Perficient Healtchare Solutions Blog

Subscribe via Email

Archives

Follow Healthcare Technology on Pinterest

Archive for the ‘Health Information Exchange’ Category

Includes Enterprise HIE and State-Wide HIE

HIT Solutions for Population Health

I’m going to take a “improve / disseminate disease management HIT Solutions for Population Healthand improve outcomes of the group” view of Population Health. The technology solutions that can be applied are vast. For the sake of this blog, I’d like to talk about these four:

  • Analytics – The accumulation and aggregation of data needed to improve outcomes and improve medicine.
  • Interoperability – The sharing of clinical data needed to manage patient interactions.
  • Patient Engagement – The conversations and interactions with the patient when they are not within the four walls of traditional clinical setting.
  • Financial Management – The connection between the patient payment and the quality received.

An integrated analytics platform for improving population health provides insights to care providers, case managers and the individual patient.   Care providers can see which patients need important health screenings or care interventions, setting the stage for enhanced preventive care and better management of chronic diseases. Patients can now be engaged at a higher level to achieve their care goals through many patient engagement platforms including both active and passive participation through portals and remote monitoring devices.

Interoperability is a key element of population health because all of this data is never in application, database or even one data center locality. Integrated systems streamline data sharing and support population health initiatives; however, many organizations don’t have a clear vision for how to meet the demands of the ever-changing healthcare industry.

While the technologies employed to achieve these goals most certainly include a data warehouse, analytic / predictive modeling and perhaps reasoning tools, I think the integration challenge is vast and perhaps overlooked. Most of what I read is very focused on more appealing topics like the dashboard or the cool visualization tool. However,  integration of this sort requires state of the art integration technology to do the heavy lifting on moving data and correlating data for the population health analytics platform.

Last, but certainly not least, there is the challenge of understanding the financial impact of treating the patient. Not speaking in terms of profitability here, but simply “are we putting our financial means behind the right care or populations of patients to achieve the best outcomes”. It is impossible to know without understanding cost vs. quality at the patient level.

How do we understand total cost of care? The Perficient High-Performance Costing Expressway enables transparency of fully burdened margin by service, patient and procedure. For decades, spreadsheets and costing software have been the best alternatives in determining cost of care. It is now more important than ever to transform these methods and leverage administrative, clinical and financial data in order to gain control of healthcare costs. Creating transparent costing models to indicate profitability across multiple dimensions of data is the key to driving healthcare costs down.

Embracing data-driven decision made for populations of patients requires agile thinking to pinpoint and respond to the short- and long-term needs of the organization. This shift requires finance departments to transcend from the typical focus on aggregating data to a value-added analytical view of hospital data. This new approach will provide greater visibility into changes in variables and assumptions and will require organizations to fully understand and ensure transparency exists for key performance indicators.

I will be speaking in conjunction with Oracle CMIO Dr. Sanjay Udoshi and Lesli Adams, MPA, Director of Clinical Informatics at the upcoming Population Health Colloquium in Philadelphia #PopHealth15.

Please join us at the MINI SUMMIT IV: WHO IS YOUR CHAMPION OF CLINICAL OUTCOMES? NAVIGATING ENTERPRISE-WIDE ANALYTICS AND THE DIGITAL SAFETY NET on Tuesday, March 24th at 1:30 EST.

For more information download our white paper:  Aligning Patient Outcomes with Financial Data

Hot Topic: Retail Strategy for Healthcare #HITsm Tweet Chat

shutterstock_159153632Participants of a tweet chat hosted by HL7 Health Standards on Friday, March 6, certainly had a lot to say on the topic: A Real Retail Strategy for Healthcare.

The hour-long session drew 104 healthcare professionals who posted 980 tweets in response to five questions centered how the industry could benefit from the retail industry’s best consumer experience practices.

For those unfamiliar with the hashtag, #HITsm is an acronym for “healthcare IT social media.” HL7’s weekly #HITsm tweet chats encourage the exchange of ideas and best practices on current health IT topics. Read the rest of this post »

The Health Information Exchange (HIE) Teeter-Totter

The cyber-attack on Anthem, the nation’s second-largest health insurer, directly reflects the vulnerability of healthcare organizations, which are years behind other industries in regards to protecting personal information. In today’s healthcare industry, the federal government encourages sharing information across the continuum, which is critical to improving patient care. The challenge is the balancing act between protecting personal information and making it useful – the health information exchange teeter-totter. Current federal privacy regulations and the industry standard call for encrypting information that is sent from the database; however, on-premise data commonly remains unencrypted, making it vulnerable to an attack.

