Tina Esposito, VP, Center for HIS, Advocate Health Care, Chapter 2

As VP of the Center for Health Information Services, Tina Esposito knows very well the value of digging deep into analytics to find answers. But she has found that when it comes to learning what clinicians actually need, the best course is to simply ask them. By going “to the source” instead of making assumptions, leaders can help provide what those on the frontline need, says Esposito. In this interview, she talks about how the Center came about, the change in thinking that was needed to become an ACO, and the interoperability challenges that come with multiple EHRs. Esposito also discusses the concept of patient-centered care, why her team is focused less on HCAHPS and more on building loyalty, and why she’s excited for the future.

Chapter 1

Chapter 2



* Patient-centered care

* “The shift to value-based payment has started to ensure we stay true to that.”

* From episodic to holistic care

* Interoperability challenges with multiple EHRs

* Looking “beyond the financial benefit” with big data

* Focus more on patient loyalty, less on satisfaction

* Leveraging technology to follow patients

* “It can’t get any more rewarding.”



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Bold Statements

It’s no longer, did I deliver on a key process? Certainly, that’s important, but now I have the ability to actually take it down to a patient and understand what efforts were put forth to ensure the best outcome. I can now do that. I can now see that.

Physicians absolutely want to make sure that we are fiscally responsible, but that’s not what gets them out of bed in the morning. They want to make sure that they’re doing the best they can for the patients they’re serving. And so, it’s vital to have a very balanced approach on ensuring, measuring, and assessing data.

As the consumer has more and more of a choice on where they would like to go and what clinician they would like to see, it becomes very important that we are aligned with their values and their needs from a healthcare provider. I think it’s the gradual shift around reimbursement that really has allowed this change in the way that we view that.

We can’t provide a nurse for every patient that we see, but is there a way we can leverage technology as resource, as a way to ensure that every patient is followed and is supported well beyond just visiting a hospital or seeing a physician in an office?

At the end of the day, big data and analytics is a means to an end, and that end has to be where you, as an organization, see yourself.

Gamble:  One of the terms we hear a lot is patient-centered care. When you talk about that as a goal or as a pillar, what does it mean as far as being able to provide patient-centered care?

Esposito:  I’ll give an example, something that occurred to me as a little bit of a light bulb. It’s a term we throw around all the time. We think we know what that means — it means putting the patient in the center, but I would say that this shift to accountable care and value-based payment has really started to ensure that we stay true to that.

I’ll give you an IT example. I’ve been here 18 years, and I can remember a time where much of my analysis, data pull, evaluation, and measurement really reflected process. We wanted to understand how we’re doing with DRG 475 or whatever heart failure diagnosis it may be, and it was a very episodic view of care being provided. Fast forward now to the accountable care world where it really is about how are we doing with this patient? What care has been provided to that patient — not just wh...