New Q‑Centrix report: mixed news about the state of the healthcare system

A new report from Q‑Centrix, a healthcare quality solutions provider focused on improving the quality and safety of patient care in the U.S., shows that the healthcare industry is gearing up for some major transformations in the year ahead.

The report, published last week, looked at the quality of program participation and resource needs across three main areas of healthcare quality reporting: regulatory, infection prevention, and clinical registries.

Most of the findings are encouraging. Hospitals and healthcare providers are becoming more committed to providing the highest quality of care.

According to the report, the industry will see a growth in value-based care, with an estimated 4% annual increase in value-based payments and an estimated 7% average annual increase in participation in major clinical registry programs.

However, new data points out that healthcare-associated infections are still a widespread threat in hundreds of hospitals across the U.S. Over 5,000 infection control practitioners (IPC) are needed to effectively prevent infections, a gap that might take years to fill.

Let’s take a deeper look at the Q-Centrix report, to understand how the healthcare landscape will shift in 2019 and what affect the changes will have on patients and providers.

Higher participation in clinical data registries

The increase in participation in major clinical registry programs mentioned in the report is by far the most important finding.

As the industry makes the transition from fee-for-service to value-based payment, more hospitals are starting to adopt clinical quality measures (CQMs) and to participate in The Centers for Medicare & Medicaid Services (CMS) quality reporting programs. The top 20 major registries are expected to grow in participation at an average of 7% each year until 2021.

State-level registries are spreading, too. There are currently eight sponsors and 23 programs across eight states. “The findings show not only that clinical registry participation continues to increase, but that it is growing faster than originally anticipated at both the national and state levels,” said Q-Centrix CEO Milton Silva-Craig in the report.

These registries represent the gold standard in terms of clinical
quality data. They were designed to work in the best interest of patients.

They keep records about everything, from demographics to treatments to patient-reported outcomes. Registries also help professionals decide what is the most effective treatment for a disease by comparing the effectiveness of different treatments and analyzing various approaches to a procedure.

The number of hospitals submitting to these registries is projected to increase from 18,432 in 2017 to 23,773 by 2021, according to the report.

Clinical data registries with the highest participation in 2017 were The American College of Surgeons Cancer (5,039 facilities) and The American Heart Association (2,026 facilities).

“The fact that the top five most-participated-in registries address the nation’s two deadliest diseases is a strong clue that hospitals and healthcare providers are eager to ensure they are providing the highest quality of care in these specialties,” added Silva-Craig in the report.

Data centralization, the key to better healthcare

Data is collected via secure online portals or electronic health record (EHR) systems.

Registries, the report shows, have become more sophisticated, updating their data collection forms, which in turn led to an average increase in data abstraction times of 19%. This means professionals are getting faster feedback on the quality of care provided and patients are the first to reap the benefits. On the other hand, it also means that registry participation is now more complex and time consuming. Cost, interoperability and vendor management are some of the most common barriers faced by hospitals.

The good news?

Health providers are now better equipped with cost-saving solutions that “break down traditional silos in registry management, ” Silva-Craig explained. One of those solutions is the centralization of quality data reporting.

Q-Centrix Chief Product Officer Brian Foy gave an analogy inside the report to show how hospitals are currently operating, while facing increased competition from outpatient facilities: “It is like having your utility and living expenses increase each year, but you only receive pay cuts and never a raise.”

In order to stay relevant and streamline operations, many hospitals have started merging. In 2017, the report shows, mergers in the industry set a record with 115 transactions.

Reporting processes are even more challenging for these newly formed health systems with multiple facilities and departments. Their data is often recorded in unstructured formats and stretched across multiple EHR systems. Already short-staffed doctors and nurses struggle to log in every piece of information from billing codes and medication lists to tests and appointments.

By centralizing data reporting, health systems can take the burden off the staff’s shoulders, allowing them to focus more on patients.

In an attempt to streamline how data is collected, the CMS will soon remove three reporting measures. The changes are expected to save costs and hours for the affected hospitals.

A Q-Centrix analysis paints a different picture. Q-Centrix estimates a burden reduction of more than 400,000 fewer hours than the CMS estimate and cost savings of nearly $15 million less.

Despite the gap between estimates, Q-Centrix writes that hospitals will still continue to make progress by using technology to abstract data instead of doing it manually. This will improve security protocols, reduce medical errors and decrease costs.

The Q-Centrix report offers four steps towards a successful centralization:

1. Having a central person in charge of quality for an entire hospital or system to ensure that quality reporting is accurate and results are translated into actions.

2. Adopting software solutions that allow for capturing data for all hospital processes.

3. Engaging top physicians in quality efforts, which will inspire their teams to take more action in freeing themselves from administrative data.

4. Coming up with improvement initiatives. Some examples from the report: based on number of beds putting in place a recommended number of infection preventionists, participating in more clinical registries or updating tech systems.

The challenges of collecting data

The new report brings some less-than-stellar predictions regarding the way hospitals deal with infections.

About 1 in 25 hospital patients has at least one healthcare associated infection on any given day, according to the U.S. Centers for Disease Control and Prevention (CDC). Whenever this happens, the hospitals are penalized by the CMS by lowering their Medicare reimbursements. In 2017, this was the case for a whopping 750 hospitals. The main culprit? A massive shortage of infection control practitioners (ICPs).

Ideally, each hospital should have one IPC per 100 occupied beds. The report discovered that there are currently 900,000 beds and only 3,600 ICP tending them, a far cry from the 9,000 needed. This situation is endangering patients, causes slow discharge times and increases care costs.

According to the report, it might take years until the situation improves. Typically, nurses become certified ICPs in one to two years and cost hospitals approximately $100,000 per year to hire them full-time.

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Overall, the Q-Centrix report brings hope for the entire healthcare industry. More and more hospitals are embracing a patient centric-approach and harnessing the power of data to deliver high quality care for less. This shift isn’t accidental. It’s a survival mechanism in response to the rise of outcare facilities that offer more convenient and cheaper health services, including surgeries and radiation, without the need of an overnight stay. Either way, as competition in the healthcare industry increases and providers turn to technology to streamline their work flow, patients are guaranteed to receive better care for less.