Try these steps to success in outcomes management
Try these steps to success in outcomes management
Decide why you want data, then educate patients
Success or failure in outcomes management rests on how you structure your program. Collecting data will be futile if you don’t know why you’re doing it and what you hope to achieve, says Marcia Stevic, RN, PhD, director of health outcomes, for the Health Services Advisory Group, a consulting firm in Phoenix.
"Are they going to be monitoring their population overall or their patients’ health [on an individual basis]?" Stevic asks. "Are they going to evaluate a specific treatment or program? Are they going to identify opportunities for early intervention and prevention? Are they in capitated plans [and want to] understand the risk distribution across new members so they can tailor services to that registry?"
Whatever your goals, there are some basic steps for effective outcomes management, outlined by Stevic:
1. Spend time planning and designing your measurement program.
If you find a data collection tool you like, don’t simply begin using it without preparation. You want to make sure it’s valid and reliable, according to the medical literature. And you want to consider the best time and method of collecting data from patients, says Stevic.
For example, you must decide whether to administer the questionnaire to a subgroup of patients or to all patients, and whether it will be mailed, completed in the office, or posed as an interview during history-taking.
2. Keep your data collection time frame consistent.
If you’re matching health status, patient satisfaction, or cost with clinical outcomes to evaluate a certain treatment, make sure you use the same time frame for all data collection.
If you are evaluating the health status of individual patients after a treatment, think through your follow-up time frame so it is long enough to capture results. (A few days or even a week after surgery, your patients may still be focused on pain relief rather than functional improvements.)
3. Create an organizational structure to accommodate outcomes management.
Plan your collection processes
You should integrate outcomes measurement seamlessly into your process, so it isn’t an inconvenience for patients. That requires planning. Who will conduct the data collection? How will you schedule survey time for patients? Who will perform data entry if that is required?
If you don’t have anyone on staff who can enter data and organize reports, you may want to hire an outcomes management service to do that for you.
In a large, multispecialty practice or a practice affiliated with a hospital or health system, others may already be monitoring outcomes. You can begin by piggybacking on their efforts, which will provide the added benefit of data comparisons, Stevic says.
4. Use validated and reliable instruments.
"There isn’t a good clinician who is approached for participating in a drug trial who would ever consider changing the data collection protocol or the dosage of the drug," says Stevic. "Yet, if you present a standardized reliable and valid survey tool, such as the SF-36 [health status questionnaire] to them, people don’t hesitate to want to fiddle with the dosage change questions or drop questions.
"Or they’re very cavalier about data collection putting it on the counter, or just keeping people busy while they’re in the waiting room where there’s no privacy," she says.
A host of validated health status, quality of life, and symptom identification surveys are available from the medical literature, specialty societies, or commercial vendors. Stevic urges practices to view the validated surveys as diagnostic tools, similar to a lab test or an X-ray.
5. Educate patients about your outcomes program.
If you give a health status questionnaire to patients in the waiting room, make sure they know its importance, Stevic says. Don’t simply include it in a stack of registration paperwork.
Stevic recalls watching a patient give the SF-36 to his grandchild to color in the bubbles. "You certainly can’t call that valid data," she says.
For patients to take the surveys seriously, you need to give them private space (even if it’s in the lobby) to complete it. And both staff and physicians need to explain how it is used to evaluate their health and influence their care.
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