Improving appropriate utilization is a priority for every health system – and it’s the focus of this post, which is Part 4 in a series focused on how high-performing healthcare systems are using clinical process improvement to tackle the common priorities in healthcare often referred to as the “triple aim + 1” or the “quadruple aim.” Part 1 took a high-level look at increasing clinician engagement, delivering quality patient care and containing costs. Part 2 targeted clinician engagement and satisfaction. Part 3 delved deeper into solutions for improving patient safety and quality of care delivery. This piece wraps up the series by focusing on how healthcare systems are effectively reducing costs through appropriate utilization.
Many healthcare organizations are focused on understanding, changing and managing clinician practice behaviors to achieve quality and cost containment goals. However, before tacking clinician behavior, it is essential to align electronic health record (EHR) content and workflows to ensure you are making it easy for them to do the right thing and not inadvertently driving inappropriate utilization. Unfortunately, you likely know from experience appropriate utilization is easier said than done without the right tools in place. As a CHIO, I experienced the frustration of pulling together teams and implementing changes, then waiting to see if they had the desired effect – but never knowing for sure what exactly was working or why.
The LogicStream Health software platform removes that mystery from the process. Clinicians and administrators are able to pinpoint areas of concern, take action and analyze results quickly. The software empowers clinical operations-led EHR optimization efforts focused on improving clinical processes and driving change among clinicians.
The key is that the software gives all clinicians directly involved in clinical process improvement the ability to simultaneously analyze EHR content data, patient data and clinician data to improve and control the care they deliver around specific clinical initiatives and goals. Through targeted efforts to ensure proper usage of high-cost and high-volume medications, lab tests and other orderables, LogicStream Health customers have achieved significant savings while improving the quality of care delivery.
Below are just a couple examples of health systems with cost containment initiatives that together saved more than $3 million. These types of savings are the standard for LogicStream Health customers based simply on what they want to focus on and the priorities of their organization. Those who understand the power of true clinical process improvement are focused on improving patient outcomes while reducing cost and making care delivery enjoyable for their clinicians.
The first example is focused on medication utilization. A large, multistate health system on the U.S. west coast used LogicStream Health software to examine prescribing trends for its top five most-used medications system-wide. The team assessed usage levels, put in place standard protocols, tracked adoption of those protocols and identified areas for further targeting due to ongoing variability. By making simple changes, such as using less-expensive acetaminophen tablets versus the IV form and swapping higher cost medications for equally effective but lower cost alternatives, the organization is saving $2.7 million annually. Now it is targeting the next five medications as it continues to squeeze out unnecessary pharmacy utilization.
The second example involves lab tests. Research has shown the biggest opportunity for savings from appropriate lab test utilization comes not from the most expensive tests, but from lower cost tests that are ordered frequently without providing much benefit for patient care, are repeated unnecessarily, have limited use, or have become obsolete. Examples can include daily blood tests, frequent thyroid or hemoglobin A1C checks, and genetic testing, which only needs to be done once in a person’s lifetime. An academic medical center in the Northeast used the LogicStream Health software to help eliminate use of low-value, high-volume lab testing procedures. The medical center focused on reducing use of genetic testing and the creatine-kinase-MB (CK-MB) test used to assist in diagnoses of acute myocardial infarction. By establishing a clear ordering pathway for genetic tests, including checking to see if the tests already have been performed, using less expensive screening tests first, and limiting the ordering to approved groups, and by replacing CK-MB tests with more effective alternatives and specifying very limited circumstances for continued CK-MB use, the medical center is saving $356,000 annually in lab tests.
Right now you may be thinking about the variation in lab tests and medication utilization in your own organization. There is opportunity in every health system to streamline use of antibiotics, opioids, other medications and lab tests by standardizing care delivery to improve outcomes and reduce costs. All you need are the right tools to help you make it happen.
To learn more about the high-cost medication reduction, click the button below to download our case study. When you’re ready to start on your cost-savings journey, schedule a demo with one of our subject matter experts to learn how you can put clinical process improvement and control software to work in your organization.