Health Plans

Collaboration, convergence essential to Quadruple Aim

February 7, 2018
Collaboration and convergence are essential to achieving the Quadruple Aim in healthcare.
Vice President, Marketing

I recently visited my primary care physician for a minor health issue and, a week later, saw my gynecologist for a routine exam. At the end of the primary care visit as I was checking out, the patient care coordinator handed me a paper with instructions on how to set up my new account on the patient portal. The physician practice, and the health system that owns the practice, was implementing a new electronic health record (EHR) system.

The following week after my visit to the gynecologist, I received a second paper with instructions on how to set up my new account on the patient portal. My gynecologist’s practice, which incidentally is located right across the street from my PCP’s office, is owned by a different health system, which was also implementing a new electronic health record system, this one from a different EHR vendor.

A few weeks after that, I visited a third healthcare provider, a specialist whose practice is in the same health system of my PCP. At the beginning of the visit, the nurse practitioner asked me a host of questions – medications, supplements, family history, prior surgeries, prior diagnoses and treatments. Information I knew was available, or should have been available, in my EHR. And information I knew I had previously relayed to my PCP just three weeks ago.

Multiple logins. Incomplete data.

So now I have two patient portals with two different logins. They look different and contain different information. It isn’t wrong information, just incomplete. On the right-hand side of one portal, there is a list of all the providers I’ve seen in the past two years. Except there is only one provider listed even though I have seen others and my primary care doctor is not listed. The other portal – the one through my PCP’s office – contains a list of all my procedures and tests, except none of my annual gynecologic exam information is available.

Each portal has incomplete information about me and my healthcare history. Each portal is a distinct, siloed information source that reflects clinical data available from that particular healthcare system. Do these two healthcare systems have access to more complete and shared information about my health record? Probably. But from my patient view, it doesn’t seem that way.

Furthermore, even with this move to a new EHR, presumably with the goals of presenting a more complete and accurate patient record and making life easier for physicians and patients using the system, it didn’t eliminate the need for the nurse practitioner to ask me the same questions about medical history that I’ve answered many times before, nor did it stop him from commenting in frustration about the administrative burden of IT systems and reporting requirements.

We can do better to improve the patient and provider experience.

In healthcare, we talk a lot about the Quadruple Aim – improving health outcomes, lowering cost, creating a better patient experience and improving physician satisfaction, what we at Geneia call restoring the Joy of Medicine. But these four guiding principles, which are interconnected and depend upon one another, will never be reached without greater collaboration and convergence within the healthcare system and among all who are involved in patient care.

Quadruple Aim image for improving health outcomes, physician satisfaction, patient experience and lowering costs

A healthcare system that improves health.

At Geneia, we believe in the healing power of personalized, patient-centered care and understand that to achieve the Quadruple Aim requires healthcare providers, health plans and employers to align around shared goals and better collaborate in support of personalized care.

When everyone works together within a unified, shared platform, has access to the same information and is aligned around common goals and outcomes, then care improves and cost goes down. Patients are engaged in their care and trust their care team, and their overall experience improves. And physicians who are able to spend more time with patients and focus more on patient care and less on administration and reporting find joy and satisfaction in practice.

When I think about my ideal patient experience, it sounds something like this:

  • I log in to my patient portal – one portal – from my computer or the app I’ve downloaded to my smartphone.  I can view my health data – my health history, procedures, vitals and other clinical information.
  • I can see a list of my providers and ways to contact them, including directly through e-messaging within the portal. I can view past and future appointments and complete pre-check-in or view pre-operative instructions.
  • I can view a complete list of medications and supplements, and update them as needed.
  • I can set and track progress against fitness, dietary, weight or other health-related goals, and it becomes part of my health record.

Furthermore, my physician can access the same information and even has time right before my appointment to review it, so she isn’t spending valuable appointment time confirming information but instead talking with me about my health, my concerns, my goals and my expectations. This is the essence of personalized care.

And this is our vision at Geneia. A healthcare system that achieves the Quadruple Aim. One based on shared data and collaboration, and one that functions optimally in support of improved health and truly patient-centered care.