New Orleans New Health Care Network
Learn about the new Gulf South Quality Network
Although the United States spends more per capita than any other country on healthcare, numerous studies show that our overall quality of care does not reach the standards of other developed countries. Few in the American healthcare system are happy with the status quo of high costs and unsatisfactory outcomes, and many have been seeking innovative ways to correct it. Here in New Orleans, the newly established Gulf South Quality Network (GSQN) is doing its part. “Ours is the first clinically integrated healthcare network in Louisiana,” says Dr. Jeff Griffin, the board chairman of GSQN which is an independent company but one that is affiliated with East Jefferson General Hospital. “The concept of clinical integration is that all the providers in the network work to improve care and make it more efficient and cost effective.”
Central to these three intertwined goals of better outcomes, lower costs, and increased efficiency is technology. Electronic health records are part of this technological component. Instead of the current record-keeping system in which separate manila folders containing patient data are dispersed among the file cabinets of all an individual’s healthcare providers, EHR integrates them into a digital record. This way, patients don’t have to input their personal information, insurance information, and medical histories over and over again. Medical offices share this information, and doctors can quickly see what diagnoses, tests and treatments a patient has received from other doctors.
But clinical integration goes far beyond EHR. Networks like GSQN don’t just share information; they compile it and analyze it. Doctors can see larger trends about how their patients are faring, how the larger patient population in the network is doing, and how doctors’ own outcomes measure up to that of the network. “We use benchmarks that have been set up by a quality committee,” says Bill Bopp, the president of GSQN. “In determining those benchmarks, we look at national outcomes and community factors. Then we develop attainable goals for the physicians, and naturally cardiologists will have different benchmarks and goals than dermatologists.”
When particular physicians fall outside of the benchmarks, the network provides the resources to help them improve. And when physicians achieve good outcomes, their success can give them leverage in negotiating with insurance companies. “We have 370 physicians now that provide care,” says Bopp. “An opportunity may come along when we’re working with an insurance company, and as we engage with their membership and achieve better outcomes, it will save the company money. A portion of those savings would be shared back with the network to compensate physicians that meet or exceed measures.”
Clinical integration can find cost savings in other ways. By analyzing treatments across populations, one may determine that a cheaper drug or medical device may be as effective as a more expensive one. Or aggregated data can be used to learn which patients are soon likely to need an expensive hospital stay, and their providers can take measures to prevent it. Furthermore, the electronic format of medical and payment information allows for cheaper, quicker digital communication between insurance companies and healthcare providers.
Physician networks focused on clinical integration are a trend gaining momentum across the country. Bopp, who has been with GSQN since June, is an expert at setting up these networks. He developed two other such programs over the last seven years. One was a network of 350 physicians in west Texas called Covenant Health Partners, and the second entailed some 3,800 doctors in a network affiliated with Indiana University. “Currently, the Gulf South Quality Network draws on doctors at EJ and it is about the same size as Covenant was, but we’ve had interest from other physicians in the community. I’m expecting that the network will grow to include up to 1,500 doctors,” said Bopp.
“Most physicians out there are solo-practitioners or members of small medical groups, which can be a challenge for them,” Bopp continues. “This network gives them the opportunity to come together into infrastructure that they wouldn’t be able to afford otherwise. They can keep their autonomy but be part of network that’s preparing for healthcare reform.”
Not every EJGH doctor is a member of the network. Some have chosen not to join because it entails more work or for other reasons. Nevertheless, GSQN is driven by doctor participation. Chairman Dr. Griffin, who is a colon and rectal surgeon at EJGH, notes that nine out of ten board members are physicians. “The whole issue is that most doctors are idealistic about their patients. They focus on giving quality care,” he says. “This tool takes it to whole new level for us.”
Since the network is technology based, it shouldn’t be surprising that it’s unified by a website. Doctors log in to view the data gathered and compiled by the systems. Offline, different committees meet on a regular basis in order to collaboratively look at outcomes, and network administrators also make one-on-one visits to doctors. “The network started last year and is up and running, but it will probably be a five-year journey to get everything fully implemented,” says Bopp. “I think we’ll be able to do some things that bring national recognition to healthcare in our community.”
-HENRY ALPERT