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Archive for the ‘Health Information Exchange’ Category

Includes Enterprise HIE and State-Wide HIE

Key Components to Collaboration between Payers and Providers

There is no doubt that the relationship between payers and providers is beginning to change, evolving from challenging and adversarial interactions into more collaborative exchanges. Kurt Allman, in his article in Healthcare Payer News this week, outlines 3 components for this relationship to be successful:

collaboration

  1. Data collection
    “Payers collect a lot of data, which can provide a broad picture of what is happening in a population and across the entire continuum of care. Health systems bring a rich vein of information related to specific components of that continuum.”
  2. Transparency
    “We rely on this data to make sure we know what works, and when it doesn’t work, we use the information to identify opportunities for improvement,” says Kevin Sears, vice president of payer strategy and product development at CHE Trinity Health in Lavonia, Mich.
  3. Mutual understanding
    In the past, providers worked to drive up revenue from the payer, while the payers needed to drive down costs to please their customers, both employers and employees/members. Now the two have to work together to reduce waist and improve care.

Now, we see that payers and providers must collaborate in order to truly drive value, more so than they ever needed to in the past.

When payers and providers work together to achieve all three of the above imperatives, they’ll identify opportunities that will become mutually beneficial. Each can begin by asking themselves whether their high-priority projects are working to help them to obtain higher transparency, data collection and sharing, and a mutual, more collaborative relationship with the other.

 

Enterprise Warehouses: The gift that keeps on giving

I read a blog post recently with references to Oracle’s Marc Perlman @marcdperlman speaking about how Healthcare entities are nearing the timeframe where they can reap the benefits of implementing electronic health records.  To quote Marc, “As healthcare providers look to establish enterprise data warehouses, they should begin with a specific project that hinges on this kind of data-driven approach.  Once done, enterprise data warehouses become “the gift that keeps on giving,” because they can be used to spread actionable insights to other parts of the organization, as well.”

The Gift That Keeps On GivingAs my colleague, Lesli Adams @lesliadams writes in her blog: A healthcare treasure map leading to a single data warehouse, the Oracle Enterprise Health Analytics platform is a treasure trove of data.  The platform combines Oracle Database, Oracle Healthcare Data Warehouse Foundation, and data modeling, integration, and analytics capabilities in an integrated stack that runs on Oracle’s highly engineered Exadata Database Machine. The result is a scalable, high-performance data warehouse that serves as a central repository for health data analysis, which can be done using the built-in tools that come with the system, Oracle Endeca Information Discovery, Oracle Business Intelligence Enterprise Edition, or other analytics applications that are available to run on it.

Perficient is uniquely positioned to deliver the Oracle Enterprise Health Analytics platform as well as strategic healthcare analytic roadmaps.  Perficient will be at the Population Health Colloquium #pophealth, and we are looking forward to talking with you about Health Analytics and Population Health.

See our presentation on Tuesday at the Mini Summit on Shared Accountability:  How Informatics and Data for Clinical Decision Workflow Engages Consumers on the Quality/Cost Equation. Sponsored by Oracle Health Sciences and Perficient, featuring:

Sanjay Udoshi, MD, (@smudoshi) Physician Architect, Clinical Analytics, Product Strategy, Oracle
Lesli Adams (@lesliadams), MPA, Director, Oracle Healthcare Business Intelligence, Perficient, Inc.

Meet our dynamic team at booth #32 to discuss new ways to optimize your systems, along with new solutions that will take your business to the next level.

Join us in Philadelphia! Follow our healthcare experts on Twitter @Perficient_HC and check our Healthcare blog.

 

Follow me on twitter @teriemc

Improve care coordination with direct secure messaging #HIMSS14

Direct secure messaging (DSM) is a transmission standard promoted by the Office of the National Coordinator for Health Information Technology that meets the Meaningful Use Stage 2 requirements of electronic health records (EHRs).  It works much the same way as regular email, but the message is encrypted, which prevents unintended use of the protected health information that is included within.  DSM can be used to send patient information among physicians, among provider organizations and to other 3rd parties, including patients.  

shutterstock_157839875Healthcare providers have been using direct secure messaging for care coordinating for a while but there may be ways to use it more fully to reduce readmissions, reduce unnecessary testing and procedures and even increase provider productivity.  Some benefits may include:

  1. Providers can insert secure messages into any point of their workflow.
  2. Primary care providers can interact with specialists to potentially result in fewer referrals; ultimately reducing costs to the healthcare system.
  3. Hospitals can improve transitions to nursing facilities and nursing homes can improve the communication with providers to reduce the need for readmissions back to the hospital.
  4. Medical records departments can interact with the patient send their records more easily saving them time and money.
  5. Researchers can seamlessly interact with patients on release of health sciences information.

