Author Archives: HITC Editor

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Healthcare in the past several decades has been marked by consumers seeking healthcare services; visiting a physician, being admitted to a hospital, seeking emergency room care. But achieving positive patient outcomes today will mean taking healthcare to consumers, as well as encouraging them to want that healthcare. A panel of four experts discussed engagement strategies at the HealthCare IT Connect Accountable Care and Healthcare IT Strategies Summit.

One key to understanding engagement is understanding what barriers exist to prevent that engagement, said Gary Capistrant, senior director of public policy at the American Telemedicine Association. “A lot of people are invested in the status quo and they are a barrier. And while the idea of patient engagement is very appealing, it’s useful to think beyond that, to consumer management and consumer direction. What are the tools to get the consumer beyond engagement?” he said.

Telehealth is one avenue of engagement, bringing services to patients from a remote site. But these services currently are only in rural areas, delivered only by physicians and only involve television, largely because of Medicare coverage, Capistrant said. “But urban people may also have problems reaching a doctor,” he said.

But barriers to telehealth also include doctors who don’t want to do telehealth. State to state licensing and practice rules also are barriers. Even “doctor-patient relationships are a way to keep telehealth out by enshrining the relationship,” Capistrant said. “I think a consumers should decide what their relationship is, and how they will deal with a doctor.”

Capistrant pointed to a number of state actions (Arkansas and Mississippi are leaders) in telehealth, as well as bills in Congress on changing Medicare coverage of telehealth.

Customizing the Patient Experience
Vree health provides patient-centered care through customizable configurable patient experience, said Lena Lattanzi, Executive Director of Product Management at Vree Health. “We can organize patient care, aggregate data from EMRs and systems to provide a central location for everyone to have access to information,” she said.

Vree provides care for patients before a physician visit, and even leading up to surgery. When the patient goes home, the company’s services offer patient monitoring and clinical health checks. “We can make sure medications are accessible, patients can get to appointments, have a primary care physician, and are going to the right site for care,” she said. Vree also analyzes its results and compares success with other initiatives.

Today’s organizations largely focus on the highest cost patients (the sickest), totaling 3% of all patients. Vree, however, offers services across the spectrum.

But technology alone is not engaging patients, Lattanzi warns. Most healthcare apps are used for less than a week, largely because the apps are not personalized. “We need to engage patients without engaging them.”

Cost savings from engaging the sickest
Huge differences in monthly healthcare costs exist between the healthiest patients (making up half the patient mix) and the sickest 3%. Costs could run up to $6,000 per month for sickest patients, said Brian Ralston, CMIO Chicago Market for Tenet Healthcare.

Tenet, however, experienced dramatic savings from the sickest patients, using complex case managers, contacting patients constantly and making decisions. “A lot of it was access—they could get information to me quickly and efficiently,” Ralston said. Online tools for analytics, data evaluation and care management also helped get information quickly to those who needed it, and could make a doctor visit more efficient. “It is horrible what’s being dumped into the short patient visit (refills, health maintenance, symptom announcement),” Ralston said.

One challenge of meaningful use is to strategically use online patient portals. While a hospital or health system can introduce a portal, outpatient settings probably already have similar portals, producing too many sources of information.

Engagement at an academic medical center

Northwestern Medicine, an academic medical center north of Chicago, uses a team-based care approach, “and the patient is the most important part of that team,” said Lyle Berkowitz, Associate Chief Medical Officer of Innovation. He noted that a very small percentage of a patient’s life is spent with a healthcare provider. So, how can they provide high quality care, efficiently?

Telehealth—Northwestern has offered these services for years but “in a fee for service environment, it’s better to have patients come in.” But for certain patients, convenience is key. But for certain patients, convenience is important.
Patient portals—a lot of interactions are conducted online. The patients are often happier and more engaged, “but they’ve signed up for the system so they would be. And most physicians find it easier than phone tag,” Berkowitz said.
Remote patient monitoring—Northwest has used monitoring on its own employees, the uninsured and higher risk patients. The healthcare system has been experimenting with these unique groups, including giving them an app monitor every day, and asking them if they felt better compared to the previous day.

