Coordination of Care Through Integration and Standardization: UnityPoint Health

UnityPoint Health, formerly Iowa Healthcare, a multi-city integrated delivery system based in Des Moines, recently underwent a transformation aimed at empowering primary care physicians to take the lead in care coordination for patients. “Our focus is on providing the best outcome for every patient, every time,” says Todd Holling, assistant director of clinical applications for the health system. “We’ve tried to infuse that goal into every part of our business—not just the front-line providers, but also the administrative and IT ranks, so that everyone understands that what they do makes a difference.” Leveraging a governance structure that enables geographically disparate facilities to share and adopt each others' best practices, UnityPoint is driving standardization of processes throughout all of its facilities—an evolution that IT staff see reflected in the challenges they face. “Driving toward more integrated and standardized platforms is our number one priority,” says Holling, whose role includes applications support for radiology, cardiology, lab, pharmacy, oncology, and more. “We have a lot of moving pieces, but at the end of the day we’re all trying to do the same things. The more variability we have in our IT platforms, the more costs, complexities, and issues we face.”

Coordination of Care

One of UnityPoint’s goals is to better coordinate patient care among providers and service lines, resulting in optimum management of population health. “All of the patient’s providers need to be talking together and coming up with the best plan of care for the patient,” Holling says. “From an IT perspective, we need to be able to utilize the information in our systems to empower better clinical decision-making. We need to be using patients’ datasets to support comprehensive care and be proactive, with the end goal being less time spent at our facilities. Coordination is critical to meeting patients’ needs.” That means writing complex interfaces between ology-specific platforms and the health system’s Epic EHR. “The more interfaces you have between systems, the more potential there is for problems,” Holling says. Smooth integration between platforms—for instance, he notes, the system’s McKesson PACS communicates easily with its EHR—aids in minimizing the complexity. “We meet quarterly with McKesson’s design and development team to help shape the direction of the product based on the space we’re in,” he says. Shaping the evolution of its PACS platform is important for UnityPoint because of the critical role imaging can play in care coordination, Holling notes. “Imaging is very important to screening and preventive care,” he says. “We want to see our physicians being able to make appropriate clinical decisions, choose the correct imaging procedures, and have the accessibility to have the results at their fingertips—and share them with their patients as well.”

Empowerment and Integration

Looking ahead, Holling says, UnityPoint’s roadmap for its imaging services is structured around supporting the growth in demand and increasing the accessibility of reports. “We want to be more virtual with our architecture, lighter in our delivery format, so that people can access imaging data anytime, anywhere without having to download a full client,” he says. “We need always to be engaging our physicians so that we know what we can do to better support them.” To that end, the health system hosts an annual imaging summit and convenes a quarterly PACS governance committee with a physician champion from each of its facilities. “We discuss the roadmap and direction of our PACS ecosystem as we move forward,” Holling says. “It increases communication, makes our radiologists and physicians feel that their expectations are being heard, and drives system improvement based on their input and feedback.” In the future, UnityPoint aims to integrate imaging into its patient portals, making reports and images more accessible to patients as well. “It’s easier for people to see things graphically versus getting a written report or care summary,” Holling points out. “When patients have access to their own imaging, it makes them feel more involved and empowered, and helps them understand what’s going on with their own care. Ultimately, we will be able to deliver images to patients so that they can access them digitally and in real time from their homes.” All of these initiatives point to the critical role of imaging informatics in enabling not just better coordination of care, but better management of health across populations. “It all boils down to effective communication between providers,” Holling says. “We’re always driving toward that goal of the best outcome for every patient, every time.” Cat Vasko is editor of HealthIT Executive Forum.