As we guide primary care providers (PCPs) through the transition to value-based care, one question frequently arises: how exactly does Pearl’s technology integrate with existing Electronic Health Record (EHR) systems? It’s an important question worth exploring. In this article, we’ll dive into how EHRs and the Pearl Platform fit into a practice’s workflow, and our ongoing work to enhance Pearl insights for PCPs through seamless EHR integration.
Pearl vs. the EHR
EHRs primarily focus on supporting providers around the main “transaction” of primary care: the visit. During the visit, EHRs enable providers as they see patients, helping them document conditions, activate visit workflows, and bill for services rendered. Outside the visit, EHRs are the main source of patient records and include tools to schedule appointments and facilitate practice-patient communication before and after visits. Because the EHR is so integral to practice operations, providers have a deep understanding of how the EHR fits into their practice workflows and the visit itself — so how does Pearl fit in?
Our mission at Pearl is to empower providers to deliver better quality care at a lower cost and realize the promise of value-based care. Our technology delivers insights that help practices focus on high-impact opportunities with the goal to provide better, more efficient care.
Our aim with the Pearl Platform is to help providers take the right next action because they have insights available to make that decision in their independent clinical discretion. As an illustrative example, a patient with poorly-controlled diabetes and asthma with recent deterioration may be identified by Pearl’s predictive algorithms to be potentially at risk for a preventable ED visit. In the platform, her hexagon in the Patient Map would be red and clinical staff would see an alert recommending an appointment. With this insight, her PCP may better assess and potentially avoid further deterioration of her conditions if the PCP decides further action is warranted.
We see Pearl as a complementary enhancement to the EHR — not a replacement for it. Right now we’re primarily focused on enabling providers outside of the visit itself — to help answer the question: Who’s not on my patient schedule who should be?
Pearl makes sense of data from sources outside the EHR, or buried within it, to bring insights that help providers take proactive, value-based actions with the goal to improve patient care. These insights focus on who in your patient panel may benefit from your attention or proactive intervention, and why. What’s changed in their care? Have they been diagnosed with new conditions outside your practice? Have they been admitted to the hospital or discharged? Are they taking any new medications?
Knowing the answers to these questions helps PCPs more proactively and effectively identify the patients likely to need their attention. Supporting proactive panel management outside the visit helps to maximize performance in value-based care, by keeping patients from slipping through the cracks.
Integrating Pearl with the EHR
We’re starting to bring these insights to providers during the visit by integrating with the EHR. Our goal is to prepare physicians with the insights they need at the moment of care, without introducing additional friction so they can focus on the patient in front of them.
So what does Pearl and EHR integration look like today? We’ve introduced an integration with our partner Vim that will bring our Conditions to Review insights directly into the EHR experience. In the Pearl Platform, the Conditions to Review feature identifies certain chronic conditions that have previously been associated with a given patient, but have not been diagnosed in the current performance year for that patient so the provider may decide if there are applicable conditions for the current performance year.
Vim activates during any EHR encounter when Conditions to Review are available for the patient in context — ensuring the provider need only conduct their normal workflows for this integration to add value. If the provider decides to accept the conditions using Vim’s EHR overlay, our integration automatically adds them to the patient’s chart, helping to streamline point-of-care workflows and enabling them to spend more time focusing on the patient, instead of their computer.
It’s important that providers reassess chronic conditions each year because accurate, ongoing diagnosis assessment and coding helps improve patient care and performance in ACO REACH. Properly recording existing diagnoses and conditions informs CMS of how a practice’s patient panel should be risk weighted, which helps establish an accurate benchmark and ensure that providers are appropriately compensated for managing patient conditions.
Looking Forward
As we think about further integrating Pearl insights and the EHR, we want to make sure that we stick to our product principles. We want these integrations to empower PCPs and enhance their understanding of how best to care for their patients. We want to further enable a more proactive care model that prepares providers with insights that might not be available in traditional tools. And we want to make sure we’re supporting patient-centric care throughout the experience.
With these principles in mind, our product vision for EHR integration is expansive. Next, we’re looking to surface quality gaps for Medicare Advantage (MA) patients to help providers succeed in MA programs. Over time, we will explore integrating more Pearl features beyond Conditions to Review into the EHR so we can bring the most helpful insights to providers at the point of care. Equipping providers with a daily digest of who’s coming into their offices today and what they should know about patients as they enter the visits may be a powerful way to bring more longitudinal insights into the visit.
We’re also exploring integrating more EHR data into the Pearl Platform to help us uncover better insights about patient panels. We’ll start with getting more timely clinical data from EHR partners so we don’t need to rely as much on claims data to understand a patient’s care journey. We’ll also be exploring appointment data so the platform can provide more relevant suggestions for potentially bringing in patients sooner than scheduled as well as surfacing insights that providers can review in an upcoming visit.
We’re proud to be partnering with providers to make primary care more focused on value-based care for patients, and we’re excited about the opportunities that EHR integration offers to help PCPs improve care quality and patient outcomes.