These initiatives have generated questions: Will patients actually download it? Will they continue with it? If they continue, will it provide something valuable? Can we act on a problem that arises?

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Healthcare IT Connect sat down with Calvin Togashi, Pharm.D.,M.S., Partner, HealthQEC/formerly with Kaiser Permanente to discuss challenges physicians are faced with today around patient-provider communications and how through advanced improvements best outcomes can achieved.

Healthcare IT Connect: What are some of the challenges facing patient-provider communications?

Calvin Togashi: Time is the biggest challenge. The Center for Disease Control and Prevention estimated 1.2 billion office visits in 2010. For physicians, there just is not enough time in a 10 minute office visit to address current and chronic medical issues. After the office visit, there is even less time available for following up, sharing information and making decisions with patients. Meanwhile, in between office visits, patients often have more questions about their medical issues and treatment.
Lack of integration is another challenge. Physicians know what they want to communicate to patients, but the information is trapped in multiple systems – vital signs, appointments, laboratory results, prescription refills, registries, demographics and contact information. Some electronic medical records have integration between systems. Others are stand-alone islands that require manually pulling together information for each patient. Physicians want integrated system where they can filter diabetic patients for elevated hemoglobin A1c, check for the last oral hypoglycemic prescription refill and send patients encouragement for diet and exercise in just a few clicks.


HITC: Can you describe some of the important messages that physicians may want to send patients?

CT: There is a wide variety of messages including reminders, information messages, notifications and alerts. Reminder messages could be for an upcoming office visit, procedure or imaging appointment while information messages publicize health fairs, blood drives, prescription mail order savings or exercise and nutrition tips. Notifications may cover missed appointments, refills waiting in the pharmacy or pending laboratory order. Finally, alerts require action like a drug recall, poor air quality for asthmatics and appointment changes.

HITC: In a busy physician practice, how can the office staff help deliver these messages?

CT: The method to deliver messages needs to match the patient’s preference. All patients are not technologists! Some patient prefer paper. Other patients prefer phone calls, emails or text messages. Likewise patients may have language preferences. Physician practices that cover a wide geography may also see differences in affluent and less affluent areas.
The office staff need to review current practices for contacting patients. Manual phone calls and letters are very labor intensive. Consideration should be given to changing the delivery workflow and automation of processes to match patient preferences. The goal should be to increase patient satisfaction while decreasing staff effort. Our Prompt Outreach tool can deliver individualized outreach messages by email, pdf letters and text messages.

HITC: Why should physician practices invest in patient-provider communications today?

CT: Patient workloads continue to grow for physicians and office staff. Better communication can reduce manual work, refocus staff on their unique skill sets, organize the flow of information and lead to improved physician, staff and patient satisfaction.

HITC: Where will advances in technology take patient-provider communications?

CT: As health related sensors improve and become ubiquitous, there will be an explosion in individualized data collected continuously. Monitoring of vital signs, physical activity, electrolytes, glucose, hormones and drugs, measurements once available only in the hospital, will be readily available from transdermal, corneal or ingested sensors. The next challenge is to correlate sensor data with individualized patient outcomes and communication between patients and providers how to steer care delivery toward the best outcomes.

Calvin Togashi presented at the 2014 Accountable Care And Health IT Strategies Summit, Chicago IL, September 2014.  The session Patient Portals: Effective Approaches and Future Trends can be viewed on demand, in HD video with accompanying PPT. To subscribe to view the presentation please register here  

Calvin Togashi, Pharm.D.,M.S., Partner, HealthQEC/formerly with Kaiser Permanente
Matt Sarrel, Healthcare Expert; GigaOm Analyst; CEO and Founder of Sarrel Group
Jonathan C. Silverstein, VP Biomedical Research Informatics, NorthShore University Health System
Lauren Sullivan, Director Application Services, Sinai Health System 

Challenges created by the ever-growing demand of patient needs, changes in healthcare delivery as a result of The Affordable Care Act, HIPAA regulations, and the HITECH mandate, physicians and healthcare providers must rapidly adapt to an ever-changing environment. To maximize efficiency, enhanced communication between providers and patients, and provide consistent high quality care to patients, new platforms that integrate medical care and digital technology are being developed and deployed. Communications technology encompassing a broad range of tools such as smartphone applications, outbound messaging, emails, patient portals, telemedicine and more are continuously evolving.

