New Hyde Park, N.Y.-based Northwell Health recorded wins in several care-quality initiatives by embracing imperfect data, executives told Becker's Nov. 4.
In October, the National Association of Accountable Care Organizations presented an excellence award to the system's accountable care organization, Northwell Health ACO, for its work in creating an algorithm to identify patients at risk for hypertension and increasing depression screenings.
The organization began focusing on hypertension performance between late 2022 and early 2023. In one year, the percentage of patients diagnosed with hypertension with a recent controlled blood pressure reading — equal to or less than 140/90 — increased from 67% to 78%.
One of the main challenges from this project was aggregating data from about 40 EHRs, according to Nancy R. Beran, MD, vice president and ambulatory chief quality officer of Northwell.
The number of patients and the size of healthcare organizations are ever-growing, too, she said, causing the denominator to constantly expand. For Northwell, leaders analyzed hypertension improvements among about 200,000 patients.
"I think lots of health systems have taken on hypertension," Dr. Beran said. "I think for us and for a lot of large accountable care organizations, it's, how do you take on hypertension across myriad stakeholders and a large denominator? How do you take a population health approach? How do you standardize your approach to blood pressure and create a standard and goal so that you move the needle?"
To achieve substantial results, Northwell created a framework for clinical standards to be rolled out across all service lines. Each service line, from cardiology to internal medicine to pediatrics, had its own hypertension standard before the system launched an overarching clinical standard.
Northwell also increased depression screening rates and supplied resources through a specialty-agnostic approach.
About 30% of the system's patient population sees a Northwell primary care physician, so to increase screenings, the organization had to engage all specialties, according to Ramsey Abdallah, DHA, assistant vice president of quality management and performance improvement.
In the first four months of the initiative, depression screening rates increased 5%, leading to 75,000 additional screenings.
The key to these successes was "being comfortable with imperfect data," Dr. Abdallah said.
"Perfection is the enemy in many of these initiatives because you're not going to be able to start [with complete data]," he said. "You just have to get OK with, you know what, I'm 70% of the way there. Let's start, and then we'll continue to build the bridge as we move forward."