How to standardize workflows to transition to value-based payments
Interoperability standards have been discussed for many years to allow effective transfer of data from one system to another. While the promise of this type of standardization has yet to be realized, there are real benefits of standardizing workflows within the same hospital and provider networks regardless of the number of disparate systems. As mergers and acquisitions continue, groups scramble to integrate operations and are often forced to focus on what is needed just to survive their growth. As casualties of this process, silos and lack of standardization quickly take their tolls, putting groups at a disadvantage during their transition to value-based payments. Standardizing workflows effectively will assist greatly in making sure the data needed to manage patients and improve outcomes is readily available to those providing patient care, but also for those that have to prove value to attract patients in competitive markets and negotiate with payers. Standardizing workflows should be completed by leveraging the right strategy to avoid inefficient and ineffective processes that do not support your goals.
Assess your governance structure and determine the changes required to get clinical and operational consensus as well as widespread buy-in. Involving the right people in the right way at the right time and defining sound communication, processes, policies and accountability is critical to defining defensible standards that will produce desired results.
Incorporating Quality Measures
To align your organization with the transition to value based payments, quality measures need to be incorporated into workflows. Quality measures change over time, making the management of measures across multiple programs is beneficial. Customized crosswalks to map like measures across programs makes the process of incorporating measures into standards more manageable.
Systems and processes require workflow optimization to define effective standards. Five rights make it right: implementing standards requires the right tools to collect the right data elements at the right time in the right place by the right people. Attempting to define standards without regard to workflows can result in unexpected gaps, inefficiencies, frustration and training challenges. When there is consistency on how information is collected and recorded, the information tends to be easier to find and retrieve not only from a reporting perspective, but for simply viewing information in a chart. Data overload and inconsistencies can get in the way of finding the clinical information that is most relevant and important to managing the patient’s care at any given moment.
Defining standards using updated governance, policies and procedures while incorporating quality measures and workflow, will put your organization in a better position as you continue to make the transition to value-based payments. Standards that you roll-out should be easy to defend and be widely accepted. The processes put in place to manage your standards across multiple locations and systems, must account for change, expect change and accept change to adapt to new
standards quickly and effectively.