» What is your organization currently doing, or what have you seen other organizations doing, regarding patient portals?
». Patient portals can provide a host of benefits: streamlining, provider workflow, improving patient-provider communications, improving quality of care, etc. From the implementations that you’ve seen, what are their strong points and where could they be improved?
» For those organizations without a patient portal, what are some other ways to enhance and streamline Patient-Provider communication?
» There are many interesting innovations and new technologies enhancing Patient-Provider communication? What are some of the more successful case studies or use cases have you seen and what are the factors that lead to their success?

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Guest editorial contributor: Matthew D. Sarrel, MPH, CISSP

Online patient portals are used by healthcare organizations to support critical activities such as enrollment, reporting, claims management, and outreach communication with patients. A prominent goal of such systems is to facilitate the provision of better care while lowering the costs associated with that care. While a patient portal must meet the needs of the healthcare organization developing it, it must, above all, meet the needs of the patients who are going to use it. Patients require easy and rapid access to the information they need about providers and services.

Patient portals can be used to provide a variety of services. Typical uses for a patient portal include scheduling doctor visits, obtaining lab results, and accessing health and wellness information. Patient portals serve as a vital link between healthcare organizations and patients. In many cases, patients can exchange secure messages with their health care teams. A successful patient portal enhances patient-provider communication, empowers patients, supports care and prevention between visits, and, most importantly, improves patient health.

NEC’s InfoFrame Elastic Relational Store (IERS) provides leading edge database technologies that serve as a powerful foundation for a patient portal. IERS relies on technologies developed by NEC to provide high scalability and performance. IERS’ scale-out architecture transparently expands the system without downtime as demand and data volume increase; two things that a successful patient portal is sure to experience.

IERS automatically allocates resources in order to balance the data processing load among transaction servers in order to provide a reliable high-performance database environment. Data is also protected using security mechanisms and distributed across multiple servers for improved reliability. They system automatically load balances itself and overcomes system failures to enable business continuity without service interruption. The result is a speedy data-driven patient portal that stays up and running to provide the online services patients need the most.

IERS has already been used to develop high volume patient portals. HealthQEC, a healthcare analytical and information technology consulting firm, selected IERS as the database behind their Prompt Outreach patient portal. Prompt Outreach is a cloud-based communication system that provides a cost effective way for healthcare organizations to contact and share information with patients using email, SMS, phone, and a variety of other methods. “We chose IERS because of its advanced scaling capability (elastic scale-out and scale-in mechanism) to meet the high volume requirements of a SaaS model. We were also drawn to IERS because of its high performance, reliability and availability for mission critical applications,” says Rafique Khan, Director of IT for HealthQEC.

In addition to exceling as a database for patient portals, IERS is a great choice for the following uses in a healthcare setting.  IERS is well-suited to be deployed as a:

  • Logging system for insurance claims processing
  • Central repository tracking data from diagnostic devices
  • Patient treatment and outcomes analytics database
  • Research driven predictive analytics database

NEC’s IERS is an elastically scalable high-performance database with many uses in healthcare. More information on the platform can be found on the NEC website and the NECtoday blog.

 

Matthew D. Sarrel is a healthcare IT expert, GigaOm Analyst, PCMag.com Contributing Editor, and Internet.com Frequent Contributor. He is also CEO and Founder of Sarrel Group, a consulting firm based in New York City and San Francisco. He has been designing and building big data solutions in healthcare and medical research settings for over 15 years. Follow him on Twitter at @msarrel.

