In 2016, Watershed Health published a detailed report regarding use of its integrated delivery platform on quality, safety and patient outcomes. View the executive summary below, or contact sales@watershedhealth.com for the full report.
The Impact of Creating a Virtual Integrated Delivery System on Quality and Safety
Healthy Gulf Coast Care Transitions, Mobile, AL
Watershed Health, New Orleans, LA
Alabama Quality Assurance Foundation, Birmingham, AL
Contact information:
Randy Granata, RN-BC, DNP, CMAC
randy.granata@providencehospital.org
Arthur Grant, MD
chip.grant@watershedhealth.com
Bart Prevallet
bart.prevallet@area-G.hcqis.org
Abstract
Introduction
Care fragmentation results in poor health care quality, increased inefficiency, and higher overall cost of care and forms the root cause for the failures within the U.S. health care system. The ideal health delivery model would provide a shared platform enabling and promoting continuous care coordination, and exists today as an integrated health care delivery system.
Purpose
To improve health care quality in a real-world community by creating a virtual integrated delivery system.
Methods
The intervention consisted of three phases aimed at reducing fragmentation: (1) Providing a single software platform to health care providers whereby communication and data sharing were promoted and facilitated, (2) Key stakeholders promoted participation in a virtual network and participants were incentivized by tailored features of the system that benefited their practice, (3) A community-wide coalition for healthcare quality adopted and endorsed the platform as the key enabler for quality improvement. The clinical outcome measure was 30-day hospital readmission.
Results
Measures of reduced care fragmentation, including provider participation, communication, data sharing, and root cause analyses progressively increased during the intervention. The all cause baseline 30-day readmission rate was 17.8% for traditional Medicare beneficiaries. In 2015, 5.4% of Medicare patients (1,128 of 20,968) participated in the intervention and the all cause 30-day readmission rate was 17.6% (3,484 of 19840) in the non-participants compared to 15.3% (173 of 1,128) for patients participating (p=0.07). In 2016, 11.3% of Medicare patients (2,285 of 20,268) participated in the intervention and the all cause 30-day readmission rate was 17.4% (3,127 of 17,983) in non-participants compared to 11.9% (271 of 2,285) for patients participating (p<0.001).
Summary
First, a wide variety of disparate health care providers practicing in a highly fragmented environment can adopt and actively participate in a unified virtual care network enabled by a single software platform. Second, participation leads to communication and just-in-time sharing of data at the point of care. Third, through data sharing, communication, and quality initiatives including root cause analysis and quality transparency, the key outcome measure of 30-day readmission is significantly reduced.
Conclusion
A virtual integrated delivery system is readily achievable in a real-world setting of care. All providers willingly participated in the virtual network because of unique self-interests that were met through participation, and were not incentivized in any other way. Through active participation, communication was enhanced and quality and safety improved. As a result, the intervention resulted in meaningful and substantial reductions in the key outcome measure of 30-day hospital readmissions. The real-world nature of this intervention coupled with the organic growth observed suggest that this intervention is highly scalable.
For the full Pilot Porgram report, contact Sales@watershedhealth.com.