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Archive for October, 2011

Healthcare’s Cost and Quality Conundrum: System Integration to the Rescue

by on October 31st, 2011

Perficient has created this series, “Healthcare Analytics and Meaningful Use” to drive discussions around unlocking the true potential of EHRs with analytics. Stay tuned for this four-part series to be published throughout October and November.  We welcome your comments and questions below.

Healthcare decision makers are being called upon to reduce waste, improve operational processes, and identify organization and community needs by using healthcare data to make informed decisions.  The new set of objectives has resulted in a frantic need for better information to make more informed decisions.  As a result organizations need to integrate systems to ensure that data is readily accessible.

System integration provides a solution to the problems and inefficiencies throughout the healthcare delivery chain stemming from a disconnected process. Healthcare organizations are investing heavily in updating outdated HIT systems with new integrated platforms to allow data sources from multiple places to be housed and available for analysis and to change their approach to healthcare from a traditional model to a patient centric model.

How organizations change the way they deliver care is heavily dependent upon technology and access to data.  While EHRs are an important part of the solution, the ability to share, exchange and integrate data from the EHRs and other service components across the healthcare delivery spectrum is critical.  In other words, after the patient has visited a specialist a summary of that visit needs to be shared electronically with their primary care physician.  By sharing information the vacuum that typically plagues the healthcare industry is replaced with a strong network of information that serves care givers, patients, healthcare organization and public health agencies.

System integration is a critical piece to making the most out of HIT investments and to ensure that healthcare is delivered in an affordable fashion that drives quality. As the national vision of a connected and interoperable healthcare industry becomes more of a reality, organizations are examining how they can benefit from better connecting their own systems.

Organizations must find a way to draw data together in a fashion that will aid the organization, their patients and partners.  The solution must avoid redundancies and sufficiently meet operational and clinical needs – meaning improve outcomes while also lowering costs.

While system integration is necessary to provide analytics, there is only so much money available to fund the endeavor.  Stay tuned for the final post – When Containing Costs Contain Solutions.

Want to learn more?  Register for our upcoming analytics webinar and you will be entered to win one of two Perficient client badges to the February HIMSS Conference in Las Vegas!

Perficient Webinar! ACO = HIE + Analytics: Managing Population Health with Information Exchange and Analytics

by on October 27th, 2011

With the release of the Accountable Care Organization (ACO) rule, healthcare providers must be able to identify, access and seamlessly share patient information to drive efficiencies and enjoy a potential share in ACO program incentives. Additionally, more than half of the 93 draft National Committee for Quality Assurance (NCQA) ACO measures are also Meaningful Use measures, which further elevates the need to achieve meaningful use stage 2 or higher.

Given these goals, success will ultimately depend on an organization’s ability to share patient data at the point of care and its ability to gain meaning from historical and longitudinal data for use in managing population health. Healthcare organizations will need to give focused attention to the IT strategies, appropriate architectures, and roadmaps they will use to move from desired state to reality.

Join Perficient as we discuss the practical architectural approach for creating an ACO. As Health Information Exchanges (HIE) evolve into their second generation, they are able to the support the functional ACO tasks of delivering and managing care for a defined population, accept payment, distribute savings to participants and perform disease management with predictive modeling to improve outcomes.

Register today and you will be entered to win one of two Perficient client badges to the February HIMSS conference in Las Vegas!

Perficient White Paper! 9 Key Business Drivers of HIE

by on October 26th, 2011

A successful Enterprise HIE must be secure, accurate, dependable, appropriate and responsive to
the need of the users of this clinical information to ensure that appropriate care is delivered. Enterprise HIE is driven by true healthcare needs. These key drivers include:

  • Ensuring appropriate care is given at the correct time
  • Promoting preventive medicine
  • Avoiding inaccurate person identification for services
  • A self-sustaining business model for Enterprise HIE
  • Decreased reliance on paper
  • Allowing physician practices to focus on core competencies
  • Electronically moving clinical information among disparate systems
  • Improving continuity of care with multiple providers
  • Leveraging government focus

Download our new white paper, Nine Key Drivers of Enterprise Health Information Exchange to learn more about this topic.  You can also visit our Information Exchange page on the healthcare microsite for even more content on this topic.