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Delivering value-based care so vital for healthcare reform will depend on culture as much as new data analytics. A keynote panel at Healthcare IT Connect’s Accountable Care and IT Strategies Summit discussed how these two factors intertwine.

Platforms that associate data are important, but each vendor platform is different, requiring some comparison shopping by providers and healthcare systems, warned Jeremy Orr, Chief Medical Officer of Optum Analytics.

Healthcare systems often have a lot of data on people with advanced disease, but what’s needed are data on people who don’t have advanced disorders and don’t see providers as often. Optum aggregates from EMR databases, claims, and socio-demographic data from public databases, and matches these at the patient level to give patient centric view at all levels of care.

Some of the most valuable data is the hardest to work with, however: the patient history. Narrative patient histories are not structured datastreams, and even structured entries can be wildly wrong. While more than half of data in EMRs is unstructured, it is quite valuable for predictions, benchmarking and other value estimates.

Use data to capture the rotation of money
In the tradition to value-based care, it’s important to collect data not just for your EHR but also your community at large, including emergency room visits and appoints with outside providers, said Shashi Tripathi, CIO for the 28-location Springfield Clinic in Illinois.
For value based care, there’s going to be rotation of money, Tripathi said. For example, 28% of inpatient cost will move somewhere. Why not move it to outpatient care to improve quality and reduce costs? He asked. “The same procedure in an outpatient facility is half the cost of inpatient care,” he said. Analytics point to these cost savings.

Another issue with value based care is complexity. Springfield includes Southern Illinois University’s school of medicine, and the Clinic will host EHRs on the same platform, totaling 900 providers on the same platform. “Eventually, we will get data in real time, even with institutions that arte in competition with each other,” he said.

Focusing on care gaps and hospitalization prevention has also helped prod reluctant providers. “Providers don’t want to move to value based care. Our proposition is that if you fill these care gaps, you’ll get more patients and in the long term your patients will be more healthy,” he said.

The New England perspective
The Dartmouth-Hitchcock Healthcare System has had an online patient portal for a long time, and a data warehouse since 1980, said Barbara Walters, executive director of Dartmouth-Hitchcock and CEO of OneCare Vermont. “But the ACO experience begins our data story. We were part of the CMS Demonstration Project,” she said.
“Data’s fun, but this is really about delivery and execution,” she said. Data can become a source of resistance, as the search for the perfect model and report causes delays. At Dartmouth-Hitchcock, the center:

  • Uses the primary care medical home as building block.
  • All RNs are care coordinators at this point, instead of triage points.
  • Specialists are in charge of appropriateness and unit costs, and should only be taking care of patients who actually need whatever care it is.
  • Clinical partners must be willing and ready to participate.
  • System administrators are dedicated to giving providers accountable and timely data.

    “Our motto is “First do no harm to the doctors” because they need to spend time with patients, establishing relationships and finding out what’s wrong with patients. It takes a laser-like focus to do this,” Walters said.

Taming wild west healthcare in Montana

To meet healthcare IT needs in the Billings Clinic in Montana, “we needed to have a common EMR platform,” said former CMIO Karen Cabell. Their new platform launched in 2004, and the clinic provides to systems in small towns throughout the vast, sparsely populated state.
Using a common EMR platform “means we don’t’ always go with the ‘best in breed,” so we can have an integrated solution on a common platform, she said. The Billing Clinic culture has helped introduce value added care. It has a very heavy physician leadership in the organization that coordinates tightly with the clinic’s administration, including IT. “We’ve had an explicit partnership with IT and quality, and that’s helped us as well.”

At the clinic, all physician and operational data goes into an enterprise data warehouse. But the clinic doesn’t allow anybody to get to data without feeding the data through the clinic’s cloud first, to verify sources and protect data.

