Trends in value-based care favor hospitalists, expert says
Value-based care’s ascendancy equals increased opportunities for hospitalists who know how to wield informatics, speak the language of systems improvement, and have an ability to function as a commodity within a health system, according to the dean of hospital medicine.
“If I were a betting man, I’d say there is no way value-based care can happen without hospitalists,” Robert Wachter, MD, MHM, said during a leadership summit at this year’s annual meeting of the Society of Hospital Medicine. Dr. Wachter is the New York Times bestselling author of “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.” He also is a professor and chair of the department of medicine at the University of California, San Francisco.
Darnell Scott
There is no way value-based care can happen without hospitalists, says Dr. Robert Wachter.
The rise of hospitalists might seem counterintuitive to some, according to Dr. Wachter, since one of the main goals for value-based affordable care organizations is to cut rates of hospitalization. But then reality sets in.
“There will be talk about closing hospitals and building competencies in ambulatory care. That’s the first 5 minutes, but then there is the realization people are still going to get sick, representing a massive amount of cost, and as far as I can tell, there is no alternative to having hospitals for this,” Dr. Wachter said. “Hospitalists will come out just fine.”
This will be true particularly for hospitalists who understand that electronic health records companies have helped health systems collect massive amounts of data but do not offer help for how those data can be applied to drive better outcomes and improve performance ratings, according to Dr. Wachter.
“These companies have no competencies in data analytics or data visualization,” Dr. Wachter said. “I am hopeful because Silicon Valley has woken up to the possibilities of this and are looking for ways to partner with health care. … The world of improving value, safety, and patient experience is going to be a world enabled by thoughtful use of informatics. So, if you don’t have those competencies, I think it’s important to grow them over time.”
Speaking the language of “lean” or that of other systematic strategies for improvement will also increase the value a hospitalist can bring to an organization, according to Dr. Wachter, who said that as hospital senior leadership and frontline personnel work together to implement system improvement, new leadership roles for hospitalists, ranging from chief patient experience officer to chief quality officers, and everything in between, are being created.
Another “hopeful trend” for hospitalists is the growing focus on the provider experience, said Dr. Wachter, since improving systems is not possible if staff are not engaged. “It’s impossible to believe you’re going to accomplish your goals of improving care and improving patient experience, and efficiencies, with a cadre of burned-out doctors,” he said.
Dr. Wachter said that to be indispensable, hospitalists need to understand they often are commoditized, offered by their senior leadership as bargaining chips when deals are made with surrounding health systems seeking to outsource some of their hospitalist functions.
“Managing a large community-affiliated network was not a core competency in the past,” Dr Wachter said. “But it will become increasingly important.”
