Manager solution is that we will be able to see what protocols are needed to improve patient care. Being able to form our action plans based on concrete, current data helps us to better understand our patient population and the impact of physician interactions.
IBM Watson Health: Can you give us an example of how you will put these action plans into motion?
Ramnaresh: When we first started evaluating technology partners, we were focusing on diabetes, chronic obstructive pulmonary disease and heart failure, and how we could improve patient outcomes and increase their overall patient satisfaction. But we had no mechanism of saying, “Who were those patients? When was the last time they were seen in the office? And what protocols do we need to utilize for the patient’s condition to improve?”
Let’s take a diabetes patient, for example, who needs help managing his or her weight. There was no set protocol or guide to follow on how to achieve that goal. Having IBM Watson Health affords us a clear path of best practices so that our providers do not have to start from scratch every time.
IBM Watson Health: What will these changes mean to both your patients and your organization?
Ramnaresh: We believe that incorporating these analytic capabilities will help us improve outcomes, provider satisfaction and reimbursement revenue for the organization.
Find out more about Watson Care Manager.
Hear how other leading organizations are balancing the shift from volume to value-based care by reviewing the IBM Watson Health case study library here.