Today, nurses get lists of sickest 5% of population. There are a variety of disease specific navigation tools to identify gaps or transitions in care. In addition, a palliative care team uses automated EMR tools to “find” patients and suggest consults. Value-based care and analytics have reduced readmission rates from 30% to high teens, while a pain management team finds patients electronically and arranges consultations. “We even found ways to avoid skilled nursing consultation—one extra day in the hospital saved a lot on post-acute care.”

View the keynote panel from  the 2014 Accountable Care And Health IT Strategies Summit, Chicago IL, September 2014,  in HD video with accompanying PPT. To subscribe to view the presentation please register here 

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NEC_Calvin_Togashi

Healthcare IT Connect sat down with Calvin Togashi, Pharm.D.,M.S., Partner, HealthQEC/formerly with Kaiser Permanente to discuss challenges physicians are faced with today around patient-provider communications and how through advanced improvements best outcomes can achieved.

Healthcare IT Connect: What are some of the challenges facing patient-provider communications?

Calvin Togashi: Time is the biggest challenge. The Center for Disease Control and Prevention estimated 1.2 billion office visits in 2010. For physicians, there just is not enough time in a 10 minute office visit to address current and chronic medical issues. After the office visit, there is even less time available for following up, sharing information and making decisions with patients. Meanwhile, in between office visits, patients often have more questions about their medical issues and treatment.
Lack of integration is another challenge. Physicians know what they want to communicate to patients, but the information is trapped in multiple systems – vital signs, appointments, laboratory results, prescription refills, registries, demographics and contact information. Some electronic medical records have integration between systems. Others are stand-alone islands that require manually pulling together information for each patient. Physicians want integrated system where they can filter diabetic patients for elevated hemoglobin A1c, check for the last oral hypoglycemic prescription refill and send patients encouragement for diet and exercise in just a few clicks.


HIT: Can you describe some of the important messages that physicians may want to send patients?

CT: There is a wide variety of messages including reminders, information messages, notifications and alerts. Reminder messages could be for an upcoming office visit, procedure or imaging appointment while information messages publicize health fairs, blood drives, prescription mail order savings or exercise and nutrition tips. Notifications may cover missed appointments, refills waiting in the pharmacy or pending laboratory order. Finally, alerts require action like a drug recall, poor air quality for asthmatics and appointment changes.

HIT: In a busy physician practice, how can the office staff help deliver these messages?

CT: The method to deliver messages needs to match the patient’s preference. All patients are not technologists! Some patient prefer paper. Other patients prefer phone calls, emails or text messages. Likewise patients may have language preferences. Physician practices that cover a wide geography may also see differences in affluent and less affluent areas.
The office staff need to review current practices for contacting patients. Manual phone calls and letters are very labor intensive. Consideration should be given to changing the delivery workflow and automation of processes to match patient preferences. The goal should be to increase patient satisfaction while decreasing staff effort. Our Prompt Outreach tool can deliver individualized outreach messages by email, pdf letters and text messages.

HIT: Why should physician practices invest in patient-provider communications today?

CT: Patient workloads continue to grow for physicians and office staff. Better communication can reduce manual work, refocus staff on their unique skill sets, organize the flow of information and lead to improved physician, staff and patient satisfaction.

HIT: Where will advances in technology take patient-provider communications?

CT: As health related sensors improve and become ubiquitous, there will be an explosion in individualized data collected continuously. Monitoring of vital signs, physical activity, electrolytes, glucose, hormones and drugs, measurements once available only in the hospital, will be readily available from transdermal, corneal or ingested sensors. The next challenge is to correlate sensor data with individualized patient outcomes and communication between patients and providers how to steer care delivery toward the best outcomes.

