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Part 1: Evidence-Based Care, a Tenet of the ‘Triple Aim’

Published 4/7/2021

This blog is the first part of a two-part series that will explore how the providers in an ACO like Kelsey-Seybold Clinic use evidence-based care to improve outcomes, while also lowering the incidence of unnecessary/duplicate tests, and hospitalizations.

In medicine, all good physicians look closely at details of their patients’ symptoms and risk factors to help them achieve better health. In an Accountable Care Organization (ACO) where the philosophy of care is based on evidence-based practices, physicians work closely with each other and their patients to deliver the right care, at the right time, and in the most appropriate care setting based on their needs according to good science. This philosophy helps improve quality and satisfaction, while also lowering total cost.

When evidence-based care is built into the practice, it guides the physician to help make sure things like allergies, screenings, or other recommendations based on the patient’s medical record don’t fall through the cracks. It’s this proactive approach that creates a culture focused on providing the best possible care for each patient.


Making a real difference

If I have a patient with both diabetes and hypertension, multiple studies have shown that they also have kidney disease, and the use of an ACE inhibitor or ARB medication helps reduce mortality. Evidence is guiding this medical decision with a goal of helping to protect their kidneys. But something like this could be easily missed at a check-up. At Kelsey-Seybold, we’ve developed an electronic medical records system that has built-in best practice alerts based on scientific evidence to help us get the right patients on this medication.

For culturally diverse populations, evidence-based care is essential. For example, most men are screened for prostate cancer starting at age 50. But evidence tells us that African American males should be screened for prostate cancer at age 40. It’s a best practice that helps us catch more severe cancers earlier to reduce total medical cost and improve outcomes.

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High-quality healthcare, value, and patient satisfaction

Better value is also built into the system when both evidence-based and coordinated care is practiced. For example, if I have a patient that goes to the ER for chest pain, but the patient’s medical records show that he has recently completed a stress test, EKG and chest X-ray, the physicians at the ER can see the results and more easily make a diagnosis and recommend follow-up. The patient can be sent home without expensive duplicate tests, saving on costs in the ER setting and reducing the incidence of complications from unnecessary treatments.

This combination of quality care, value, and patient experience all come together to create high patient satisfaction and improved outcomes: That’s what makes evidence-based care so powerful.

Not all medicine is the same

For employers looking for the right healthcare coverage for their employees, it’s this big-picture approach that can lead them to the right plan. Employers offering a Kelsey health plan enjoy the benefits of evidence-based care, such as lower cost, better outcomes, fewer employee sick days, and higher productivity.

And when the employer has healthy, happy employees, it’s easy to see that evidence-based care is a big win-win.


Victor Simms, MD, MPH, FACP

Chief of the Department of Internal Medicine at Kelsey-Seybold Clinic

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NOTE: Each employer plan is separately underwritten and results will vary based on the population demographics and other factors.