Human Interaction: Key Ingredient to EHRs Success

“I believe the key to this program’s success was simple human interaction.”

This sentence near the end of a recent article in Group Practice Journal had a rather jarring effect on me. Tucked into a description of a program undertaken by Cornerstone Healthcare to drive fee-for-service revenue from value-based care, I realized these twelve words neatly sum up how to tap into the power of an EHR.

In 2011, Cornerstone achieved patient-centered medical home (PCMH) status from the National Committee for Quality Assurance (NCQA).  But the North Carolina-based provider group pushed further to take advantage of the rich data it compiled to qualify for PCMH. They just needed to figure out how to tap into their EHR to proactively understand the care needs of its patient population.

Cornerstone’s initial program focused on high-risk diabetes patients identified by three criteria. They adopted Humedica Mindedshare population management software to analyze data stored in the Allscripts EHR to identify the right patients. They also created a new position called patient care advocate (PCA) to call targeted patients to check on their health status, provide education and schedule follow-up appointments if needed. The PCA noted the patients’ status in the EHR for the doctor to review.

The program proved so successful, after just six weeks Cornerstone hired two additional PCAs. The provider reports one-third of the calls made resulted in appointments with a 90% completion rate.

Cornerstone learned the personal touch approach is also profitable. In the six months studied from March to September 2011, each appointment kept resulted in $216 in revenue. More importantly, they believe the program kept many high-risk diabetes patients out of the hospital because they were motived to re-engage in preventative care.

In the article, Dr. John J. Walker writes “[v]irtually any physician practice with an EHR system and the right population management software can use the same approach to drive both quality and new revenue.”

A key ingredient in that recipe is also human interaction to push the positive outcomes achievable from the right technology even further.

Do you have any examples of how the human touch combined with an EHR propelled even greater patient outcomes? Share them here.

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About the author

Steven H. Shaha, Ph.D., DBA, is a Professor at the Center for Policy & Public Administration, and the Principal Outcomes Consultant for Allscripts. Dr. Shaha received his first doctorate in Research Methods and Applied Statistics from UCLA and has taught and lectured at universities including Harvard, University of Utah, UCLA, Princeton, Cambridge and others. An internationally recognized thought leader, lecturer, consultant and outcomes researcher, Dr. Shaha has provided advisory and consulting work to healthcare organizations including the National Institutes for Health (NIH), and to over 50 non-healthcare corporations including RAND Corp, AT&T, Coca-Cola, Disney, IBM, Johnson & Johnson, Kodak, and Time Warner. Dr. Shaha has presented over 200 professional papers, has over 100 peer-reviewed publications in print, over 35 technical notes and two books. He served on the 15-member team that authored and piloted the Malcolm Baldrige National Quality Award for Health Care, and he contributed to the Baldrige for Education.



Roseann Flores says:

11/23/2012 at 4:27 pm

As a new manager to my home agency, I have been challenged with restoring staff morale, accountability for quality care as well as the multiple regulatory rules we must honor, all while meeting patient & staff satisfaction. So, yes,I would say even the idea of change wrecks terror to most of my employees.
Several of my staff are seasoned clinicians and feel that the old way is proven and good enough. As I have shared best practices, I do see empowerment and hope being restored to their faces. and it is demonstrated in a culture change!
At first the idea of taking computers into the home was met with a multitude of excuses (some quite valid), staff felt burdened with another thing (Point of Care), another requirement. I had been sharing with the team the need to break down teachings to manageable pieces for our patients, such as , low sodium diet – to agree on one change at a time. Well, I began modeling it for my team. I started with doing one visit in the home & just doing clinical monitoring. Then I had them do any measurements (wound, ambulation, etc) in the home the next week or two. Then I had them document the medications in the home.
Most clinicians are now doing the vast majority of the revisit and the start of care in the home because we agreed on taking change at a comfortable pace. The newer nurses we able to document in the home more easily but have had other things to work through.
Change may not be easy, may seem scary but if taken in small doses, it can be manageable & success paves the way for less fear & more success.


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