Want to learn more?  Register for our upcoming HIE webinar and you will be entered to win one of two Perficient client badges to the February HIMSS Conference in Las Vegas!

Perficient Sole Recipient of IBM Information Management & Business Analytics Awards

by on October 24th, 2011

It’s always a pleasure being nominated, but winning is even more fun, isn’t it?  I’m happy to say that today Perficient was named the sole recipient of IBM’s 2011 Information Management Solution Excellence Award.  We were also the sole recipient of IBM’s 2011 Business Analytics Solution Provider Achievement Award.  That’s two times the fun! 

The Information Management award is, in large part, to recognize efforts related to our partnership with Premier healthcare alliance, a healthcare performance improvement alliance serving more than 2,500 hospitals and 77,000 additional healthcare sites, which resulted in an Integrated Performance Platform Solution.  This solution leverages several IBM technologies to support the analytical needs for healthcare providers that require a robust data model and analytical applications. It delivers critical information and key performance indicators for patient safety, quality outcomes, core measure reporting, service line management, physician alignment, surgical analytics and integrated care for the development and inaugural deployment of this innovative solution.

“Together with Perficient and IBM, we’re building a transformative new infrastructure based on data that is unified, easily-accessed and from providers, payors and patients,” said Denise Hatzidakis, Premier’s Chief Technology Officer. “This new data model provides clinical decision-support at the point of care delivery, helping providers make faster, better decisions to reduce preventable harm and waste.”

Also, check out our interview with Denise earlier this year.

At previous IOD events, Perficient has been honored with awards including Warehouse Pack Partner of the Year, Information Agenda Partner of the Year, Best of Show 2010 for Retail Analytics and multiple Cognos Partner of the Year awards.

Data in Action: Applying Analytics to Healthcare

by on October 24th, 2011

Perficient has created this series, “Healthcare Analytics and Meaningful Use” to drive discussions around unlocking the true potential of EHRs with analytics. Stay tuned for this four-part series to be published throughout October and November.  We welcome your comments and questions below.

Data in and of itself has no value. To add value data must be “crunched” or analyzed to examine changes, predict impacts and determine what is working and what isn’t working.  There are some “formulas” at work here:

Date + Meaning = Information  (data crunching)

Information + Experience + Context = Knowledge (someone using the information)

EHRs play a pivotal role in providing the healthcare industry with a rich, robust set of data to empower organizations and people. Previously, healthcare analytics have focused on ways to evaluate health by compiling data about epidemics, diseases and illnesses.  Today’s analytics are different  –  they include decision makers throughout an organization.

Dashboards
Dashboards allow business leaders to measure, monitor and manage a business by providing up-to-date information on a departmental level.  A dashboard provides a set of analytics to the right person at the right time to ensure that a department runs efficiently and effectively.  They allow decision makers to be responsive to current situations and make more informed, on-the-spot decisions.

Clinical Alerts
Clinical alerts are viewed as a potential solution to improving care and the overall health of at-risk and high-risk populations. Recent studies confirm that EHR clinical alerts add great value to the healthcare system and society by alerting physicians to missed healthcare opportunities.  Providers use clinical alerts to change trends that are correlated to health risks.  Clinical alerts are heavily dependent upon EHRs, and require a system to determine if missed healthcare opportunities such as vaccinations or health tests exist.

Quality Management
Quality management focuses on outcomes.  It requires patients receive the proper care at affordable prices.  Healthcare quality management relates to procedures or policies that positively affect quality of life, decreases premature deaths and financially strengthen an organization.  Essentially, quality management is a progressive way to calculate the bottom-line that includes patient’s health and outcomes in addition to financial viability.

50,000 foot view of Healthcare Analytics
Healthcare analytics can be mesmerizing considering they provide insight into a data-rich industry that has historically been unable to use its data to address efficiency, effectiveness or equity issues.  Healthcare analytics bridge the gap between knowledge and action but require EHRs and integrated HIT systems.

Stay tuned for the next blog which examines the role of system integration on healthcare analytics.

Want to learn more?  Register for our upcoming analytics webinar and you will be entered to win one of two Perficient client badges to the February HIMSS Conference in Las Vegas!

