A Legacy of Local Healthcare Solutions

Changes brought by the Affordable Care Act have caused tremendous shifts within most healthcare organizations. But for the Metropolitan Chicago Healthcare Council (MCHC), which merged this year with the Illinois Hospital Association to form the integrated Illinois Health and Hospital Association (IHA), it has simply meant tweaking its focus while continuing to pursue an eighty-year-old mission: to serve its members by identifying the precise issues they face and developing local solutions.

Its history of accomplishments along these lines runs deep. In 1956, MCHC established standards for blood-bank operations. In 1963, to leverage savings through economies of scale, it developed the Chicago Hospital Council Group Purchasing Service, the first group-purchasing organization in the country.

Recently, with help from senior director Adam Lynch, the organization has shifted attention to current issues, such as adjustments in reimbursement and how those changes relate to patient outcomes, accountability, and risk management. It recently began increasing its educational programming in patient financial services, for example, to better prepare hospital staff for dealing with recent Medicare and Medicaid changes.

“None of today’s challenges are unique to Chicago, but we’re still focused on developing collaborative, innovative, cost-effective solutions that are tailored to provide value to member healthcare organizations in the metropolitan area,” Lynch says.

With that priority, one of MCHC’s primary challenges has been developing programs and initiatives that meet the needs of more than 150 hospitals and healthcare organizations that range from academic medical centers and community-based facilities, to for-profit systems and large multi-state networks.

For the past six years, MCHC has been working on its Health Information Exchange (HIE) initiative. Lynch says his primary role has been to bring all the parties together and raise awareness of the program among members who might not yet be part of the network.

To date, 40 percent of MCHC’s institutional members have signed on, resulting in more than one million clinical messages per week, 1.7 million unique patient records, and 34 million admit, discharge, and transfer (ADT) records since going live in September 2014.

“Our plan has always been to build participation gradually. As one of the three largest healthcare markets in the country, we wanted to be able to avoid any systemic problems or false starts once we went live. A slower startup is also a better way to prove the efficacy and sustainability of the system,” Lynch explains.

Although still in its early stages, the HIE system—developed collaboratively through 7,500 hours of time by MCHC members—is already delivering benefits to participating organizations. According to Lynch, there have been reductions in duplicate tests and services and improvements in the efficiencies of administrative tasks. In addition, primary care clinicians are able to follow up with patients more proactively, thereby reducing readmissions. The system is creating a database of information that will make it easier to identify trends in the near future.

“HIE gives us greater visibility throughout the system into the continuum of care as we see more and more cross-facility patients,” Lynch says. “We’re just at the beginning of this tremendous opportunity to use the data not only to improve the delivery of care and patient interactions, but to use the information to develop better solutions for whatever issues we face.”

To illustrate the impact on patient interactions, Lynch recounts a story of playing “doctor visit” with his five-year-old son. After a brief exam and a shot, his son (acting as both nurse and doctor) spent the rest of the appointment typing details into his computer while providing Lynch (the patient) with just a few cursory comments.

“HIE will help us give doctors more time to focus on patients because so much of their history and essential clinical information will already be accessible right at the physicians’ fingertips,” Lynch says.

The changing healthcare environment has meant evolving roles for many practitioners, including the responsibilities of physician assistants (PAs) and advanced practice registered nurses (APRNs). To document and assess their contributions, MCHC created a joint venture with University HealthSystem Consortium  to establish The Center for Advancing Provider Practices (CAP2). The program compiles data to create benchmarks and comprehensive toolkits to help maximize the effectiveness and efficiency of PAs and APRNs within care teams.

CAP2 is a nationwide initiative with more than 200 participants in thirty-one states. It will provide information that Chicago-area facilities can use to compare their efforts and results to other providers nationally—and to take advantage of best practices that can improve efficiencies and outcomes locally.

Lynch calls HIE and CAP2 “just the tip of the iceberg,” because of the many subtle changes that will come in the wake of their implementation.

“There will be lots of process changes below the surface so organizations can use the new tools effectively,” he says. New clinical approaches to treatment based on immediate access to electronic information will materialize; new methodologies will be developed for aggregating and analyzing data to improve patient outcomes; and patients will be better informed of the benefits of participating in HIE.

However these new processes are determined, Lynch is encouraged by the dynamics involved to reach them.

“Competitors are coming together to think through the issues and identify the most appropriate solutions,” he says. “That’s very exciting because it’s exactly what MCHC encourages. We want to break down walls between organizations to find ways to lower costs and improve outcomes that lead to a healthier patient population.”