Part 2: The Triple Aim - The Energy Behind Improved Outcomes and Value Through Evidence-Based Care
Published 4/21/2021
This blog is the second part of a two-part series that explores how providers in an ACO like Kelsey-Seybold Clinic use the Triple Aim to improve outcomes while lowering the incidence of unnecessary/duplicate tests and hospitalizations.
Stretching your muscles as part of an exercise routine helps prevent injury and leads to more successful workouts. As someone who enjoys weight training, I always incorporate stretching to help avoid the injuries and tight muscles that would otherwise impede my performance.
As a physician, I also believe there are many ways to stretch within the practice of medicine – to provide benefits to patients and employers. One of the most powerful ways we can do this is by leveraging what we at Kelsey-Seybold call the Triple Aim. [Part 1: Evidence-Based Care, a Tenet of the ‘Triple Aim’] When we employ these three tenets of better value, better quality (evidence-based medicine), and higher patient satisfaction, we can stretch and strengthen how we practice evidence-based care to produce dramatic, positive changes for patients and impact medical costs borne by employers.
The Triple Aim for Stronger Care
The Triple Aim is an approach that relies on evidence to guide medical decisions. When we stretch the figurative muscles of the Triple Aim, our providers are able to achieve things like reductions in hospitalizations, improved outcomes and lower mortality, and better value.
The application is wide ranging, particularly useful for managing chronic conditions. A diabetic patient of mine reported blurry vision and symptoms that sounded like sugar toxicity. Rather than send him straight to the emergency room, we ordered stat labs in clinic and treated him with hydration and insulin. Over the course of his visit, his blood sugar went from 600mg/dL to under 300mg/dL. We were able to send him home and follow up with him the next day, when his blood sugar was at 180mg/dL, and scheduled his follow-up appointments with a diabetic educator and endocrinologist for within the week.
Without stretching ourselves to go above and beyond, this patient may have been sent straight to the hospital, where he would have been admitted as an inpatient into intensive care, incurring thousands in medical expenses and lost wages. With this example, it’s easy to see when the Triple Aim is used, the patient’s and the employer’s cost is much lower, and satisfaction is much higher, with the same or even better outcome due to reduced risk of exposure to other illnesses and unnecessary procedures in a hospital setting.
Across All Spectrums
Using the muscle of our ‘Triple Aim’ – evidence-based care – helps us eliminate five-day hospital stays by treating DVT blood clots in an outpatient setting and allows us to perform appendectomies in our own Ambulatory Surgery Center as opposed to inpatient surgery, a more costly setting.
Whereas many separate, individual practices may lack the resources or collaborative partnerships to achieve the same results, a multispecialty accountable care organization like Kelsey-Seybold can accomplish this through tight coordination across practices. In other words, Kelsey-Seybold is structured with the unique capability to stretch and strengthen evidence-based medicine – with physicians in more than 50 specialties, Ambulatory Surgery Center capabilities, and an electronic medical record that helps us use patient information to guide higher-value medical decisions. Having the quality metrics and infrastructure investments to go above and beyond enables us to provide a higher level of continuity of care and savings.
An accountable care organization that emphasizes value-based care, like Kelsey-Seybold, has an additional incentive to provide lower total medical cost. With a focus on value-based pricing, physicians are incentivized to keep employees healthy, and the way to do that is to manage chronic conditions and focus on preventive care to keep employees from needing expensive acute care.
Stronger Care Means Stronger Employers and Employees
For employers, the benefits of this approach are many, beginning with lower total medical cost as a benefit to your bottom line. By following the Triple Aim, putting a priority on care quality, and satisfaction, we can proactively treat our patients in ways that create a dramatically better value. And because employees are healthier, they’re able to be more productive in their lives — and in the workplace. The result is a more satisfied patient, and it’s not a stretch to say that employers are more satisfied, too.
Author
Victor Simms, MD, MPH, FACP
Chief of the Department of Internal Medicine at Kelsey-Seybold Clinic.
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