Managed Care - August 2012 - (Page 29)

way we deliver care and service. Technology and system redesign have the power to unleash efficiencies while improving quality and greatly expanding access. It will not happen overnight, but there is every reason to believe it is possible. MC: Electronic medical records must also be on your list. LEviNE: Electronic health records and the ability for everyone taking care of the patient to see information and understand what’s happening will not only eliminate waste and redundancy but will also prevent some of the mishaps involving well-intentioned caregivers who don’t have a full picture of the patient’s circumstances. MC: You have a system like that at Kaiser Permanente. LEviNE: Yes, we do. We’ve made a decade-long, $4 billion investment in an electronic health record that has been implemented in the ambulatory setting and in our hospitals. While the transition from paper records wasn’t easy, there isn’t a single physician who would go back. The power of the electronic health record is not just in digital capture of the same information that used to be entered in the paper chart, but in the decision support that is built in so that we can ensure that physicians who are caring for patients don’t have to rely on memory to order certain tests or to check certain things. Our clinicians have designed and built prompts into the system, and tools to deliver decision support at the point of care, and continue to do so. MC: What other advance in the integration of care can help patients the most? LEviNE: There must be seamless integration of the care provided by primary care physicians and specialists. There has been a lot of attention paid to the patient-centered medical home and the need for a robust primary care workforce, but the piece we can’t forget is we have to have seamless movement of information — with the patient — between primary care and specialty care. That will enable the specialists to do what they do best and the primary care physicians to be kept informed and knowledgeable, and fully able to coordinate the care their patients need across the continuum of care, and over time. MC: That sounds like both technology and relationships. LEviNE: One of the things that the ACO model holds out as a promise is that people are actually going to have to get to know each other, talk to each other, and work out agreements. For example, what simple dermatologic conditions should a primary care physician be able to care for and what should go on to a specialist and how quickly? Specialists will have to be responsive to primary care physicians. We need to move from a world of “handoffs” to a model of shared accountability for the care of patients. It is going to require both human and technological hands across the chasms and gaps that we currently have, the silos of care, in order to ensure that W hile the transition from paper records wasn’t easy, there isn’t a single physician who would go back. patients are served well and that we really are moving from a provider-centered model of care to a patient-centered model. MC: Physicians don’t always embrace change. Who is going to bring them around? LEviNE: These new organizations are going to depend on effective physician leadership, which will paint a compelling vision of the future and enable people to commit to doing things that they wouldn’t necessarily, on their own, decide they wanted to do. The work of leadership is ongoing, and nothing very important happens without it. These new ACOs are going to depend on physician leadership that is capable, committed, and courageous. Physician leaders are going to have to be able to stand shoulder-to-shoulder with hospital and health plan leaders in agreeing on a shared vision and mission. Then they will have to appeal to the sense of mission and purpose that their physician colleagues chose the profession for, as they make the case that the alternative is much worse. The world has gotten more challenging, and we have an obligation to bring our physician peers and colleagues along with us. MC: Do we have enough physicians who are interested in taking on these tasks? LEviNE: There’s no question that there’s a gap between what we need and the inventory of leadership that we currently have. But physicians are pretty smart and have the capacity if given the opportunity to rise to the challenge. I have been AUGUST 2012 / MANAGED CARE 29

Table of Contents for the Digital Edition of Managed Care - August 2012

Managed Care - August 2012
Editor’s Memo
Contents
Legislation & Regulation
News & Commentary
Medication Management
Evidence Review
Compensation Monitor
Private Exchanges: Practice Makes Perfect
Hospitals and Providers Ganging Up on Plans?
Q&A: Kaiser Permanente’s Sharon Levine, MD
God Save the Health Care System!
Future Points to Greater PBM/Plan Cooperation
Formulary Files
Plan Watch
Tomorrow’s Medicine
Outlook

Managed Care - August 2012