Minnesota-based HealthPartners has developed a deceptively simple online diagnostic tool, called virtuwell, that has the potential to drive costs down and improve efficiency. Patients complaining of common problems answer questions about their symptoms online. Physician assistants sign off on treatment within 30 minutes, and patients pay $40 or less for the service, depending on their health insurance. Bringing technology to bear on the diagnoses of simple ailments lightens physicians’ burden and costs patients significantly less.
Southcentral Foundation’s Nuka System of Care
This groundbreaking program shows how commitment to quality, measurement, a renewed focus on the patient, and relentless improvement can transform care. Thirteen years ago, the nonprofit Southcentral Foundation, which serves and is owned by native Alaskans in and around Anchorage, confronted providers’ central challenge: improving quality while controlling costs. The foundation’s answer was panoramic. It offers a range of ways for patients to speak up and get help, including focus groups, advisory committees, and a 24-hour hotline. It built training into its culture. And it guarantees patients same-day primary-care access. The results have been stunning: a 42 percent reduction in urgent-care usage, 36 percent reduction in hospital days, and a 58 percent cut in specialty-clinic visits.
Medical errors kill up to 98,000 patients every year, according to the Institute of Medicine. In 2003, Ascension Health, which has 113 health care facilities across the country, set the goal of eliminating preventable injuries and deaths in care. According to a 2011 study, the system has achieved 25 percent lower mortality, 65 percent fewer birth traumas, and 89 percent lower neonatal mortality rates than national averages through a systematic analysis of errors and the adoption of eight strategies for improvement. As the Affordable Care Act increases pressure on hospitals and other providers to reduce errors and begins to reward value over volume, the nation’s largest Catholic, nonprofit health system offers an important model through its decadelong “quality journey.”
Providence Health & Services
Providence Health & Services stays on the cusp of innovation by continually experimenting with and deploying rapid, system-wide improvements. Its Electronic Modified Early Warning Score and Response System, now running in three states, uses a computer algorithm to monitor patients at risk of deterioration, paging the rapid-response team if a patient’s score reaches a critical threshold, long before an emergency call is needed. Providence Health is also part of a consortium of providers in Oregon that has received a grant to develop a Medicaid Coordinated Care Organization designed to demonstrate that an unprecedented level of coordination among traditional competitors could save billions of dollars in medical costs.
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