In the Know

Why Delivering the Right Care at the Right Time Effects Costs

07.10.2017 St. Joseph Hoag Health

We live in the age of rankings and top 10 lists. From the best graduate schools to the fastest-growing small businesses and most employee-friendly employers, the public increasingly relies on third-party rankings to choose between competing brands, businesses and service providers.

Certainly, nowhere is this trend more pronounced than in health care and the endless “best hospital” lists that rank institutions based on quality of care and other factors.

But what is quality health care? And how can patients evaluate the quality of care they receive?

According to Christy Mokrohisky, VP of population health management at St. Joseph Heritage Healthcare, quality health care for patients is as simple as getting the right care at the right time.

For St. Joseph Hoag Health, this means offering a full continuum of care (shown below) that empowers patients to access services from multiple sites and sources – from Acute Care to Recovery & Rehab Care to Community-Based Care – ultimately connecting care receivers to urgent care, wellness services, and everything in between.

Making sure patients get the right care at the right time starts with Population Health Management (PHM), the use of large amounts of patient data to determine population-wide health trends and solutions, and then leveraging those findings through personalized care. “The purpose of health care is to improve the health of patients, but we have built a system that often intervenes too late, when a person is very sick and needs expensive hospital services,” Mokrohisky explained. “Population Health Management is all about knowing who our patients are, offering services to keep them healthy and intervening with care as soon as symptoms begin. We use data to be proactive and preventive on the individual patient level to arrive at a new level of care.”

Mokrohisky said that PHM is about engaging patients, and asking the right questions, to encourage better outcomes. Are patients engaged enough in their health? Do they understand what might happen if they don’t take the prescribed action? “A diabetic may feel good enough on a day-to-day basis, for example, to start missing the at-home blood-sugar tests,” she said. “However, daily diabetic monitoring is important because it alerts us to problems. When we know what the problems are, we can intervene with the right care and ultimately change behavior to increase their chances for successful, long-term outcomes.”

St. Joseph Heritage Healthcare uses the “Triple Aim” approach, established by the Institute for Health Care Improvement, to assess the quality of care:

  1. Improved Health. Promoting wellness and reducing the risk of illness or disease.
  2. Enhanced Patient Experience. Measuring and tracking a particular population’s experience of care, including quality, access and reliability.
  3. Reduced or Managed Cost. The goal of measuring and controlling the per-capita cost of care.

For forward-thinking businesses that invest in PHM, the ROI can be dramatic. After its first year, Western Digital’s on-site wellness center that is operated by St. Joseph Hoag health, reported employee participation rates of more than 50 percent and a $1 million savings in both its productivity and cost of claims. Adding to the good news was an increase in anecdotal employee satisfaction leading to a noticeable boost in morale and a happier, healthier population.

At St. Joseph Hoag Health, wellness has become a crucial component of efforts to build healthier communities. This approach is shifting the traditional focus away from treating illness to preventing illness. This new model of care puts the patient at the center of the process, rather than the doctor or provider, and allows individuals to take greater control over their wellbeing and health care.