The Healthcare Information Teeter-Totter

Anthem followed industry standards and encrypted the medical information that was shared outside of their database, but because they failed to secure their on-premise data, hackers gained access to up to 80 million records that include social security numbers, birthdays, addresses, email, employment information and income data for customers and employees. Scrambling personal data makes it less valuable to hackers, but also makes it more difficult for healthcare employees to track trends and share data with other healthcare providers and states.

Other industries such as the financial services industry keep personal information in separate databases that can be closed off in an attack. Avivah Litan, an analyst for Gartner who specializes in cyber-security, said healthcare organizations “are generally less secure than financial service companies who have the same type of customer data.” For example, the attack on JPMorgan Chase last summer compromised the personal information of over 80 million households and small businesses, but the breach was limited to non-financial information because the more sensitive information was walled off, which meant hackers could not penetrate it.

Unfortunately, in healthcare the question isn’t whether the next data breach will occur but rather when will it occur. Balancing out the health information exchange teeter-totter will continue to be a challenge for the healthcare industry. The criminal value of the information that healthcare organizations store combined with the slow adoption of security measures make healthcare organizations prime targets for hackers.

Using the Finance Playbook to Improve Quality in Healthcare

I loved an article I read in a recent issue of HFMA Magazine in the Healthcare Value section. The title is “The Secret to Building Effective Quality Programs” written by John Byrnes, MD. The finance playbook, described ICD-10 Impacting the Financial Playbook and Improving Qualityby John, includes these cornerstones:

Rule #1: Don’t allow clinicians to calculate cost savings. Finance and clinical counterparts should partner together using transparent calculations and data.

Rule #2: Ensure quality reporting is comprehensive. If a hospital can report financial data for every department, they should be able to report quality data. Make the data available across clinics and define system wide measures.

Rule #3: Ensure quality-control resources are adequate. By demonstrating the business value of quality improvements, the quality department should be able to secure the resources needed to build quality control processes.

Rule #4: Equate Chief Quality Officers to Chief Financial Officers. If it takes the CFO level position to ensure the financial health of the hospital, why wouldn’t we want an equal position to ensure that effective quality control procedures are established?

The common thread here is data and leadership isn’t it? On the data side, enterprise data warehouse solutions are important to source data for common measures for the hospital. This intersection of quality and finance also will be affected by the upcoming conversion from ICD-9 to ICD-10 coding methods. By permitting more-specific coding of patient conditions, it may be possible for care management organizations to identify which members require disease management and to tailor programs more precisely to their conditions, thereby raising the efficacy of disease management and saving both lives and money.

This article initially attracted my interest because of my background in finance and operational analytics, but I also had an unfortunate encounter with a mid-size hospital system recently with a family member that shook me to the core. There was no Quality Officer and no incident reporting process in place and no one to turn to after a life threatening situation unfolded with a close family member. My heart sank not only for my loved one, but for those who would encounter this in the future. I did report this to the Joint Commission and I hope that the culture has changed for this organization.

@teriemc

 

Gearing Up for 2015: 10 Trends Impacting Healthcare in 2015

HITS SNAPSHOT – GEARING UP FOR 2015 10 Trends Impacting Healthcare in 2015Technology is a major player in the evolving healthcare environment, and organizations are increasing their health IT budgets to adapt to the “new” industry. Having the right technology in place can enhance patient experience, help meet regulatory requirements and provide key insights that reduce costs and improve outcomes. In our recently released HIT SNAPSHOT we have identified ten trends impacting the healthcare industry that can help determine which technology investments should be made to achieve the greatest return on investment.

Download the guide now

Top 10 Healthcare Industry Trends Blog Posts from 2014

Top 10 Healthcare Industry Trends Blog Posts of 2014As we wrap up 2014, let’s take a look at the top 10 blog posts from our thought leaders. These blogs were published on Perficient’s Healthcare Industry Trends Blog.