Connected Health Symposium 2011: Living in the Clouds

by on October 21st, 2011

In the book As The Future Catches You, Juan Enriquez notes that “in a knowledge economy, you can work at your desk, in your home, in a hotel, or in a plane.”  As a person that operates in just that manner, there are real concerns not about just the connectivity to accomplish that mode of working but the idea of where my work desktop really should be located. Is it time to move beyond carrying around all of my software applications, personal data files and move into the cloud? The real question is whether or not I would have more security and confidence with my ability to work anywhere without the challenges of managing my personal laptop.

The question is more than just an experiment with living on the Internet.  When I consider my reliance on my laptop and the upcoming revolution of browser-based or tablet operating systems, it is time to formulate an opinion on the timing and the nature of the move. Last week, Apple rolled out iCloud as part of their iOS 5 upgrade. As I began to use it, there was a quick realization that this technology is really a game changer. We talk a lot about cloud as a part of future solutions in healthcare, but when you personally use it, the idea becomes more concrete.

In a simple experiment, I setup the iCloud to synchronize my contacts from Outlook running on my Windows laptop to my iPhone and iPad.  To make it more interesting, I changed my photo on my personal contact record, not a data field.  Instantly, and without cables or iTunes sync, my new contact photo appeared on my iPhone and iPad simultaneously – wirelessly and through the cloud.  I created a new contact on the iPhone and it appeared in Outlook.  The idea that we could apply this technology to really synchronize patient information from acute to ambulatory settings seemed very much closer and more possible.  I realize that we have to address privacy and security concerns to make cloud technology work in healthcare, but my iCloud experience is fueling big dreams about what is possible.

The cloud provides the instant on, always available information that healthcare professionals have to crave.  Many of them are constantly on the go, unable to sit at a single desk to interact with an IT system. The ability to work untethered but with up to date, accurate information should be more than a dream at this point, but table stakes in a life and death game. It isn’t surprising that there is a high adoption rate of smart phones by medical professionals – they need the technology to cope with daily work demands. The access to secure, managed patient information via mobile platforms and served up by the cloud will soon be expected, thanks to this demonstration by iCloud.

If the heart of accountable care is managing the transitions of patients from one healthcare setting to another safely and accurately, then we need to stop talking about interoperability and make it happen with cloud technology.  Let’s take an important lesson from Steve Jobs: Dream Big!

2011 Connected Health Symposium: Meeting Patients Half Way Reduces Costs

by on October 20th, 2011

Here at the Connected Health Symposium the showroom floor is atwitter with conversations around patient engagement.  Everyone is discussing ways to best engage patients and, not surprisingly, what the price tag of such ambitious efforts will amount to.  I am confronted with enthusiastic smiles when I point to data that shows that engaging patients actually reduces costs for healthcare organizations.  Meeting patients half way with collaborative tools is actually cost effective healthcare at its finest.

In fact, data from IHI shows that patients receive better care when healthcare organizations put the highest emphasis on the entire healthcare system that patients use to receive care.  By incorporating the critical components of clinical care into executive decisions, healthcare executives better realize quality outcomes and became market leaders.  IHI found that organizations had better clinical outcomes at lower cost when: (1) Data is integrated in such a way that design of care can travel across an entire patient episode and (2) Patients were engaged in the design of their care.

The fragmentation of the patient experience leads to increased cost and decreased patient experience.  This is a lose-lose situation for healthcare providers.  Conversely, providers can win through increased collaboration with patients.  There are many smart options available to invite patients into decisions related to the design of clinical care.  Healthcare portals can be used to empower patients by providing meaningful access to their care and connect a patient to the entire health system that impacts their care.  Similarly, community portals can be created to connect patients to those with similar disease states for information sharing, support, and advice.  This empowers patients to work with healthcare organizations in creating cost saving, and patient centric, clinical care.

One great example of patient engagement in care using collaborative and social technologies were found in the “Miami Project” used to enhance the quality of care for diabetic populations in low income areas.   In a joint effort between Microsoft and the University of Miami, a group of diabetes patients were given computers and trained on the Internet.  They were then able to communicate with doctors and nurse practitioners via portals.  The portal was used not only to transmit data about weight and self-administered blood sugar tests but also as a virtual classroom to learn about nutrition, exercise, and diabetes care.  Patients were enabled with the ability to send instant messages and email to their healthcare providers and to discuss their disease with other diabetes patients via discussion boards.  These patients were invited into the design of their care plan.  This research showed a strong correlation between patient involvement and a decrease in the high cost of readmissions and the ongoing management diabetes.

