Accelerating quality performance in the real world

The National Academy of Medicine defines quality as the extent to which healthcare services enhance the likelihood of achieving favorable health outcomes for both individuals and populations while aligning with the latest professional knowledge.

Quality improvement serves as a systematic framework aimed at enhancing care delivery. Its primary goal is to standardize processes and structures to minimize variation, achieve consistent results, and elevate outcomes for patients, healthcare systems, and organizations. Best practice shows that key structural components should include the implementation of cutting-edge technology - such as automation and AI, strong organizational culture, and engaged leadership who are ready to drive change management, adoption, and knowledge capital.

Challenges in achieving quality performance

However, in today’s complex healthcare landscape, the pursuit of quality performance is not just impacted by internal processes and structures. Macroeconomic forces put even greater pressure on healthcare systems to deliver high-quality care while optimizing costs. 

For example, in regions with high costs of healthcare—such as California and specifically the Monterey Peninsula, where Montage Health is located, constrained budgets limit the ability to invest in quality improvement initiatives. At Noteworthy 2024, Meg Dingae, Enterprise Human Experience Director at Montage, shared how the community-based health system navigates a competitive healthcare landscape while striving to provide exceptional care at a controlled cost. 

Closing care gaps is a primary focus for Montage. As Dingae explained, Montage has identified five primary care gaps related to cancer screenings and diabetes management. By leveraging technology, they can identify patients who have not completed these screenings, and through automated outreach, patients receive reminders, which significantly increases the likelihood of them receiving timely care. This AI-powered approach has yielded impressive results in reducing care gaps and improving health outcomes.

Similarly, a physician-executive from a large non-profit health system discussed the innovative use of Notable’s AI Agents to increase access to care during the Noteworthy panel. 

The physician executive shared, “During the COVID-19 pandemic, we used Notable to reach out to our patients, starting with the most vulnerable, to say, ‘Hey, you qualify for the COVID-19 vaccine, and we have vaccines available. Would you like to schedule an appointment at one of our clinics?”

She continued, “We were able to run really efficient mass clinics with patients actually getting consented by Notable before they came in…”

By turning to AI and automation, these leaders were able to accelerate quality performance while managing costs and keeping the patient at the center, despite external factors that would typically hamper this critical work.

Best practices for accelerating quality performance

While addressing the operational and financial challenges and providing real-world examples, both leaders also shared best practices to encourage fellow executive leaders in attendance to look for opportunities to enhance quality performance within their organizations.

1. Leverage automation technology: Investing in technology that streamlines administrative tasks can drastically reduce the burden on healthcare providers, allowing them to focus more on patient care. Automation tools can help identify care gaps, schedule appointments, and manage follow-ups. As mentioned by Dingae, Notable has enabled Montage Health to automate alerts for preventive care, significantly increasing their screening rates.
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2. Engage healthcare providers in decision-making: Establishing a strong partnership between healthcare providers and administrative teams is crucial. By involving clinicians in decision-making processes about AI Agent workflows and quality measures, organizations can secure buy-in, enhance staff satisfaction, and improve overall clinical outcomes. 
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3. Focus on patient-centric care: Both organizations advocated for a philosophy centered on patient engagement and convenience. As healthcare becomes increasingly complex, it is vital to streamline processes from the patient’s perspective—ensuring that appointments are easy to schedule, follow-ups are straightforward, and communication is clear. This approach not only enhances patient satisfaction but also promotes adherence to necessary care, ultimately driving better health outcomes.
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4. Continuous monitoring and improvement: Establishing a system for feedback and continuous improvement is fundamental to sustaining quality performance. Regularly reviewing data and metrics regarding patient care quality allows organizations to identify areas of improvement and adapt strategies accordingly. Choose tools that leverage automation and analytics to provide the insights necessary for ongoing enhancements and help collate the diverse quality measures demanded by payers.

Conclusion

The healthcare landscape is ever-evolving. Navigating mixed reimbursement models while striving for quality performance requires leaders to address challenges head-on. By implementing AI and automation, engaging healthcare providers, emphasizing patient-centered care, and focusing on continuous improvement, organizations can accelerate their journey toward achieving high-quality healthcare. 

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