Once HIEs are fully implemented, query based networks will provide robust data exchanges, but DSMs will continue to be valuable especially for smaller practices and hospitals that do not have the means to implement sophisticated EHRs.  Read the rest of this post »

Analyzing the healthcare industry tipping point using Therbligs

Do you remember therbligs from your Operations Management class? 

The word therblig was the creation of Frank Bunker Gilbreth and Lillian Moller Gilbreth, American industrial psychologists who invented the field of time and motion study. It is a reversal of the name Gilbreth, with ‘th’ transposed. Therbligs are 18 kinds of elemental motions used in the study of motion economy in the workplace. A workplace task is analyzed by recording each of the therblig units for a process, with the results used for optimization of manual labor by eliminating unneeded movements. (Wikipedia)

shutterstock_128890124I remember, and it was a lifetime ago.  But then again, the Gilbreth’s were turn-of-the-century industrial psychologists who invented the field of time and motion study.  I consider them the founding parents of Industrial Engineering.

So why are we talking about therbligs in Healthcare?

Ah, young Jedi, the time has come to learn our lessons much the same way that the industrial giants like Ford, Carnegie Steel and General Electric learned 100 years ago during Teddy Roosevelt’s administration.  These early lessons became the standards of the mid-century boom in manufacturing and production output.

So the healthcare technology space has finally gotten to its tipping point.  In order to survive, the healthcare industry will need to invest in Industrial Engineering principles and it will need to do product line, service line, episodic, acute and outpatient time and motion studies.

Read the rest of this post »

Trends to Watch in the Healthcare World in 2014

What’s transforming the ways in which healthcare is provided?

  • legislation
  • new competition
  • innovative incentives
  • a call to refocus on priorities
  • a more empowered and digitally engaged consumer, who has more and greater expectations for quality of care and convenience of care.
  • a renewed attention on healthcare by the consumer market thanks to ongoing press about healthcare.gov and the Affordable Care Act
  • new services and business models in healthcare that we’d never seen before recent reform

Susan DeVore, Premier healthcare alliance…and much more.

Susan DeVore, CEO of our partner and client Premier healthcare alliance, wrote a post yesterday fro HealthAffairs.gov titled, “The Changing Health Care World: Trends To Watch In 2014.” In the article, she introduces the new trends she expects to see in healthcare this year. We are also seeing each of these trends impact conversations about investments our clients need to make this year and next year.

I have summarized the trends below.

1. Investments in Chronic Care -

  • Chronic conditions increase costs by 3X, so, “The biggest health care consumers are those with multiple chronic conditions.”
  • We should see more investments in Ambulatory ICUs and patient-centered medical homes as providers work to improve their shared savings payments and better manage chronic conditions within primary care facilities.

2. New Job Roles in Healthcare

  • DeVore has seen an increase in the popularity of hiring “health coaches” who are there to listen, inspire and motivate and spend time getting to know the patient’s family and life situation as it affects their ability to both access care and to care for themselves.

3. Home Health Care

  • Back to the days of the house call.
  • “Marketing firm BCC Research predicts that the market for remote monitoring and telemedicine applications will double from $11.6 billion in 2011 to about $27.3 billion in 2016.”
  • Technology is increasing access and convenience of healthcare from outside the traditional care setting, especially for rural, hard-to-access locations.

Read the rest of this post »

Healthcare CIOs are carefully moving to the cloud

Recently our company has increased our focus on what healthcare organizations are looking for when it comes to cloud computing, in large part due to our acquisition last year of two fantastic Salesforce partners (ClearTask and CoreMatrix). I found this article in Healthcare Informatics to be very interesting. It’s titled “The Many Flavors of the Cloud” and includes interviews with some key CIOs regarding how they view private vs. public cloud solutions and the sensitivity – and often the mandated security requirements – around health data when stored in the cloud.

There are some obvious advantages to providers moving to private cloud storage for all types of data across the organization, but also some critical considerations for any CIO or CMIO. Here are the key takeaways I got from this article.

MedicalImaging_AndroidTabletApp

Medical imaging takes up a lot of storage space in the healthcare space. Imagine a 24 hour study of your heart that takes up a terabyte of space. The cloud can enable better scale for this type of need.