Calvin Togashi presented at the 2014 Accountable Care And Health IT Strategies Summit, Chicago IL, September 2014.  The session Patient Portals: Effective Approaches and Future Trends can be viewed on demand, in HD video with accompanying PPT. To subscribe to view the presentation please register here  

Calvin Togashi, Pharm.D.,M.S., Partner, HealthQEC/formerly with Kaiser Permanente
Matt Sarrel, Healthcare Expert; GigaOm Analyst; CEO and Founder of Sarrel Group
Jonathan C. Silverstein, VP Biomedical Research Informatics, NorthShore University Health System
Lauren Sullivan, Director Application Services, Sinai Health System  

Challenges created by the ever-growing demand of patient needs, changes in healthcare delivery as a result of The Affordable Care Act, HIPAA regulations, and the HITECH mandate, physicians and healthcare providers must rapidly adapt to an ever-changing environment. To maximize efficiency, enhanced communication between providers and patients, and provide consistent high quality care to patients, new platforms that integrate medical care and digital technology are being developed and deployed. Communications technology encompassing a broad range of tools such as smartphone applications, outbound messaging, emails, patient portals, telemedicine and more are continuously evolving.

» What is your organization currently doing, or what have you seen other organizations doing, regarding patient portals?
». Patient portals can provide a host of benefits: streamlining, provider workflow, improving patient-provider communications, improving quality of care, etc. From the implementations that you’ve seen, what are their strong points and where could they be improved?
» For those organizations without a patient portal, what are some other ways to enhance and streamline Patient-Provider communication?/br> » There are many interesting innovations and new technologies enhancing Patient-Provider communication? What are some of the more successful case studies or use cases have you seen and what are the factors that lead to their success?
» Any parting words of wisdom for our audience?

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Niall_Brennan

Niall Brennan, acting director, office of enterprise management, US Centers for Medicare and Medicaid Services presented a keynote session ‘
Using CMS data for healthcare change’ at Healthcare IT Connect’s Accountable Care and Healthcare IT Strategies Summit in Chicago.

Healthcare’s future is more dependent on data than science fiction, and the US Centers for Medicare and Medicaid Services can help with the data, says Niall Brennan, acting director of CMS’ office of enterprise management during his keynote address. 

“I run the mysteriously named office of enterprise management, but it has nothing to do with Star Trek, and everything to do with data analytics and stewardship of meaningful use,” Brennan joked.

As the nation’s largest single payer for healthcare in the US, CMS generates data on billions of claims and non-claim points. The agency is transitioning from a passive payer of claims to active purchaser, and it wants to drive innovation. Therefore, the agency is employing analytics for advanced information projects, and responding to exponentially increasing demands for data from providers, payors and other healthcare stakeholders making the switch to value-based care.

The CMS data site, https://dnav.cms.gov, the agency’s data navigator, consists of dashboards and data that are aggregated by state, hospital region and county levels, as well as by chronic conditions and facility usage:

•  ACOs—CMS sends monthly claims feeds to ACOs. For the first time in a fee for service system, providers can see a whole patient, bringing the system one step closer to patient centered care. Successful ACOs will integrate this data and bring it into point of care.

•   Quality entry program—part of ACA that deals with private/public reporting. Previously, physicians would get report from private insurers, but nothing from Medicare. With QEP, third party entities can receive Medicare data, as long as they can combine them with data from other payors. The QEP can also create comprehensive reports on a provider’s practice.

•   Research dissemination—The Chronic Condition Warehouse stores “tons of Medicare data, linked across setting, across time, across payors,” said Brennan. Researchers access encrypted data remotely and securely. This is safer for patients, and cheaper for researchers.

•   Blue Button—The VA, DOD and CMS adopted this online tool for patients to access their own data. In a beta program so far, Blue Button beneficiaries can download 3 years of their hospital, provider and treatment data. 300,000 people have used it so far. The aim is to avoid duplication of care, and coordinate with providers.

CMS’ own analytics has been newsworthy:

CMS data released in April found very high variation within very small geographic areas. Variations for circulatory disorder DRGs in Manhattan, for example, are “spectacular.” 

 
To view Niall Brennan’s in HD Video and synchronized PPT at the ACO HIT Connect Media Portal Click Here».

 
Lear more about the Accountable Care & HIT Strategies Annual Conference Here»  - for more information regarding sponsorship opportunities at the 2015 conference email robw@healthcareitconnect.com  to submit a speaking proposal please email victorias@healthcareitconnect.com.

