New Payment/Care Models

TOOLS FOR IMPROVING CLINICAL OUTCOMES

Tools for proactively managing patient health, coordinating care across providers, and supporting new care and payment models.

Evolving models of care and reimbursement are driving healthcare providers and organizations to seek technology that can help track, analyze, and predict patterns of care to coordinate care for improved system value. Hospitals, health systems and providers are looking to interoperable health data systems, such as QHN, to advance clinical outcomes, improve quality, and lower costs.

Providing coordinated care across all care settings, better follow-up care and helping to creating more cohesive care teams is the foundation of value-based care models. These models are typically focused on practice transformation activities to support the management of a patient panel (population management). The necessary care team and work-flow changes require expanded access to real-time clinical data from disparate health organizations and sources. QHN is working to eliminate “gaps in care” so patient information is available when and where it’s needed.

QHN Tools to Support New Models of Care:

  • Patient Summary Query, providers may query the patient longitudinal record for all associated patient information from disparate sources, this now includes HIE-to-HIE data exchange with out-of-state sources.
  • Direct Messaging, this service is available for free to QHN participants and allows for secure provider to provider communication. Direct may be used for referrals, to push patient information to other healthcare providers and other secure communication needs.
  • Encounter Notifications-ADT Alerts, used to automatically notify participating providers that their patients have had a hospital or ED admit, transfer or discharge. This now includes alerts for out-of-state care episodes for connected HIEs. Talk to your Clinical Account Manager to learn about “Subscription Alerts” for your patient panel.
  • Integration of Behavioral Health Information, Mind Springs Health is now sending their discharge summaries and Clinical Care Reports electronically through QHN. This information is also available to authorized providers in the QHN Patient Summary.

RESOURCES FOR THE TRANSITION TO VALUE-BASED PAYMENT

Transforming Care Practices Initiative (TCPi)

TCPi is one of the largest federal investments uniquely designed to support clinical practices through nationwide, collaborative, and peer-based learning networks that facilitate practice transformation. More information about TCPi.

Primary Care Transformation Resources Catalog

This catalog features a comprehensive listing of Colorado opportunities to enhance and improve practice efficiency and effectiveness. The opportunities outlined in the catalog are varied and many include in-person facilitation and assistance, skill training for practice staff and assistance with optimizing providers’ use of health information technology. View and download the catalog.