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Dr James L HollyBy Dr. James Holly, CEO, Southeast Texas Medical Associates

I don’t expect you to know what the number 8,760 means, but I’ll tell you.  It’s the number of hours in a year.  As a primary care doctor for over 30 years and the CEO of a private practice, I can tell you that if you are a patient who requires a lot of care, you are likely being seen by a physician maybe one or two hours a week, and that doesn’t amount to very much when you consider the total hours in 365 days.  So what does that mean?  Who is in charge of managing your health for most of those 8,760 hours in a year?  The answer is you.

As we get older it becomes more difficult for us to care for ourselves, and without a plan and a proper support system it can be nearly impossible.  For many of us, if we get sick and need hospitalization, we’ll likely get some discharge papers when we leave the hospital.  But for many patients, those papers don’t mean anything unless they can be followed. And for the physicians providing the post treatment care orders – in order for the plan to actually work – it is crucial to have a better understanding of the patient beyond their illness.

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There are more influences that matter for that patient that go beyond how many times a day they should take the prescribed medication.  You have to consider the family situation, education, genetics, poverty, location, transportation situation and a whole lot more.  Each of these factors is an important key data point that helps us facilitate as much knowledge as possible around the patient, and to make it as easy as possible to do the right thing for the individual patient.

The organization and analysis of the raw data obtained in the care of patients can then produce information on the basis of which decisions, treatments, and plans of care can be provided to patients. These materials can help patients take charge of their own care and become actively involved in the management of their own health after they leave the hospital.  We wanted to audit information that was going to make a difference, and we knew that started with the way we looked at our patient data.

As an example, if we are discharging a patient who, in his post treatment care report states he must schedule a colonoscopy, but we don’t have data that shows this patient lives alone, has limited means of transportation and has financial challenges, chances are this patient will not follow up with the post treatment plan as outlined.

With analytics, we wanted to track how we could better serve our patients and provide them with a post treatment care plan that could work for them, and more importantly get them on board with following through with the plan.  This might include getting in touch with the patients extended family to help transport the patient to and from treatments or find ways to work with insurance companies to get procedures approved or have co-pays waived.  We knew by better understanding our patients at a 360 degree point of view, we could make a difference in their lives—and we were able to prove this with our data management reports.

IBM’s analytics software allows us to deliver care intentionally, rather than coincidentally.  When we see a patient with a master plan already designed based on the analysis of all their data, we can intentionally intervene in their lives in ways that will make a difference, and that is a beautiful thing.

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1 Comment
 
April 14, 2011
8:07 am

I’m impressed! You’ve managed the almost impsosblie.


Posted by: Lissa
 
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