 

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ANNOUNCEMENT
2014 Accountable Care & Health IT Strategies Summit 
September 18-19, Hyatt Regency McCormick Place, Chicago Keynotes:

ENTER Health Affairs
PROMOTIONAL Code: ACOHA
To Receive 30% Discount on all Rates
Keynotes:
Niall Brennan, Acting Director, Offices of Enterprise Management, CMS
Kathy Lewis, VP, Clinical Network Services, Surescripts
Dan Johnston, U.S. Army Medical Director Lieutenant Colonel Doctor
Jeff Arnold, CEO, Sharecare

Who Will Attend: 300+ Business, Clinical and IT leaders from across the country who are mobilizing their organizations to participate in ACOs and/or be effective partners for payers in value based purchasing initiatives.

2014 Focus Topics: The 2-day program incorporates opening keynotes, keynote panels, collaborative networking round tables as well as keynotes and breakouts assigned to 3 distinct executive forums as below:

(i)  Data Analytics and Population Health Management Forum
(ii) Consumer Engagement, mHealth and Connected Medical Home Forum
(iii) Healthcare Performance and Risk Management Forum

Accommodations: Group Rate ($209) available at the Hyatt Regency McCormick Place, Chicago, IL, Book Online Here >>

About Health Affairs

 

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print, online, on mobile and on iPad.

Additional and late-breaking content is found at www.healthaffairs.org in Web First papers, Health Affairs Blog, Health Policy Briefs, Videos and Podcasts, and more.
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Project Directors and leading HIT Strategists will lead roundtable discussions around specific technology and project initiatives that are at the leading edge of the Accountable Care and Health IT innovation and transformation process.

Where: Hyatt Regency, McCormick Place, Chicago  April 18-19 2014
When: 
Chicago, IL  April 18-19 2014 
View Agenda    |   View Speaker Information  |   Hotel Rate $209 Book Online Today  |  Register to Attend

Roundtable 01. 
Danielle Sims, State Project Officer within the Office of Programs and Engagement, Office of the National Coordinator of Health IT, (ONC).

Regional Extension Centers: Trusted Advisors in the Field
Regional Extension Centers (RECs) have close working relationships with providers participating in ACOs, are aware of health IT challenges, and have structured service offerings around those challenges. As captured by ONC’s FACA ACO workgroup, major challenges ACOs face includes: patient engagement, quality measure abstraction, aggregation, and reporting, vendor/EHR product, data exchange among providers, IT strategy, scaling notification services, and population health management. Health IT plays a significant role in overcoming these challenges; RECs have been providing health IT and practice transformation services to support providers who face these barriers.


Roundtable 02. 
David Overton, Executive Director of Clinical Integration, St. Joseph’s Regional Health Center

St Joseph Health Partners:  Surviving and Thriving in Payment Reform
St Joseph Health Partners (SJHP) is a Clinically Integrated Network formed under FTC guidance to lead the St Joseph Health System into the future of pay for performance and value based purchasing.  SJHP is focused on 4 key strategic imperatives as it relates to payment reform; Medicare ACO, Commercial payer partnerships, Patient Centered Medical Home, and Care Coordination.  SJHP is in year 1 of the 3 year Medicare Shared Savings Program and is focusing on reducing readmissions and inappropriate utilization of healthcare services through care coordination.  SJHP has partnered with a national commercial payer to manage the health of the St Joseph Employee Health Plan but also to co-brand a health insurance product that drives steerage to the health system and creates incentives to steer patients to the lowest cost and appropriate healthcare services through the medical home.