If you missed these you may want to take a look.

#1. What the Market Says You Need in Your Patient Portal
by Melody Smith Jones | June 19, 2914

#2. Connected Health Trend Countdown: #1 Health Plans Go B2C
by Melody Smith Jones | February 5, 2014

#3. Changing Delivery and Spending of Medicaid Through DSRIP
by Priyal Patel | May 22, 2014

#4. Healthcare Gamification: Avoiding Chocolate Covered Broccoli
by Melody Smith Jones | February 4, 2014

#5. How Enterprise Mobility Management can Improve Patient Care
by Kate Tuttle | May 7, 2014

#6. Perficient Ranked One of the Largest Healthcare Consulting Firms
by Kate Tuttle | August 25, 2014

#7. Connected Health Trend Countdown in Review
by Melody Smith Jones | February 6, 2014

#8. Apple: The New Digital Hub for Healthcare Data
by Kate Tuttle | September 9, 2014

#9. Healthcare Benchmarking
by Priyal Patel | July 9, 2014

#10. The Problem with Health IT is in the Definition
by Kate Tuttle | October 13, 2014

 

 

A New Patient Adventure…A Hair Pulling Experience

I grew up in a small town in Iowa and lived in and around my hometown for 30 years. It wasn’t unusual for my commute to work to be interrupted by a John Deere tractor driving down the highway. When I hit 30 I traded in my rural roots and headed off to the booming metropolis of St. Louis for a change of scenery. I, like A Day At The Doctor...A Hair Pulling Experiencemany others, struggle to schedule routine and regular doctors appointments so when I moved, finding a new doctor was not a priority. I have been blessed with a relatively healthy life thus far and tend to view healthcare as sick care. (When I’m sick I will go to the doctor.) Needless to say, it took me a while to take the time to find a new doctor after moving to St. Louis. In fact, it didn’t happen until I had found a veterinarian and a groomer for my dogs, a hair stylist I liked and a car repair shop that was reliable and trustworthy. To be honest, I still may not have a doctor if it weren’t for the fact that I needed to get a refill on my prescription.

Who Uses FAX Machines? Doctors Do…
I took some time looking online to find doctor reviews and patient referrals and, of course, listened to word of mouth from my new friends in St. Louis. Once I settled on a doctor I made a call to schedule an appointment and then contacted my previous doctor back in Iowa to have my records FAXED to my new doctor. The fact that fax machines are still being used, not only as the primary technology but the only one, both humored and frightened me at the same time. But I thought whatever works to get my information to the new doctor, works for me. Having my previous medical history in the hands of my new doctor would save me time. I wouldn’t have to fill out the medical history paper work because I took the time prior to my appointment to have my records faxed to them…Right? Wrong, this didn’t save me any time at all.

A NEW Patient Again and Again…
I was advised to arrive 20 minutes early to fill out paperwork and when I arrived I checked in and was handed a blank stack of medical history forms to fill out. I began by filling in the easy stuff, name, social security number, birth date, address but when I got to the medical history part I felt like writing “check the records that were faxed to you.” I stumbled my way through the paperwork and turned it in, thinking to myself, if that were a test I would be happy with a C. I sat back down and waited for the nurse to call my name, and when she did, I followed her back as she proceeded to ask me questions about my medical history. The same questions that I had just struggled to answer on paper. And again, I felt like telling her to “look at the paper work I just wasted 20 minutes of my time filling out.”

At this point I was ready to see the doctor, get my prescription and be on my way. The doctor entered and I had a similar experience with her, a lot of repeated questions and answers, but I survived, got my prescription and set up another appointment for the following year. I was pretty proud of myself for scheduling a routine appointment! As painful as this visit was, I was glad that it is only a process that new patients have to endure, so I wouldn’t have to do it again…Right? Wrong, I received a letter in the mail that my doctor is closing shop, leaving me once again with the rigorous task of finding a new doctor and worse yet, becoming a NEW patient again.

