When Steward Health Care System first embarked on its journey as a Pioneer Accountable Care Organization in January 2012, the process was akin to building a plane and flying it at the same time, according to Dominique Morgan-Solomon, vice president of population health for the Boston-based provider.
"The infrastructure needed to manage populations wasn't there," Morgan-Solomon said during an educational session at the Healthcare Information Management and Systems Society (HIMSS) 2014 conference in Orlando, Fla., last week. "I had three nurses and a population of 35,000 beneficiaries. If we just estimate that 10 percent of those are high risk, over the course of a year, that's a large panel for any particular nurse to manage."
Morgan-Solomon said Steward's initial goal was to ramp up staff quickly in a market with four other ACOs trying to do the same thing.
To that end, she said, analytics were vital to her work.
"People kept coming in and saying 'What programs are you going to put in place?'" Morgan-Solomon said. "I don't know. I don't know what the problems are. The analytics piece was a critically important piece for us."
Through leveraged partnerships, Morgan-Solomon said that Steward was able to better understand its population, and thus able to build out its care management platforms and strategies.
Another challenge, Morgan-Solomon said, was ensuring all of that data could be used both within and outside of Steward's ACO bubble.
"Seventy percent of our business--about 300,000 covered lives--are in the risk business for us," she said. "Whatever we were doing for Pioneer, I had to be able to extrapolate to other commercial populations. I knew this was about building infrastructure to be able to manage in the long run."
Morgan-Solomon said that analytics tools helped Steward to integrate claims, clinical and patient reported data all at once. That information, she said, enabled not just executives, but clinicians to be proactive rather than reactive.
"It wasn't enough to have dashboards and report cards going to executives," Morgan-Solomon said. "Nurses need to know on a day-to-day basis how well they are performing against their targets, how well they are enrolling patients and how their engagement rates stacked up against their peers. When we put that information in their face at a personal level, it gave them goals to meet."
According to Morgan-Solomon, all data is meaningless unless you understand who's going to view it and how it will be used.
"What the providers wanted to know was 'what does my panel look like?'" Morgan-Solomon said. "They wanted to know 'Who are the people on my panel who are more likely to need something in the near future? And what am I going to do about it?' The data needed to be actionable."
To learn more:
- view Morgan-Solomon's presentation (.pdf)