Roundtable 03.
Sandy L. Chung, MD, CMIO, Health Connect ACO

Advancing Consumer Engagement in a Physician Lead ACO

Roundtable 04.
John Clark, MD, JD, CMO, IU Health ACO

Transition from Fee-for-Service to Value-Based Payments
Medical groups entering the world of Population Health Management face several challenges negotiating the transition from Fee for Service to Value-Based payments with their physicians.   Indiana University Health Physicians (IUHP) has been putting a significant portion of its primary care physicians’ salaries at risk for quality, patient satisfaction, and access to care for more than 15 years.   Over the last three years the advent of Accountable Care / Shared Savings and full-risk contracting has challenged the group to provide incentives for its physicians aligned with quality of care and service to the whole population of patients it serves while simultaneously encouraging the transformation of office-based work flow to effectively manage value-based contracts.     IUHP has met these challenges with both contractual incentive programs focused on technical quality of care, patient satisfaction, and patient access to care for which the physicians feel a reasonable degree of control as well as team and region-based shared savings incentives tied directly to overall cost of care for risk populations.   Importantly, IUHP has negotiated for fixed up front “transactional” payments for physicians participating in processes designed to maintain quality of care while improving care coordination for the sickest of patients.   Using these dual mechanisms IUHP ensures that quality of care and patient satisfaction stay at the forefront of care delivery processes while allowing those processes to evolve to meet the needs of population health management.

Roundtable 05.
Linda Oliver, Director of ACO Implementation, Atrius Health

Identifying At Risk Populations and Operationalizing Data for Care Interventions

Roundtable 06.
Craig Behm, Executive Director, MedChi Network Services

Exploring the Network Services Model for Primary Care Transformation in Maryland
MedChi Network Services (MNS) is a management services organization founded by MedChi, the Maryland State Medical Society. The mission to support the private practice of medicine was originally carried out through practice support such as revenue cycle management, coding reviews, EHR optimization, and other related services. When medical society leadership reviewed the final ACO regulations – including physician-leadership, no downside risk, and an advance payment program – they encouraged MNS to expand their service offerings and organize physician groups. Working in the rural parts of the state, MNS was able to form 3 MSSP ACOs consisting entirely of independent, primary care physicians. The challenges faced during the last two years of integrating over 30 different practices with a dozen EHR systems have been significant, but they also offered numerous opportunities to add value at the point of care. MNS is transforming primary care physicians into population health managers.

 



 

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unitypoint_healthcare
A new Accountable Care Organization between UnityPoint Health Partners and UnitedHealthcare aims to move the Iowa Health System in the direction of rewarding quality and value and away from one based on volume of care. The “Triple Aim” objective: increase patient satisfaction, improve the health of the population and reduce the cost of health care.

“UnitedHealthcare continues to work with care providers statewide to help enhance health services and improve coordination of care for patients,” said Steve Walli, CEO, UnitedHealthcare of Heartland States.

“We believe our collaboration with UnityPoint Health Partners will deliver enhanced quality, better outcomes and greater efficiency for our health plan customers in these communities.”

Currently annual physician and hospital reimbursements totaling more than $31 billion are tied to accountable care programs centers of excellence and performance-based programs, by 2018 this figure is projected to be $65 Billion.

Learn more about this new ACO collaboration, which includes enhanced care coordination and follow-up, beginning Oct. 12014

Via Accountable Care Answers

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Analytics_Global_market1

A report which studies the global healthcare analytics market over the forecast period 2014 to 2019 has stipulated that the market is expected to grow at a CAGR of more than 25%. Increased healthcare IT adoption, global centralized healthcare mandates, emerging fields of predictive, prescriptive analytics and venture capital investments are all major factors in driving the future market growth upwards. Included in the in depth market analysis, which spans the regions, North America, Europe, Asia-Pacific, Rest of the World (RoW) are sections covering factors influencing market, drivers, restraints, opportunities and challenges as well as burning issues, winning strategy and regulatory affairs.
Companies mentioned throughout the report are Cerner Corporation, IBM Corporation, Information Builders, Inc., Lexisnexis Risk Solutions, Mckesson Corporation, Oracle Corporation, Rapid Insight, Inc., Truven Healthanalytics, Inc., Vantage Point Healthcare Information Systems, Inc., Verisk Analytics, Inc.

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