Key insights about cloud computing in healthcare:

  • CIOs interviewed prefer “private cloud” solutions over public cloud solutions like those of Google, Amazon and Microsoft – more control around access & rules
  • CIOs don’t want to deal with power issues, cooling issues, and capitalizing hardware over time – 3 reasons they enjoy Cloud
  • They enjoy reduced costs in scaling a storage room, servers, etc..
  • CIOs take personal ownership over creating their own stringent security requirements for their cloud vendor, making them feel better about storing PHI or other sensitive healthcare data in it.

Read the rest of this post »

Massachusetts launches important next phase of HIE

Today, Masachusetts moved into phase 2 of a very important Health Information Exchange (HIE) project. It’s called Mass HIway Health Information Exchange, and it was announced at Beth Israel Deaconess Medical Center, where Healthcare CIO, John D. Halamka works.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician.

Halamka is one of my favorite people to follow in healthcare technology (@jhalamka). He blogs at “Life as a Healthcare CIO” and wrote about the news today in a post titled “The Next Phase of Healthcare Information Exchange.”

Halamka gives us a sense of all of the work that went into this next stage of the project, including:

  • a patient index to track which patients have opted into exchanging their patient data with other providers
  • a portal for providers to log in and access the data
  • an EMR request system to support the request & release workflow
  • a system to keep audit trails of all of the activity

For those who are fans of a “No More Clipboards” type of future in their own patient care experience, news like this is very exciting. Halamka talks about how this massive project taking place in Massachusetts is an example of how the future of healthcare information exchange can be convenient, secure, and lead to better care and health outcomes for us all.

He writes:

“I can imagine a day in the next few years, when all patients in the Commonwealth, with their consent, benefit from secure, coordinated care.    My mother suffered a major medical error in California because of inaccessible primary care records.   I truly believe that my 20 year old daughter, attending Tufts University, will see significant reduction in preventable harm in Massachusetts during her 20′s.”

That’s very inspiring.

 

Milk, Bread, Cereal…Healthcare?

Okay, show of hands, how many people have received their flu shot this year?  Where did you go?  If you are like me and most Americans these days you probably didn’t want schedule an appointment with your doctor.  You most likely needed a few things at your local grocery store, or needed to pick up extra Halloween candy at Wal-Mart or Target and ended up in their retail health clinic line on your way to the checkout line.

Retail health clinics are popping up everywhere.  You can barely go into any drugstore or supermarket without seeing one.  The sudden burst of these walk in clinics comes retail clinic cartfrom the fact that more and more healthcare needs are being driven by consumers and these days, when it comes to healthcare, consumers want what they want, when they want it.

Impact on Triple Aim

Healthcare consumers are looking for affordable, accessible and quality care without having to wait hours, days, or even weeks for basic primary healthcare services1. Retail and pharmacy-based care clinics provide just that.

Improved Experience through Access:

Conveniently located in retail locations, such as pharmacies and drugstores, supermarkets, big box retailers, and other high-traffic retail settings with pharmacies, these clinics have provided convenient and accessible primary care to more than 20 million people nationwide1.  These clinics are typically open 7 days a week, with extended hours, appointments generally only last 20 minutes and there are little to no wait times.  If you do have to wait, most provide a restaurant-style pager so people can walk around the store while they wait2.

Read the rest of this post »

HIE: 6 Opportunities for Increased Patient Safety

In my last blog post we explored the topic of shared decision making (SDM) and its impact on patient safety. This made me think of an experience we recently had with my dad. He had a stent placed about year and a half ago to open a blocked artery in his left anterior descending artery (LAD). Now I should tell you that the doctors, 3 to be exact, wanted to send him home because all of his tests came back negative, but the stubborn, yet lovable, man that my father is (I know, the apple doesn’t far fall!), found a cardiologist that was willing to listen to him and discuss his concerns and thoughts. He convinced this cardiologist to do an angiogram. They ended up finding, clear as day, a 90% blockage in the LAD and stented him right then and there, no questions asked. Needless to say he bypassed a major heart attack, (a.k.a. the Widowmaker) which could have very easily ended his life.

