In a session at the Becker’s Hospital Review annual meeting in Chicago on May 17, two consultants with The Camden Group, Senior Vice President Teresa Koenig, MD, and Vice President Eric T. Nielsen, MD, discussed critical parts of clinical integration and how integration is a journey on the road toward accountable care.
“Think of clinical integration as the contract model and a way to integrate care as well,” Dr. Koenig said.
The speakers discussed seven components of successful clinical integration:
- Establishing a mechanism to monitor utilization, controls costs and assure quality of care.
- Selectively choosing physician participants.
- Providing a significant investment of monetary and human capital.
- Using common information technology to ensure exchange of all relevant patient data.
- Developing and adopting clinical protocols.
- Basing quality of care reviews on the implementation of protocols.
- Creating mechanisms to ensure adherence to the protocols.
Dr. Nielsen, who practiced primary care for 30 years, said healthcare organizations seeking clinical integration should develop an infrastructure devoted to improving quality and efficiency. This infrastructure ideally includes a multispecialty group of physicians with a committee, set of guidelines and a commitment to improve the process. That commitment is most crucial, both speakers said.
“All this movement without change in care delivery will not get a better outcome,” Dr. Koenig noted.
Dr. Nielsen discussed how health systems benefit from clinical integration; perhaps most practically, the alignment broadens the system’s referral base. Additionally, Dr. Nielsen said integration facilitates quality improvement, builds a brand for patients and payors to connect with and expands physician leadership in clinics.
Building a viable clinical integration model is no easy task, both speakers agreed. Dr. Koenig joked that if hospitals or health systems are thinking this can be set up in one month, they should think again.
The integration involves medical management tools, population analytics, clinical protocols, a continuum of care, IT support and an overall collaborative nature among physicians and the healthcare organization.
Dr. Nielsen noted that hospitals and clinics sometimes integrate under a risk model.
When building a clinical integration model, Dr. Koenig suggests that all parties come into it planning for the greatest amount of risk.
“How would you do it differently if you were at total risk?” Dr. Koenig rhetorically asked the crowd, a mix of executives and physicians. “That’s the question you have to ask yourself.”
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