Wesley Ratliff and Premier Healthcare Use Health IT to Build an Accountable Care Organization
Dr. Wesley Ratliff is a pulmonary critical care specialist and President of Premier Healthcare, a physician-led multi-specialty provider group based in Bloomington, Indiana. Premier’s network of 66 physicians serves approximately 300,000 patients in south-central Indiana as a multi-site provider network. Premier first implemented an electronic health record (EHR) system in 2007. Using Health IT to support its care model and health care quality improvement processes, Premier received recognition as an Accountable Care Organization (ACO) on January 1, 2013.
Becoming an Accountable Care Organization
Premier was an early adopter of EHRs, even before the organization became an ACO. “We believed there was going to be a major shift in health care and we wanted to be on the front line,” noted Dr. Ratliff. When the opportunity arose to continue innovating to improve health care quality by becoming an ACO, Premier decided to join.
Health IT has been essential to Premier’s success as an ACO. The ACO initiative requires participating organizations to report data for 33 different quality measures to the Centers for Medicare & Medicaid Services. “Health IT helps us report the necessary quality measures,” explained Dr. Ratliff. “Since the measures are data-driven, we can use our EHR to collect and report on the data for each ACO quality measure.”
For Dr. Ratliff, the benefits of Health IT go beyond improved reporting. “We can create lists of patients to identify patients who have not gotten appropriate screenings or are otherwise not meeting our ACO quality improvement targets,” described Dr. Ratliff. After these patients are identified, Premier’s patient care coordinators work with the patients to schedule follow-up appointments. With Health IT, Dr. Ratliff and Premier are better targeting their care, proactively treating patients, and improving health care quality.
Premier is also using Health IT to better adapt to the ACO model of care, which emphasizes cross-specialty coordination. “We can now track conversations and next steps through the EHR. When we see one of our patients, we know their exact history, the doctor’s instructions from the last appointment, and whether or not the patient followed the doctor’s instructions,” explained Dr. Ratliff. This Health IT-driven process enables providers to easily communicate with one other and improves care coordination for Premier’s patients. “Health IT helps us make sure everything runs smoothly so we can better coordinate care," explained Dr. Ratliff.
Improving Health Care Quality Using Health IT
Preliminary results suggest the ACO effort is improving health care quality for Premier’s patients. In one case Dr. Ratliff remembers, one of Premier’s patients started feeling light-headed at work. She noticed her blood pressure was elevated. Instead of going to the emergency room, the patient was able to quickly contact her nurse care coordinator, who was able to connect her with her primary care provider and get her an appointment in less than an hour. “The patient was happy, avoided the emergency room, and received better care,” said Dr. Ratliff. “As more patients adapt to the ACO model, we are seeing more and more success stories.”
As for next steps, Dr. Ratliff and Premier are entering their second year as an ACO and plan to continue preparing for Stage 2 meaningful use and improving health care quality.