Clinical Outcomes: Know the reason why

Q. What are the components of an outcome-based program?  

A. Traditional expectations of DME services are focused on therapy compliance and basic equipment education – that's the starting point. Value-based models demand a provider move from product-centered care to patient-centered care. The key to a successful transition to these models is adding sophisticated clinical metrics on top of excellent compliance results. These clinical metrics measure goal performance, objective data and, sometimes most importantly, subjective data like self-management skills or symptom management. These goals and metrics need to be translated into patient language and need to communicate progress in an overall plan of care. 

Providers also need to take population health under consideration. Because it’s broader than disease management, they have to screen for co-morbidities and, while not the expert in treating those issues, they need to alert the care management team. Population health is not just a buzzword but the health care model of the future. Payer care managers of at-risk groups are interested in identifying behavioral and community health shortfalls and the overall social determinants of health factors. It's not enough to know that readmission rates are high. You have to know what is causing the trigger and what social factors could be contributing to an admission.  

For respiratory therapists, asking “how do you feel” questions at the point of care isn't enough. They must collect scaled answers via software to standardize them and to understand the changes from initial visits to ongoing visits. Software also enables patient answers to be tied to actions and instructions and to prompt physician interventions. Additionally, a database can be used to analyze results and identify hidden relationships that drive better outcomes. 

Zach Gantt is CEO at Encore Healthcare. Reach him at zgantt@encorehc.com.