Those Are MY Medical Records, Aren’t They…
As I began my search for a new doctor, I was able to seek additional referrals from friends now that I had lived in the area for a couple of years. I picked up the phone and called to make an appointment and the receptionist asked that I have my medical records faxed to them. After making the appointment I called my previous doctor and asked that my medical records be sent to my new doctor. I was told that they could fax the records from my single visit but that they could not fax my older records and that I would have to contact my doctor back in Iowa to have those faxed. Wait, aren’t those my medical records? I’m giving you permission to fax them, why do I have to contact the doctor in Iowa to fax them? The receptionist reiterated that she would be happy to fax my one record but I would need to fill out a release form in order for her to do that. She asked if I had a fax machine….seriously, why do all these doctors insist on the fax machine? I asked if she could email it, but email wasn’t an option. So I am now waiting for snail mail to deliver a release form that I have to fill out and drop back in snail mail in order for my request to be processed.Upon hanging up with her I called my doctor in Iowa and asked to have my medical records faxed to the new doctor. Again I was told that I would have to fill out a release form and that I could get that at my new doctor’s office. So, I now have to fill out 2 different release forms in order to get MY medical records faxed to my new doctor. And I am sure when I go to my new doctor I will have to fill out the same paperwork that I have jumped through so many hoops to get to them prior to my appointment.

I can’t wait for the day when all my medical records are stored in one place and I won’t have to get permission to have MY records sent to a new doctor. A secure and private location that is easily accessible by ALL of my doctors – both current and future!

 

Wearable Technology for All

The definition of wearable technology has changed as much as technology has in the last century. In the first waves of wearable technology we got the calculator watch, you know the one, featured in back to the future. Although we have yet to see a hover board, wearable technology has gone to unbelievable heights. From the iPhone 6, to Google Glass, the bar continues to be set higher.Calculator Watch

After the Google Glass Project (smart glasses), several other companies broke into the smart wearables market, including Apple (iWatch), Samsung (Galaxy Gear), and Sony (SmartWatch) shortly after Google. Now you can buy all types of devices, including watches, glasses, headbands, wigs, rings, etc. Using apps for personal and business computing, practical everyday tasks, fitness tracking, and healthcare monitoring.

I recently, purchased a Nike Fitband, hot pink and black of course. Syncing my iPhone with the app was the easy part, however, I learned that there was minimal features of use to me and this was not something I would keep (for $129). I returned it to the store. After that, my need for quick and convenient health data continued. I fed into the buzz around the Apple Healthkit. iPhone is wearable technology that I already was utilizing. So how could I optimize this device? The first thing I noticed was that it was automatically tracking my steps! “Sweet!” I then realized there was a plethora of data analysis tools that could keep track of my health, medical history, my fitness, and my nutrition. “Sweet, times three!”

Even as a psudo-millenial, as I attempted to use the app, I could not figure out how I could get data to input automatically. After doing some internet research, I was led to a list of Apps that can work/sync with the Healthkit. I was disappointed in the list as I was hoping to use the apps I already use, and are familiar with. They were not on the list. This list of new apps didn’t give me any indication if I needed any additional wearable technology (equals more money) to make them work. Some of them are free, some not, so how was I to choose? If I could find this information in one place, I may be able to quickly decide which apps to download or which piece(s) of wearable technology I would like to gather or start collecting.

All of this wearable technology is overwhelming. And I am only digging into the personal use market these apps are not so difficult to understand, it’s how to use them all together that is confusing. This is not only a common problem with all of our personal devices. There is a large business driven market calling for this problem to be resolved. Technology management is taking off; Hospitals have wearable and wireless technology in use all over a hospital, in many medical devices. The ability to capture and manage all the data and have it at one’s fingertips is one of the fastest going industries.

I love my wearable technology, however, just as with any market has quick progression, it may get messy before it gets better. As my life will only get busier, I am looking forward to learning all the opportunities this technology can give me to streamline my life. I encourage any busy person to look into free applications, they can simplify your day to day life in a great way. Can Siri be close to a personal assistant?! Not yet, but we are close!

