Article originally published on Medium.com | https://medium.com/p/93cbea9b6a05

Practice transformation. What does it truly mean?

Nadia Adams, CEO

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For the past 13 years, following the signing of the Affordable Care Act in 2010, I’ve worked with all types of healthcare provider organizations (health systems, ACOs, IPAs) to assist in transitioning them from fee-for-service to value-based care. Through those years, the healthcare industry has learned many lessons around contracting and incentive programs. However, from my experience, the one thing that has consistently impacted the ability for practices to successfully shift to value-based care has been engagement from the clinical team and allowing clinicians to lead the charge.

Too often, healthcare organizations are doing things TO the doctors rather than WITH the doctors. This is not unique to just the latest shift to value-based care. Dating back to the creation of Health Maintenance Organizations (HMOs) and later on with the conceptualization of continuous quality improvement (CQI) and Lean/Six Sigma, healthcare administrators have taken an increased role in dictating what clinical teams should and shouldn’t do. We, as healthcare leaders, have said, “Doctors are too busy to improve their operations to meet their metrics on their own. We will hire staff to support them in these improvement and transformation activities.” This approach resulted in making some improvements in business operations but have failed in creating sustainable change in clinical operations or those processes that require human intervention.

I feel that every person working in healthcare wants to help give each patient the care they need. I feel that our support staff tasked to assist clinical teams in improvement and transformation activities ultimately want to help these teams perform the best they can and bring joy back to the workplace.

Healthcare is the business of humans treating humans. Let’s go back to seeing our clinical teams as humans rather than numbers on a production line. To truly accomplish practice transformation, we need to start taking a human-centric approach.

In working with a variety of practice transformation teams from both payer and provider organizations, we have found significant variation in the skills base of these teams. The following list highlights the 4 Core Competencies of Practice Transformation specialists need to successfully move practices to value-based care.

1. Understanding Advanced Payment Models

The landscape for value-based contracting is an ever-evolving field. While these contracts are usually negotiated through a contracting department, Practice Transformation teams have an obligation to understand the terms of the agreements as they relate to the provider’s commitment in delivering on patient outcomes and/or other measures of effectiveness and appropriateness of care. Today, these contracts enumerate what success is for these metric goals, however, there is a gap in the ability for these clinical teams to bridge the gap between where they are today and where they need to be.

2. Non-Clinician to Clinician Relationship Building

First and foremost, strong relationships between non-clinicians and clinicians is essential for creating a collaborative and effective healthcare environment. Practice Transformation specialists need to know how to communicate, engage, and work with providers and clinical teams in order to help them understand each of their roles in supporting transformation activities. Behavior economics has become a popularized concept in engaging and changing patient behavior. There is an immense opportunity to employ similar tools such as nudges, demand generation, and minimal viable story in building lasting relationships with clinical teams as well as in influencing provider practice patterns.

3. Population Health Knowledge

We live as individuals within networks of communities and rely on our support systems and services provided in these communities to support our well-being. The transition from a focus on providing services to the sick to holistic wellness, starting way before someone shows symptoms of illness, continues to push our clinical teams to think outside of what happens inside the four walls of a doctor’s office. There’s a growing need for understanding the factors contributing to an individual’s health along with a need for effective care coordination across medical neighborhoods.

4. Rapid Experimentation

Innovating in today’s healthcare environment requires an appreciation for the complexities involved in the day-to-day delivery of care. Years of over-standardization and over-planning has created lengthy implementation times. On average, it takes 17 years for any evidence-based discovery to be implemented into the every day care setting, making up only 1% of evidence-based discoveries made. We need to empower the healthcare workforce to create an agile environment that allows for rapid experimentation of localized evidence-based solutions.