LAS VEGAS -- Aledade CEO Farzad Mostashari, MD, said that providing actionable implements in existing technologies is the best way to increase physician engagement and innovation that will, in turn, improve outcomes to keep people healthier and save lives.

To illustrate this, Mostashari pointed to an accountable care organization example that took place about four years ago. Doctors were administering a decidedly low number of pneumonia vaccines per month -- between 9 and 14, on average. The standard approaches, including education for physicians, monitoring doctor performance and admonishing patients, weren't making an appreciable difference.

Then a system change was implemented. Doctors were reminded to administer the vaccines via technologies. The ACOs per-month average for pneumonia vaccines spiked to the upper 90s.

"The docs know they should give vaccines to their elderly patients," Mostashari said. "It's not as if they don't know. They forget. We all forget. … We have them a clickable option. You have to offer them something."

The increase in pneumonia vaccinations was sustained for months, until the alert was accidentally removed. At that point, the number dropped steeply until the alert was re-implemented, which Mostashari viewed as solid evidence that simple reminders work.

But that requires change and changing a health system isn't always easy. Doctors are often paid per unit of activity, and administering more vaccinations takes more time; doctors were complaining that they had to work more hours to make up the difference, he said.

It's essential, though, that there's a systematic change, Mostashari said, and that's where the shift from volume to value comes in.

"We can't do a fraction of all the things we'd like to do," he said. "You've got to decide, 'What is is that we're going to be focusing on?' We've got to create lasting clinical change."