At Becker’s Hospital Review’s 2023 Payer Issues Roundtable, PointClickCare sponsored an executive roundtable focused on the importance of data sharing to achieve improved patient outcomes and more efficient care delivery. Two PointClickCare experts led the conversation and shared success stories: Nicole Sunder, director, health plan solution design, and Ben Zaniello, MD, chief medical officer.
Four key takeaways were:
- PointClickCare’s care collaboration platform serves health plans, hospitals and more. Historically, PointClickCare has been known for its presence in the senior care market. Over 70 percent of skilled nursing and assisted living facilities use PointClickCare as their core EMR system. “If you look at Medicare discharges, over 80 percent flow through a PointClickCare facility,” Dr. Zaniello said. However, with the acquisition of Collective Medical and Audacious Inquiry, PointClickCare has expanded its footprint into the hospital and health plan space.
- PointClickCare’s bi-directional network enables seamless, system-agnostic information exchange. As patients move through the healthcare ecosystem, bi-directional data exchange is essential to generate the best outcomes. PointClickCare’s goal is to drive value to any organization that contributes data to or consumes data from this network. If a patient falls at home, for example, and is admitted to the ED and then hospitalized, the network can provide that data to the appropriate health plan.
“In this scenario, the health plan will help with discharge planning and follow up with the patient’s primary care physician,” Ms. Sunder said. “If the primary care physician releases the patient to a skilled nursing facility, our network informs the health plan about all of the transitions as they are happening. After the patient returns home, a care coordinator can follow up to reduce the likelihood of readmission.”
- The State of New Mexico recently turned to PointClickCare to help with Medicaid care coordination. Centennial Care, New Mexico’s Medicaid program, has four managed care organizations (MCOs). To support care coordination for all Medicaid members in the state, PointClickCare brought New Mexico’s hospitals onto the network to share data. The MCOs also participate in the network. “They access hospital data to gain visibility into member discharges. They also push data and claims-derived insights back into the care coordination network to activate care teams,” Ms. Sunder said.
- Data sharing has helped New Mexico address the opioid epidemic. Blue Cross Blue Shield of New Mexico created a recovery team that is activated whenever a member with suspected or known opioid use disorder enters an ED. This team includes individuals who are post-rehab. They go to the ED and work with patients to create a bridge to outpatient treatment. This program has been very successful; the visibility that is created prevents prescribing opioids to people where it wouldn’t be appropriate.
The various use cases described show the value — and the reality — of sharing data across multiple players and putting this data to use to improve patient care and outcomes.