Connected Health 2011: Sending Your Avatar to the Doctor Instead of You

by on October 20th, 2011

The rapidly shifting role of patients within the care model has resulted in demand for easier access to healthcare professionals.  Innovations in social media and collaborative technologies provide healthcare organizations with the ability to disperse information quickly and appeal to individuals who are seeking cost-effective healthcare services, especially in remote or rural communities.  There are plenty of opportunities to learn more about this topic at the Connected Health Symposium with events like, “Improving Patient Engagement and Medication Adherence Through Health System Innovation” and “The Age of Compassionate Computing.”

One innovation in collaborative technologies was featured in AARP magazine the other day (yes, I qualify) in an article titled “Medical Treatment in a Virtual World.”  It was a fascinating article about an experimental program to advise patients in Second Life, a website where doctors and patients appear as avatars, 3-D representations that communicate with each other.  The big news is that developers say it is the first time a virtual world application has been aimed to actually deliver health care. The goal of this use of the application is not to help people with acute problems, like an asthma attack, but about treating non-life-threatening chronic conditions that make up a large part of healthcare costs such as diabetes and arthritis.

In Second Life, patients create avatars before visiting the virtual treatment center which is open only by invitation.  People interact both individually and in groups with a doctor.  Through group sessions, people can anonymously learn from experiences, comments and questions of other patients according to Reza Shaker, M.D., gastroenterologist and professor at the Medical College of Wisconsin in Milwaukee. This approach could be very successful because my experience is that people enjoy this type of anonymity of group sessions for learning and that this approach of using avatars could encourage participation in chronic care management.  Using an avatar could help people be more honest about their current situation including glucose readings, compliance with treatment plans or pain assessments.

Another place that avatars are popular is on the Nintendo Wii gaming platform and they are called a Mii.  When the Wii Fit platform evaluates your weight, BMI and level of physical fitness for your Mii then it adjusts your appearance to match your demographics.  It is interesting that you don’t feel as offended if the application makes you look overweight but instead feel motivated to make your avatar look “normal.”  Is it possible that the avatar is the key to dropping our normal human façade that prevents honest communication with medical professionals?  What are your thoughts?  Is the idea that it is easier to assess your situation honestly as an avatar?

Avatars and the Real World of Health IT

As we consider methods for chronic care management, especially outreach to individuals in isolated or remote environments, it seems logical that we would tap the Internet to connect and collaborate.  The next step might logically be to integrate personal health information including remote device readings (glucose meters, blood pressure cuffs) to their avatar to provide the feedback loop for better medical advice and monitoring.  Another idea would be to use avatars for educating people on their medical conditions and how to avoid complications.

The potential for a virtual medical clinic has great value for non-life-threatening conditions in remote or rural medicine as well.  Tracking pain levels or wellness after medical treatments could be more personal and immediate through this novel approach.  Do you think people would respond well to this approach? Is it the next big idea for innovation in healthcare?

New Perficient White Paper! Healthcare Data Meets Strategy

by on October 19th, 2011

Health plans, patients, and employers are demanding greater accountability and demonstration of value for their healthcare dollar, and these demands will only intensify in the future.  To be successful, healthcare organizations need to establish a culture of performance management; that is, an ongoing process by which organizations define their strategic direction and then deploy their business processes and management systems in support of that direction. This requires establishing performance expectations through the planning and budgeting process, and then continually monitoring performance against the plan, making adjustments as necessary.

Download our new white paper, Understanding Performance Management in Healthcare to learn more about this topic.  You can also visit our Business Intelligence page on the healthcare microsite for even more content on this topic.

Want to learn more?  Register for our upcoming analytics webinar and you will be entered to win one of two Perficient client badges to the February HIMSS Conference in Las Vegas!

Five Strategies for Implementing Provider Healthcare Data Analytics

by on October 18th, 2011

As we approach 2012, it is critically important to consider the implementation of Healthcare Analytics.  This point could not have been made more clear to me than it was during a final “orals presentation” prep to a recent prospective healthcare system client.

“Technology has finally been embraced (begrudged by some in Healthcare) by the Healthcare industry, just as Providers are facing the quandary of how to assemble useful information from the enormous amount of healthcare desperate data available through EMR’s, CPOE systems, HIM claims processing systems and other departmentDatabase systems we all know exist within a Provider”.

