As a society, we do love the idea of things that come in threes. It is usually a sign of good luck, and writers often like to think in terms of threes when creating content. There are Three Pigs, Three Bears and Three Musketeers. Plays often come in three acts. It might have started with Julius Caesar saying, “I came, I saw, I conquered,” but even rock music groups have followed the idea of the rule of three – are you familiar with Blood, Sweat and Tears, for example? And baseball has certainly taken threes to the extreme – with three bases, triples, triple plays, and three strikes.
Considering our fascination for the power of three then, perhaps it is no surprise that when the Institute for Healthcare Improvement, or IHI, put together its approach to optimizing health system performance, it settled on the idea of Triple Aim Healthcare. It is IHI’s belief that medical practices need to develop new designs in order to simultaneously pursue the three goals of achieving effective healthcare, or the “Triple Aim:”
Improving the individual patient experience by improving quality of care and satisfaction with the level of care provided.
By improving quality of care to the individual, it should follow that society as a whole will benefit.
Improving patient results and decreasing the need for chronic care management by improving systems and procedures should result in a decreased cost of providing care. Practitioners should therefore be able to experience increased revenue through more cost-efficient practice and revenue management.
Triple Aim Healthcare is an outgrowth of the IHI’s response to the ever-increasing costs of providing and receiving healthcare in the United States. This may be due to the aging “Baby Boomer” population, increased number of patients with chronic health problems, outdated office records management, lack of efficient communication systems between healthcare providers, or other contributing factors.
To integrate Triple Aim Healthcare into a practice philosophy, IHI recommends following a systematic change process which includes:
The end goal is to empower patients while broadening the impact of primary care, thereby creating a positive health journey throughout the course of a patient’s life.
Implementing the principles of Triple Aim is crucial to healthcare organizations which are making changes in compliance with the move toward a value-based payment system. According to IHI, the initial components involved in concept design for meeting the triple aims include:
An initiative from IHI and partner organizations, Pathways to Population Health, helps health care change agents make practical, meaningful, and sustainable advances in population health. Their Pathways Framework helps chart paths which can be taken to foment changes in population health. Their work has codified six foundational concepts for Pathways to Population Health:
While they encourage practices to celebrate where they are on the population health journey, they also urge them to continue to seek actions which can take population health improvement efforts to an even higher level.
In order to determine how well your practice measures up to the goals of Triple Aim, the IHI suggests asking yourself the following questions:
The adaptation of Electronic Health Records, or EHRs, can help medical practices that are seeking to implement Triple Aim Healthcare. An EHR can be used for:
Faster charting with less clicks leaves more time for patient engagement and better access to key patient information during the office interaction. This helps to increase the level of patient satisfaction. Not having to constantly go back and constantly re-enter the same patient data enables the practitioner to develop better care plans with patients and families.
Better scheduling ensures maximum office efficiency, which lends itself to the goal of lower per capita costs. It also ensures that individual patients keep up on yearly appointments and lab testing by providing for quick and easy scheduling reminders.
To work towards the aim of improving population health, practitioners need to be able to spot healthcare gaps within the patient population so they can develop and implement appropriate remediation efforts.
Perhaps one of the most important elements of achieving better patient care is the ability to foster a better flow of communication through the use of a sophisticated patient portal. This can help the practice to electronically exchange messages or share visit summaries, test results and educational materials. It also increases interaction levels before and after office visits, which helps promote the ability to learn from patients and their families
Achieving better internal communications through improved messaging systems helps to increase office efficiencies and lower costs.
One efficient way to lower costs is to improve the billing system so that claims are quickly and efficiently input to insurance providers, and are routinely paid upon a first-time submission.
Triple Aim incorporates elements which focus on mechanisms that provide support for individual patients as well as their family, redesign of primary care services and structures, improved population health management, cost control management, and total system integration. No matter what area of health or health care improvement your practice is in, achieving these components will provide benefits not just in terms of having happier and healthier patients, but also being operated in a more cost-effective and profitable manner.
The IHI has many educational resources, information, and case studies to help your practice conduct a self-assessment, understand what is involved in taking the Triple Aim journey, and collect data to assess your practice in relation to Triple Aim elements. Review the IHI materials carefully to determine whether implementing Triple Aim Healthcare can help your medical practice to be more effective, efficient and profitable.