The New World of Healthcare Will Be Built Through Collaboration

It is too soon to know what changes, if any, might be made to the Affordable Care Act as a result of the recent elections and the upcoming debates over taxes, spending cuts and sequestration. What we do know is that the most effective healthcare reform will happen through collaboration at the local level among health systems, physicians, employers, and payers.

Healthcare should not be a partisan issue. We must work together to meet the challenges of providing quality healthcare for the people in the communities we serve and control the cost of care. Our hope is that we can put aside partisan differences and focus on real solutions. There are many parts of the Affordable Care Act that are good and other parts that could be improved. We hope that our policy makers can work together on improving what needs to be improved and that we do not lose the progress that has been made on many critical issues, such as expanding the availability of insurance coverage.

In North Texas, the spirit of collaboration is strong, and the results of joint efforts are impressive.

One area of collaboration focuses on information technology infrastructure. Texas Health Resources and Children’s Medical Center of Dallas worked together to develop one of the first health information exchanges (HIE) in the state that enables us to securely share patient information across information technology platforms. We’ve participated with Sandlot Solutions, a health information technology company in Fort Worth, for several years in developing a health information exchange for securely sharing information about Medicare patients.

Texas Health is also launching an HIE in the late first quarter of 2013 that will create a patient record that combines information from physician and hospital visits, regardless of organizational boundaries and type of electronic medical record used by physicians. Currently, data is being gathered and input into the HIE from Texas Health hospitals, joint ventures and Texas Health Physician Group offices. The Texas Health HIE eventually will connect to the Dallas Fort Worth Hospital Council’s HIE so that the single-view patient record will include information from any member hospitals with HIEs.

As I mentioned in this column before, Methodist Health System of Dallas and Texas Health collaborated on a joint venture with LHC Group to create Methodist HomeCare and Texas Health HomeCare. This joint approach to coordinating transitional and home care services is already proving to be an effective link in the continuum of care, and we believe it will ultimately improve patient outcomes and reduce readmissions.

Texas Health and North Texas Specialty Physicians have learned a great deal in just a few months of working together in the Plus Accountable Care Organization (ACO), and we have plans in the works to expand on that foundation. Plus is one of 35 pilot programs under the Pioneer ACO program sponsored by Center for Medicare and Medicaid Services. Across our system, Texas Health now has more than 45,000 people covered under the umbrella of accountable care, either in an ACO framework or under a Medicare Advantage program. In early 2013, we expect that number will grow to more than 70,000 as we establish collaborative relationships for accountable care with more independent physician practices.

UT Southwestern Medical Center and Texas Health are continuing to build on the collaborative relationship we announced last year to develop and enhance graduate medical education programs with the goal of alleviating the shortage of physicians and other medical professionals in Texas. We’re also working with University of Texas at Arlington to support nursing education to meet the future needs of our rapidly growing population.

Working through a partnership announced last April with Healthways, an independent global provider of well-being improvement solutions, we have developed several initiatives that will begin rolling out in early in 2013, enhancing our alignment with both employed and independent physicians through collaborative approaches to patient care. For example, we will begin implementing a care transitions program that will expand and enhance the coordination of post-acute care.

We have also made significant strides in developing a comprehensive approach to diabetes care coordination not only in the acute care setting but also outside the walls of our hospitals. Our soon-to-be-launched diabetes management program will provide closer monitoring and management of patients with diabetes who come into our hospitals for some other condition. Specially trained nurses will follow them through their hospital stay and will help them transition from the hospital to care outside the hospital, whether that is in another facility or at home. This has the potential to make a significant long-term improvement in managing one of the most critical chronic conditions impacting the health of our communities.

We’re also developing the data infrastructure to collect, analyze and share patient data with physicians to help them better manage the overall health of their patient population.

Ultimately what all our efforts boil down to is expanding beyond our walls and working more closely with other community partners to improve the care experience for individuals across North Texas. By developing best practices and relationships with other providers we can address the behavior and lifestyle changes needed to improve the health and well-being of North Texans. And that is a mission I think we can all get behind as the industry transitions in the coming years.

— Douglas D. Hawthorne is CEO of Texas Health Resources