Excellence In Cancer Health Home

Excellence In Cancer Health Home – According to the National Academy of Medicine, quality health care is care that is safe, effective, patient-centered, timely, efficient, and equitable. The World Health Organization also includes “integration” – meaning care and services that are coordinated between providers during prevention, treatment and maintenance – as a critical characteristic of quality care.

The ability of physician groups and health care systems to provide these elements goes a long way in determining the likelihood of positive outcomes and satisfactory care experiences for patients.

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Unfortunately, health care in the United States typically operates in a way that hampers clinical excellence and often removes incentives to provide high-quality care.

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To begin with, there is a general lack of integration in health care services. Physicians, specialists and hospitals are typically disconnected from each other and do not routinely exchange patient health information and data. This leads to gaps in care, including missed health screenings, preventable medical errors, unnecessary or duplicative tests and services, and higher costs. It also makes preventing, detecting, treating and managing complex health conditions – such as diabetes, heart disease and cancer – more difficult.

Lags behind peer countries on a variety of quality of care, health outcomes, patient safety and access measures – The Peterson Center for Healthcare and Kaiser Family Foundation

The traditional payment model in the United States – known as “fee for service” – further exacerbates lower-quality care. In the fee-for-service model, health insurers pay clinicians and hospitals for each service provided. This creates an incentive that encourages providers to perform as many tests and services as possible.

In contrast with fee-for-service, the value-based care model measures and pays providers against a budget for the care of a population. This model encourages prioritizing care that is tied to quality outcomes and allows care to be delivered in lower-cost settings, including the home. In this model, effectiveness of care, cost-effectiveness, safety and the overall health of patients are the success metrics. Since the 2000s, value-based care has been an industry goal as it strives to improve the overall quality of care.

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Kaiser’s physician-led integrated care model is recognized for its high quality, cost efficiency and superior outcomes. It starts with the way our model is structured: all 8 medical groups work together with a value-based mutual agreement to provide care. When care, coverage and medical facilities are under the same umbrella, the financial incentives that encourage offering higher volumes of services are removed. Physicians can focus on preventive care and quality outcomes, instead of providing discrete services that drive income.

In this integrated system, physicians are free to focus on practicing medicine and providing compassionate, patient-centered care. Connected by integrated electronic health records (among the largest and most advanced collections in the country), physicians and care teams have access to patient health information across specialties and locations, making it easier to coordinate care. And with real-time access to accurate patient health information—including screenings, lab and test results, prescriptions, allergies, and prior physician notes—doctors and other clinicians can provide the right care in the right setting at the right time. This unique approach to care is what we call “Medicine,” with quality and medical excellence as the goals.

This interrelated model provides further opportunities for quality improvement. For example, Kaiser has developed processes in which our pharmacy departments work closely with teams of prescribing physicians to establish a formulary that is based on the latest evidence (individual physicians have the freedom to make exceptions when appropriate).

Similarly, physicians and other Kaiser professionals identify medical products—such as devices, durable equipment, and implants—that produce the desired care outcomes. This approach aligns thousands of physicians who use the same equipment and develops shared expertise, which further enables cost-efficiency by giving Kaiser the ability to negotiate for lower pricing.

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Providing access to patient health records and information to multidisciplinary teams of physicians and clinicians helps ensure continuity of treatment for better outcomes. This helps eliminate missed or overdue screenings and avoids the ordering of duplicate tests, creating a better care experience while controlling overall costs.

In our integrated model, care is coordinated every step of the way. For example, our patient-centered approach to cancer care focuses on prevention, screening, treatment and research to drive continuous improvement. Cancer screening schedules are personalized based on age, family history and other risk factors to improve early detection. Lifestyle changes that impact cancer development are supported in a variety of ways, including nutrition and weight loss programs, as well as tobacco cessation. Genetic testing connects patients and their family members with genetic counselors and physicians for careful monitoring. Patients also have access to innovative treatments such as immunotherapy and clinical trials, when appropriate. All this happens in the same care ecosystem instead of different and disconnected specialists and locations.

In a large Kaiser study published in the American Journal of Managed Care in 2021, we found that patients cared for in our Southern California integrated care delivery system had better survival rates for 8 common cancers over a 5-year period than patients cared for. In other private settings. Survival rates are even higher for black and Hispanic patients—just one example of how coordinated care can help address racial and ethnic health disparities. In addition, an internal study published in 2022 found that in the communities we serve, Caesars members are 20% less likely to experience premature death due to cancer compared to others in the community.

Health information technology improves quality by improving the ability of physicians and care team members to share clinical information. Advanced electronic health records allow physicians to quickly update information—including patient health histories, test results, imaging, and prescriptions—and make it available to both clinicians and patients, making it easier to coordinate care, share best practices, and identify potential clinical gaps or errors. .

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Physicians practice medicine in a collaborative environment that is transparent and digitally connected. All care encounters, whether in-person or virtually, are directly recorded in each member’s electronic health record. Physicians and care teams have access to all medical data for each patient, creating opportunities for quality improvement.

For example, built-in safety and screening alerts notify clinicians about potentially dangerous medication interactions, allergies, and upcoming or overdue health checkups. These alerts prompt staff to schedule screenings and appointments immediately, increasing prevention and early detection. Physicians order prescriptions through patient electronic health records, which are connected to our formularies and pharmacies.

Learning organizations with access to vast population health data have unique capabilities to support delivery science, which, in turn, drives the evolution of evidence-based advances in clinical care. – Nancy Jean, MD, FACP, Chief Quality Officer, The Federation

Physicians use other innovative technology tools to manage quality. When they are not in the same physical location, doctors can consult with each other via phone, video and secure text messaging. This is especially valuable when, for example, a primary care physician needs to quickly consult with a specialist—who has real-time access to the patient’s record—for additional expertise.

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Another hallmark of quality care is the use of evidence-based clinical practice guidelines and best practices to guide care decisions. Clinical practice guidelines are a collection of care recommendations for specific conditions, and may include detection, diagnosis, and treatment.

At Kaiser, guidelines are developed under the National Guidelines Program. Physicians and other clinical experts rigorously evaluate and synthesize available medical evidence, turning it into expert panel recommendations that inform and guide clinical decision-making. To ensure they remain current, guidelines are routinely reviewed and updated at least every 2 years, or sooner if new evidence emerges.

Each year, the program convenes guideline directors from across the organization to review and select priority topics to be included in Kaiser’s guidelines. Selection criteria may include but are not limited to:

Guideline teams are then assembled to develop the clinical recommendations. They include a core multidisciplinary group of physicians representing the medical specialties most affected by the clinical guideline topic, as well as pharmacists, health educators and other medical professionals.

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Guidelines are disseminated throughout Kaiser and made available to all physicians through our clinical library intranet site. The quick and convenient access to the guidelines improves timeliness, efficiency and effectiveness, all of which serve to improve the overall quality of care.

Focusing on prevention reduces health risks, improves early detection for diseases and increases the overall quality of care. Unfortunately, many people in the United States do not get the preventive care they need. These reasons include access barriers, high costs or simply not knowing when they are due for scheduled screenings and checkups.

Our commitment to preventive care, a coordinated care approach and electronic health records make proactive outreach to patients easier. Electronic alerts prompt physicians and other team members to schedule patients for preventive screenings, immunizations and checkups. Convenient at-home tests for human papillomavirus (HPV) and post-in fecal immunochemical tests (FIT) for colorectal cancer support early detection. And telehealth visits—including phone, video and chat—for routine and preventive care can help reduce barriers for those

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