We had an enlightening conversation with Interop Hero, Chip Grant, M.D., Founder and CEO of Watershed Health. As a clinician, Chip offers a unique perspective to interoperability and discusses his vision for a more connected industry.
As a practicing interventional cardiologist, Chip saw a reoccurring problem with his patients that needed to be solved: fragmented interoperability. Nearly a decade ago, and with a mission to improve patient outcomes through better interoperability, he founded Watershed. As CEO, Chip leans into his personal and professional experience to help deliver on that mission every day. And as someone who regularly works with providers and patients, he has a well-rounded view of the issues that need solving — and the best way to solve them.
Watershed has built a closed-loop technology platform that expands collaboration beyond a health system’s walls, making it easier to build and maintain high performance post-acute networks. Watershed uses Direct Secure Messaging and Event Notifications technology to help facilitate better communication with post-acute care teams and improve patient outcomes.
Right off the bat, we wanted to know how Watershed is using interoperability to connect and empower organizations.
Chip sets the stage by first describing his personal definition of interoperability. One, he admits, may likely be slightly different from what people are used to hearing.
“To me, interoperability has two parts: one part is connectivity, right? So, connectivity has to exist and one of the things we believe with Watershed is that no part of the healthcare network can get left out. So, connectivity has to be every provider that’s touching a patient…But it also has to be these so-called non-clinical healthcare providers — folks that support patients that are socially isolated; folks that provide meals, housing assistance. And so connectivity has to be complete. And frankly, I think that’s one of the places where we’ve fallen short in this country.”
Chip goes on to emphasize the second part of his interpretation, which is the idea of providers engaging around certain behaviors that drive interoperability. To him, this is the more important part.
“You know, interoperability sort of as a state is a nice idea. But interoperability really means providers engaging and doing things with one another around care coordination. So, communication is one of these key things. Data sharing, which, again, when we think of interoperability we think of health information exchanges, but real data sharing of key information — the just-in-time information that’s needed to take care of a patient [is another key component].”
Chip also comments on the importance of following care pathways and best practices based on guidelines as key behaviors when interoperability exists. Plus, we can’t forget about quality assurance and process improvement. Chip and his company believe that in order for real interoperability to exist, there has to be that connectivity, but there also has to be providers engaging and doing these behaviors.
In his option, the problem has been that even though the industry has some connectivity, provider engagement hasn’t been consistent. Watershed works to address both parts of this issue. The first part is establishing total connectivity that allows communities to include all the different providers that may be present in a patient’s health care journey. The second is figuring out a way to measure key behaviors as they’re happening (and not happening), and then promoting providers who are engaging, so it’s clear to the network who’s really doing the work within interoperability. We love the idea of accountability and recognition, Chip. After all, it’s added effort for providers to intentionally and mindfully engage with their patients in a meaningful way. But to Chip’s point, this extra engagement is how we, as an industry, move forward to support better patient outcomes.
As a result of addressing this two-part issue, Watershed becomes a facilitator of interoperability, but even more so a promoter of interoperability. Chip and his team travel around communities to implement their post-acute care system. Through this initiative, they witness improved health outcomes across the spectrum of post-acute care (like hospital readmissions or emergency room visits), as well as an increase in better disease management. The common denominator? Total connectivity and those key behaviors mentioned earlier (provider engagement, effective data sharing, proven care pathways, etc.).
Through Chip’s nomination, we learned this post-acute care system has been proven to reduce readmissions by 50%, leading not only to better patient outcomes, but also considerable cost savings for providers and payers.
According to Jeff St. Clair, CEO of Springhill Medical Center, they were able to cut hospital readmissions in half, thanks to Watershed. Chip and his team feel fortunate to provide a platform for these positive outcomes to take place.
After hearing success like that, we wanted to learn about specific examples of where health information and provider engagement come together.
Chip makes everything sound so simple, but the reality is all this work has been a huge industry undertaking. Lots of time and money were spent on electronic health records and health information exchange — all of which has made Chip’s work possible. Providers all across the spectrum have had to engage and work toward transitioning to these technologies. That said, there have also been lots of providers who were left out, considering Meaningful Use and interoperability were primarily focused on hospitals and doctors.
“Again, it turns out that when you’re doing healthcare, you know, in the United States, you’re managing patients with chronic conditions — it’s a team sport. And if you leave anybody out, the whole team is going to fail because fragmentation at any point along the way — lack of interoperability — is killer.”
(We love that analogy, Chip! #TeamInterop)
One thing Chip and his team have had to embrace from the beginning is the idea that they have to meet providers where they’re at. If Watershed is working with a hospital that has a sophisticated interface, they have to be able to connect and create the connectivity so they can then deliver the interoperability.
“If we have a provider or organization out in the community that doesn’t have the ability to interface, but that is using Direct [messaging], we have to be able to do that too. And we’re delighted to be able to do that too. As a matter of fact, that’s one of our favorite ways to connect because…it’s about a five-second lift on their part…And we’ve been delighted with the work that’s gone on with Direct [messaging] because it’s helped us tremendously.”
At DirectTrust, we know there are so many approaches to interoperability and opportunities to come together as an industry to support the quadruple aim. And we’ve noticed a shift in the industry to expand access to data that allows healthcare providers to care for the whole person. We were curious what Chips thoughts are, as a clinician, on how all these pieces of the quadruple aim come together.
For Chip, the quadruple aim is the “why.” It’s what gets him up in the morning. The “what” varies, he says. Direct [messaging], other standards and companies like Watershed are all “what’s” — it’s how the industry is bringing that quadruple aim to life. According to Chip, when you improve patient outcomes, you save a lot of money. When patients are having less hospitalizations and other adverse outcomes, they’re more satisfied. (Go figure!)
Chip believes healthcare providers, like himself, are doing what they do because they ultimately believe in the mission to help people live better and longer. The “why” of the quadruple aim is the reason we’re all here, he says. As for the future, Chip hopes his company can continue to be a resource to keep this work moving forward.
As we wrap up our conversation, Chip acknowledges how complicated (and often siloed) this industry can be. He admits it’s going to be hard work to get everyone connected, but he plans to remain diligent. “The mission is a good one,” he says, “and it’s worth the work.” Spoken like a true Interop Hero.
Thank you, Chip Grant for sharing your experience and perspective with us!
Learn more about the Interoperability Hero Initiative and check out our second class of Interoperability Heroes.
This post was contributed by Alyssa Foggia-Hamm.