Emtiro’s Prescription for Provider Performance

As our healthcare system shifts away from fee-for-service and towards value-based payment models, providers must focus on interventions designed to meet performance metrics. This emphasis ensures quality performance improvement and ultimately optimizes patient outcomes. Payers have proposed a wide array of interventions in an effort to improve performance metrics, but many of these interventions are not practical or do not meet the needs of primary care practices. As a result, many of the providers that Emtiro works with have become disillusioned with the “move-to-value” and have shared some of their concerns with our team.

The following list contains several concerns expressed by providers. Each concern is accompanied by suggestions for effective interventions that can be carried out by knowledgeable and experienced Emtiro Health staff members working alongside providers and practice staff.

 

 
  1. “I am tired of the ‘numbers’ people telling me how to run my practice when they have never provided care to a patient and, therefore, cannot understand what I am dealing with.”

    At Emtiro Health, we know that healthcare professionals must be heavily involved in the development and implementation of quality improvement processes in order for them to be effective. Emtiro Health employs physicians, registered nurses, social workers, behavioral health specialists, and pharmacists that rely on their own personal experiences providing patient care to inform all of our best practices. We also support practices with a team of indispensable quality improvement specialists and data analysts to ensure that our recommendations clinically align with best practices that are effective in multiple practice settings. 

    Because many quality measures can be significantly improved by effective medication therapy, our clinical team takes the time to assess medication adherence and appropriateness for high-risk patients who have been screened for intervention and require a comprehensive health assessment.

  2. “I’m already overwhelmed. How am I supposed to have time to learn what is being measured and identify patients that aren’t meeting a particular metric?”

    Primary care providers in this country are certainly overwhelmed. There is currently a shortage of primary care physicians and this trend is projected to worsen over the next decade. Because most office visits for older adults involve the management of at least one chronic disease, an enormous opportunity exists for support from an experienced clinical team.

    Since performance metrics are, for the most part, associated with long-term conditions, chronic disease management is at the heart of quality improvement. Fortunately, that is where chronic care management, care coordination, and effective prevention and wellness models have historically excelled. By providing these services, Emtiro Health can take some of the burden of chronic disease management and coordination off providers’ shoulders.

    Through our analytics services, we are able to deliver dashboards, scorecards, and a point-of-care decision support application for each contracts’ required metrics. These reports include current performance on required metrics and past trends. We also identify specific patients that are either failing to meet, or are at risk of failing to meet, a particular metric. We can then provide your practice with tailored interventions for your staff to address with specific patients, resulting in improved quality performance.

  3. “I get dozens of faxes every day from insurers across the country making recommendations without knowing my patients or their history. We don’t have the resources to verify that the recommendations are appropriate so they all just end up in the garbage now.”

    This is where Emtiro Health really shines. Through collaboration with Emtiro, practices are able to receive an appropriate array of tailored clinical services. This means that if we send you a recommendation on a patient, you can be assured that we have spoken to them and have begun to develop a patient-centered care plan that aligns with your own plan. If a health screening identifies a social or economic barrier to a patient meeting a particular quality metric, a referral is made to link your patient to a community-based resource that meets their needs.

    Communication is often the rate-limiting step in the provision of team-based care. In order to operate at our full potential, Emtiro strongly encourages all practices that we support to provide us with access to their electronic health record (EHR) and to leverage our point-of-care solution. With Emtiro’s solution integrated with the EHR, practices have quick access into a 360-degree view of a patient’s data, including the ability to input notes and send messages to Emtiro’s care team. With the entire care team working from the same data, in the same system, communication across the team shows immense improvement. Because our technology solution is able to push the most valuable and timely information to the patient’s visit screen in the provider’s EHR, informed point-of-care interventions can be made within the practice’s workflow.

  4. “It seems like I hear about a new medication or an updated treatment guideline every week. How do I keep up with it all to ensure that I am practicing evidence-based medicine?”

    In a world of medications that includes brands, generics, branded generics, biosimilars, ‘me-too drugs’, and ever changing treatment guidelines, it is no wonder that many healthcare professionals find it difficult to stay on top of the latest publications.  

    Emtiro’s physicians, nurses, behavioral health professionals, and pharmacists own the responsibility of staying informed on the latest evidence based treatment guidelines. They have developed clinical decision-making tools for providers including condition-specific algorithms that are up-to-date and evidence-based. This creates increased efficiencies and standardization in prescribing across providers in a practice, while still allowing the freedom to deviate based on clinical judgment and specific patient circumstance.

 

 

It is not easy to operate in two different payment environments in an ever-changing landscape where barriers to care frequently determine a patient’s health trajectory. This is precisely why Emtiro Health was founded and is at the core of the services we provide. We encourage providers to partner with us to lighten their load and provide the highest quality care possible to their patients. We know how to provide direct patient care because we’ve done it. We utilize healthcare professionals in these efforts because they are proven to increase performance and we use data to pair at-risk patients with the right interventions. Our clinical staff function as an integral part of the healthcare team because we work directly with our providers in their systems, within their workflows. We give providers effective tools to practice evidence-based medicine and we care for our patients by providing whole-person, patient-centered services. To hear more about how Emtiro Health can support your practice and your patients, please contact info@emtirohealth.org.

Brea Neri