My brother and I both have clinical backgrounds, so it was a little unsettling how the events of the 48 hours with my dad transpired. We went from an emergency admission to nothing is wrong with him, he can go home, to he has a 90% blockage in his main artery that we need to stent right away. Talk about an emotional rollercoaster, but in the HIE benefitsend we were glad he was okay. However, at time of discharge, another shocking and disappointing incident occurred. The nurse was going over his discharge medication regime. As she was rattling off this medication list at a speed even a pharmacist couldn’t understand, she stated, “…and 10mg of Amaryl two times a day.” My dad, who has NEVER taken a pill in his life (we are Indian so turmeric is our answer to everything!) and was still a little out of it from the whole experience was unable to catch the error that just occurred. Luckily I was there to ask the nurse, “Are you sure it is 10mg and not 1mg of Amaryl?” Her response, “Yes that is what the order states.” Again, I challenged her, “Are you sure, because I thought the cardiologist told us after surgery it was 1mg of Amaryl.” She responded, “I can go check, but I am pretty sure this is correct”. I asked her to call the cardiologist and confirm as pretty sure was not good enough. Just as I suspected, it was an error in dosage. The order was for 1mg of Amaryl, twice a day, specific to before breakfast and dinner. At this point, given all that occurred, I began questioning everything she rattled off and requested (well, damn near demanded) that she go back and reconfirm the entire list. This was my dad, my best friend, I was not going to take any chances that his safety be compromised due to a medication error.

This is just one incident that thankfully didn’t end badly.  However, every day patient safety is being compromised because information is not accurately or readily available.  Up to 18% of the patient safety errors, generally, and as many as 70% of adverse drug events could be eliminated if the right information about the right patient is available at the right time. Health information exchange (HIE) makes this possible1.”

Read the rest of this post »

The Quest for My Complete, Portable Health Record

As I have written before, I currently see several physicians who do NOT use an EMR in the office.  They are awesome diagnosticians, people and mentors but they have not taken the leap to the electronic health world.  Now, add in two hospital networks that do NOT have patient portals for accessing my records and you get one big, fat medical record quagmire!   I would love to have my entire medical record in one place AND have portable access to it.  Will I ever reach that goal?  Do I need to establish a relationship with a new physician just to obtain my goal?  I certainly hope not!  So what can be done to make my dream a reality?

puzzle personThis quest has certainly led me to devour insights from industry experts, read countless blogs and articles and consider the drastic move to a new physician.  So I was intrigued when I read the Wall Street Journal article, “Image Sharing Seeks to Reduce Repeat Scans”, this week.  Allowing patients to have access and the ability to TRANSFER images to multiple providers reduces cost, redundancy and ultimately, radiation exposure for the patient.  In addition, it allows the patient to “own” their health.  Although this is certainly a step in the right direction, this is an isolated sharing of information, not connected to the rest of the patient’s history, just another piece of the puzzle.  How can we solve the entire puzzle?

Read the rest of this post »

Top 5 Technology Trends in Healthcare – March 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5

HIMSS 2013 Conference

Earlier this month the HIMSS 2013 Conference took place in New Orleans. Nearly 35,000 individuals attended the healthcare technology conference over the six days of sessions and exhibition. Highlights included a keynote address from former President Bill Clinton, an Interoperability Showcase, several Meaningful Use workshops, and a general theme of patient engagement.

Patient Engagement under Meaningful Use

A key theme of Stage 2 meaningful use is engaging patients in their own care. Building on the Stage 1 requirement that 50% of patients be able to view their documents electronically, Stage 2 mandates that 10% of those patients actually do so. Clinical summaries must be provided following each office visit and select patients will receive notifications and reminders for additional care. Secure messaging to patients, another Stage 2 requirement, can connect them with helpful care information.

Read the rest of this post »

HIMSS 2013: An Interview with ePatient Dave

Earlier this month at the HIMSS 2013 Conference, Perficient’s Liza Sisler spoke with Dave deBronkart, better known as ePatient Dave. Dave and Liza discuss the unique roles of health, care and medication in engaged healthcare and the idea that the patient is the key to bringing all three aspects together in order to provide better health outcomes. He also talked about the role of useful digital tools to help engage patients and interoperable systems allow data to be shared and presented in a useful manner, providing better, safer care. Dave talks about the idea that patient’s healthcare data should follow them as complete and correct data at the point of care is critical to provide effective, safe health care. Lastly, @ePatientDave tells the story of Dr. Eric Topol utilizing a mobile health tool, AliveCor, to diagnose a woman on his flight home from HIMSS and the impact of mhealth tools.

When Patients Engage, Outcomes are Better

Read the rest of this post »