While we were making ready for the team preparation, I started asking myself “what are the reason(s) we [in healthcare] are racing to deploy Healthcare Analytics, and continue to miss the target?”  Then it came to me, we are healthcare people – focused on delivery of healthcare, not PhD statisticians with a research team focused on the problem.  However, the leadership teams charged with improving the healthcare “bottom line” still need to be more focused on how to turn data into strategic and meaningful information – I have noted five strategies that may just do the trick, read on!  That said, first, know the “end game”, namely your goals and challenges.

Goals and challenges:  We all need to bare in mind that that “Healthcare analytics is the Holy Grail with respect to the enhanced delivery of healthcare,” The conversion of lab data, CPOE stats, consults, and the myriad of other related data into meaningful trends holds the promise of increased coordination of patient care, patient safety, increased quality of care and cost-efficiency for not only individual patients, but also for provider system, is one of the strategic goals of accountable care.  However, turning patient data into usable information is challenging; furthermore, once healthcare providers can access the information, determining how to act upon it poses even more problems.

Finally, one must differentiate between healthcare data – the facts entered into the EMR – and information – the interpretation of the facts in a meaningful context. Just because you have a lot of data doesn’t mean you can do anything with them. It becomes mission critical, especially today with all changes occurring in healthcare, to get as much data converted into information that is usable.  What is needed are strategies to get the ball rolling!

Five Strategies to Consider:

1. Establish a Governance body (not just an org chart). Hospitals should set up a governance structure to manage implementation of data analytics capabilities. The CEO, CMO, CNO and CIO should all be involved.  The CMO and CNO need to communicate the kind of information they want to the CIO, who has the IT knowledge to conduct the actual implementation. “You need to have a governance structure [in which] the CIO takes the lead but has the [CMO and CNO] to always ensure that whatever he or she is doing is going to meet their needs,” he says.

Hospitals should also consider partnering with a professional organization experienced in Healthcare data analytics.  Reason being, the learning curve would be much steeper and the time to implementation longer if the providers try to create an analytical tool on their own. “It’s a major undertaking that takes time and a good deal of effort. [If providers do it on their own] it usually ends up on the back burner and never gets done.”

2. Determine the desired information Wanted. Due to the large amount of data available to providers, from the plethora of data sources, hospital leaders need to define what information they want. “You have to be able to filter what’s really important to you based on the hospital and specialty service you’re interested in.  Hospital Leadership should also determine when they want the data, how they want it presented and who they will share it with.

3. Format the GUI, and package the information appropriately. One of the keys to analyzing data is presenting it in an appropriate format. For example, if the hospital wants to understand the lab data for someone whose blood is drawn twice a week for five weeks, simply looking at the 10 data points would not yield any useful information. “It’s meaningless if there’s no reference point,” Instead, the hospital would need to trend the data and benchmark it against regional demographic norms and national averages.

4. Maintain the Level of Data Security. Once the provider has meaningful information, they need to decide who to grant access to and establish security protocols to ensure access is available only to those individuals who need it and have a need to know.  Access to information does not have to be all or nothing, however.  This is where HIPAA, healthcare ethics, and Governance come into play – decisions of this nature may be addressed with an established review by using the HIPAA standards developed, and the Governance/ethics teams convened by the hospital.

5. Insure Timely and Proper Sharing of the Information Effectively and Efficiently. Even if healthcare data has been converted to information and the information has been secured, analytics cannot produce benefits of improved quality and reduced costs if the information is not shared effectively.  Therefore, it is a strategic choice to use a “push” rather than a “pull” technique for sharing information with those within the healthcare system that may need it.

Present it to them in their daily work.  Don’t [make] them try to find it.  The difference between “push” and “pull” is similar to opt-out and opt-in systems. In a “push” environment, the individual would be automatically presented with data that they would have to consciously ignore or dismiss – or opt out of receiving it.  In contrast, a “pull” environment would require individuals to find the information themselves, or opt in. The former method increases the probability the individual will be aware of the information they can use to improve patient care.

Following these five strategies may not be all that you need to do, but it WILL get you started down the path of getting what you want – meaningful and actionable information that will be strategic in reducing cost and most importantly, improving the delivery of patient care…