ACO Data Tools Help Boost Prevention, Medication Compliance, Performance Results

By using as many data tools as possible, including EPIC® and MyChart®, and having physicians or their medical assistants contact patients directly if they missed medical appointments or shots, John C. Lincoln Network was able to significantly boost medical compliance and prevention within their population, says Heather Jelonek, chief operating officer, accountable care organizations, John C. Lincoln Network.

Question: What changes did you make in your workflow in 2013 to improve completion of preventive screenings such as flu shots, pneumococcal vaccine or mammography?

Response: (Heather Jelonek) First, we pulled reports out of EPIC to identify which patients had not had their flu shots and scoured the data to find out why. Was it an egg allergy? Was it simply patient non-compliance? Or did we not actually see them the previous year? Then we engaged the physicians. We encouraged the physicians or their medical assistants to get on the phone with patients to say, ‘It’s really important that you come in and you have this. I’ve been looking over your chart, you’ve been on my mind and I notice you’re overdue for your mammogram. Why don’t you come in and let’s talk about it?’

We find that when the physician, medical assistant (MA) or nurse practitioner (NP) is actually engaged with the patient at that level, we see increased compliance. Some patients have traditionally received their flu shots at CVS or Walgreens; we’re not discouraging that, but we are actually reaching out to those pharmacies to find out whether the patient came in and received it. And if the patient hasn’t had the screening, we remind them of the need of the injection and that they’re welcome to come into our office or go to a local pharmacy.

We also have functionality in our EMR called MyChart® so we can send alerts to the patients if they signed up for MyChart reminding them to get their mammogram, colonoscopy, flu shot, and pneumonia shot. We’re using as many tools as we possibly can to engage that patient in their own healthcare.

Source: Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care reviews the concentrated data dig undertaken by John C. Lincoln to prepare for participation in the CMS Medicare Shared Savings Program (MSSP). In this 25-page report, Karen Furbush, business consultant, and Heather Jelonek, chief operating officer, accountable care organization, John C. Lincoln Network, describe the sources combed by the ACO to address operational and technological challenges during the pre-launch period, and how these efforts and resulting data enhanced quality measurement and reporting for the JCL ACO.

This entry was posted in Avoidable Hospitalization, Disease Management, Elderly Care, electronic health records (EHRs), Healthcare Costs, Healthcare Information Technology, Healthcare IT, Medication Adherence and tagged , , , . Bookmark the permalink.
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