Category: Clinical Integration

Clinical Integration: 7 Myths and a Blueprint for Success, a white paper from athenahealth, calls attention to three key areas of alignment in order to achieve a successful clinically integrated network. In our early stages as a pediatric-focused clinically integrated network, we are spending time to focus on each of them:

• Incentives: Members of a clinically integrated network work together to establish a clear, measurable picture of success so they know the exact goals and benefits of what they are individually and collectively trying to achieve. CHN’s Clinical Management Data & IT Committee is responsible for selecting areas for focused clinical improvement, as well as developing, implementing and monitoring compliance with evidence-based clinical practice guidelines, designed to achieve high-quality patient care and cost containment objectives.
• Knowledge: One major goal of CHN is to share information across multiple practices in our community, resulting in more coordinated care for our pediatric patients. Collaborating in this way provides an outstanding opportunity for CHN and its members to progress to the next level of integration.
• Behavior: The goal of aligning incentives and sharing knowledge is to produce a change in behavior, one that ultimately results in integrated care for patients that lowers costs. By aligning incentives, sharing information and standardizing processes in active and ongoing management of pediatric diseases, members of CHN will ultimately improve the overall health of our pediatric population.

Health systems and networks are marching toward clinical integration — but if you ask five healthcare experts what clinical integration is, you’ll get 10 different answers.

Most agree that clinical integration aims to stem the loss of reimbursements, find more routes to efficient medical care, and move patients toward prevention and wellness. But what does a clinically integrated network look like? And what does it mean for physicians?

According to industry media that have been tracking the shift, here are 5 strategies commonly found in clinically integrated networks.

1. “Soup To Nuts” Care For Patients

A successful clinically integrated network “links all or most of the health care components a patient might encounter.”1 For example, the network would seamlessly provide a patient with primary care, specialists, hospitals, pharmacy services, and post-acute care.

These areas all share patient data and guidelines about how to treat certain conditions.

“Independent physicians can be a key component,” Hospital & Healthcare News said in January 2015. “If these doctors are not brought into a close relationship with the others, the network’s improvement aims may not be possible.”¹

2. Physician Leadership

It’s critical for clinically integrated networks to empower physician leaders and integrate physician expertise into organization-wide operations, industry experts say.¹

Physician leaders also can encourage communication, dialogue, and partnerships among members of the network. This can further help the network meet its goals and objectives.¹

3. Shared Performance Standards

Clinically integrated networks engage physicians in determining best practices.1 And because physicians who are part of these networks get involved in setting performance data for the network, there is an incentive for everyone to aim high.

These networks also ensure that each business unit plays a role in strategic planning.² Each business unit then sets an action plan detailing how it will contribute to the network’s goals.

4. Shared Savings

A successfully integrated network is better able to increase efficiency and cut costs, while still offering quality care.^2,3 Network members also can benefit from shared savings contracts.¹

Also, providers have access to group purchasing organizations, which offer medical supplies and other services at discounted rates.

5. Access To Data, Data, And More Data

Updated IT platforms are also important in any clinical integration endeavor. This might mean an enterprise-wide electronic health record system, or a health information exchange, which leverages existing EHR systems but allows for a data exchange between providers and business units.⁴

Some networks might choose a blend of the two, depending on patient needs and financial demands.⁴ In any case, logging performance data helps physicians track patient outcomes, driving better patient care and more efficient practice management—the ultimate goal for everyone involved.¹

Read about Healthy Planet, the data tool offered by Children’s Health Network.

Contact Children’s Health Network to learn more about its goals as a clinically integrated network.

¹ Hospitals & Health Networks (Jan. 13, 2015)
² Hospitals & Health Networks (July 2, 2015)
³ Hospitals & Health Networks (May 14, 2015)
⁴ Modern Healthcare (Jan. 23, 2015)