End-to-End vs. Individual Solutions

Paul BergesonI saw a movie last week in which two actors gazed in wonder at a large abstract painting until the main character deadpans, “I like incongruity.”

Incongruity is great if you’re Jackson Pollock, but it’s the last thing any healthcare provider wants when it comes to the technology that helps them do their jobs.

Clinicians need tools that adapt to and fit into their existing workflows without adding extra steps – no matter how great the promised upside.

From the very beginning, Lightbeam’s vision was to avoid incongruity at all cost. Our objective was to offer healthcare providers all the tools within all the segments they would need for total, comprehensive population health management to avoid the common trap of cobbling together multiple vendors and their software that address pieces of population health, but not everything.

So, what providers end up with is risk stratification from one vendor, care management from another, and claims analytics from a third. Instead of the optimal “one throat to choke,” they not only have several throats, but when challenges arise, the vendors spend time and energy pointing fingers at each other instead of solving the provider’s problem.

This scenario is not only an administrative and operational nightmare, but it also risks the quality of care provided to your patients, thus unnecessarily risking your scores on Medicare, HEDIS and other quality measures.

Complicating an already complex situation is the fact that many software and data analytics companies have rushed into the population health segment without much experience. Basically, two types of population health companies exist in today’s market: 1) traditional claims analytics companies that have evolved into becoming population health and trying to learn about clinical data aggregation and extraction, which is very, very difficult for somebody without a clinical background; and 2) EMR vendors that are growing to become population health management vendors. They may work well within their own ecosystem, but many, if not all of them, have enormous difficulty consuming a post-adjudicated claims file, and have an equally tough time interacting with other EMR vendors who, on the whole, do not make data sharing an easy process.

Some vendors – particularly behemoths with boatloads of cash to spend on acquisitions – are buying up competitors specializing in complementary areas of population health, then trying to cobble them together into a solution that can be pitched as “end-to-end.” While the acquired companies’ brand names may go away, their software doesn’t – it’s still a situation where proprietary platforms live in silos and rarely integrate well or smoothly from a technology perspective, and most definitely not from an end-user perspective.

Connecting these disparate systems via APIs or other interfaces are half-measures if you’re the clinician, health group, physician practice or ACO trying to use them. It’s a cumbersome process common with vendors who have cobbled together disparate systems, and it often requires users to have multiple sign-ons and multiple applications open simultaneously to accomplish what should be a one-click action.

The key to giving healthcare providers the tools they need to manage their population’s health – especially under value-based care where you’re carrying a much heavier financial risk for those populations – is to have a truly integrated workflow between modules, including care management, claims analytics, patient engagement, risk stratification, and data warehousing.

For example, in a non-integrated environment, it’s possible to pass some data back and forth, but the ability to drag and drop and move between modules and applications seamlessly isn’t easy or really possible, and it’s what healthcare providers truly need.

With “incongruity” in your population health solution, here’s what you face: You’re in the risk stratification module and see the patients to be grouped, then you click the API single sign on to get to care management, then need to look at what you just found and manually log that into care management. Now you must make another link between care management and claims analytics. It’s a lot of overhead and pain, and you’re still years away from where you need to be, unless it’s software totally integrated and written by the same company.

With a single, inherently integrated solution with population healthcare modules like Lightbeam, there’s one link between risk stratification and care management. Lightbeam users can identify a group of high-risk patients with particular care needs and immediately move them into care management with a button click.

Among the most critical challenges for healthcare providers is making the best possible choice when partnering with technology vendors. But as consolidation continues throughout healthcare, whether it’s hospitals, physician practices, IDNs or technology vendors, it’s harder to know what kind of engine is under the hood.

Fortunately, there’s a fairly simple solution to this challenge when it comes to population health solutions – ask vendors the right questions (despite how uncomfortable it makes them), whether during preliminary contacts at a conference or tradeshow or as part of a product demo.

In my next blog, I’ll detail the questions to ask prospective population health partners so you can find out what they’re actually offering and how well, or poorly, their “end-to-end” approach functions.

As for the movie – “The Accountant” – I’m glad our CPAs are much more gentle than Ben Affleck’s character . . . and I definitely think we should keep incongruity out of healthcare and in realm of Jackson Pollock, where it belongs.

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