3 Components for a Successful Hybrid Environment in Healthcare

It is no secret that healthcare organizations are collecting more information today than ever before. They’re collecting information about their own operations, their patients and the communities they serve. The challenge for healthcare organizations isn’t collecting the information, but analyzing the data and efficiently and securely storing it. Healthcare organizations that can overcome the data challenges and gain faster, fuller data insights will have the tools to positively impact patient care and overall business.3 Keys to a Successful Hybrid Environment in Healthcare

When it comes to data storage, healthcare organizations struggle with finding a balance between “on premise” and the cloud. Many CIOs recognize the need to expand beyond the home port and are quickly moving information to public clouds. However, they aren’t completely abandoning their data centers for fear they won’t have control or access to timely information. The hybrid IT solution helps to solve the data storage problem but it also brings a unique set of concerns in regards to data control, data access and data compliance.

Data Control
Data is much easier to control when it is housed in one central location. With a hybrid IT solution, however, you do not have that luxury. Data stored in multiple locations must be seamlessly connected, able to securely and efficiently move between locations and allow you to maintain full control across all platforms.

Data Access
The key to collaboration and improved patient outcomes is ensuring everyone who needs access to data has it. On the flip side, broad data access needs to be secure and only available to authorized users. With a hybrid IT solution integrated data supports collaboration beyond the walls of the healthcare facility.

Data Compliance
Changing regulations are putting added pressure on healthcare organizations. Keeping up with the evolving regulatory landscape is a challenge in itself and having information stored in multiple locations only adds to this complexity. Developing a strategy to protect data and manage it to ensure it meets regulatory requirements is critical to a hybrid IT solution.

Hybrid IT environments provide the best of both worlds when it comes to data storage and analysis. Leveraging a hybrid environment will lead to timely and accurate analysis of data which will result in the delivery of actionable insights for improved collaboration, better patient outcomes and overall lower cost of care.

Considering implementing a hybrid IT environment or just want to learn more? Join Perficient and UnityPoint Health for a discussion on the benefits of Power BI and Office 365, and how one technology-savvy healthcare provider is leveraging its hybrid environment of Power BI, Excel-enabled dashboards and SharePoint 2013.

Sign up for the November 12th webinar

Read the rest of this post »

In Healthcare, Connectivity Is Not Collaborating

Interoperability between different electronic health record (EHR) systems is one of the most important requirements that hospitals and physicians must meet as they prepare their systems for attestation in Meaningful Use Stage 2.

However, let’s examine the real goals of interoperability within healthcare: In Healthcare Connectivity is not Collaborating

1) To make sure “information follows the patient regardless of geographic, organizational, or vendor boundaries”

2) To have at least one or more instances in which providers exchange an electronic summary of care with all the clinical data elements between different EHRs. Establishing this connectivity does not insure the real goal of collaborating across the continuum of care for the patient’s benefit.

The debate still rages on the role of the patient in this interoperability process as well. We have all, as patients, had our medical files spread across a family doctor, multiple hospitals, specialists, health plans and today, even multiple pharmacies. The prospect of creating a complete picture is staggering, let alone having all of those healthcare providers really collaborate on our behalf. Is it the patient’s responsibility in this ever-changing healthcare electronic revolution to compile this electronic mess into a coordinated whole or will the industry magically create it as a result of Meaningful Use Stage 2?

It is worth arguing that interoperability in Meaningful Use Stage 2 only creates a baseline of connectivity between two or more systems to exchange information and puts in place the ability of those systems to use the information that has been exchanged. It does not create collaboration on behalf of patients within the healthcare provider community, especially between competing players like local hospital systems or healthcare providers versus payers. Having the ability to connect only trades fax machines for electronic transactions, if tools aren’t employed for physicians for example to collaborate over a single patient.

In advocating for collaboration, let’s examine the reality of an exchange of a set of electronic transactions about a patient versus where the process would need to be for genuine care coordination. Today, a fax from the hospital to the family physician is the notification that the patient was hospitalized and needs follow-up in coming weeks. Based on the type of hospitalization, a call between the attending physician and family physician may be warranted, and a potential referral to a subsequent specialist may be in order. Simply communicating electronic documents doesn’t address the interaction between key people in the decision-making process and the assumption that the inclusion of unstructured physician notes will suffice may be optimistic.

This means that health information exchange is different than health information interoperability. Exchange is necessary for interoperability, but it is not sufficient by itself to achieve health information interoperability, especially to streamline real collaboration on behalf of patients. It is time to examine an expanded view of both interoperability and health information exchange to promote ease of collaboration between the parties involved, including secure physician to physician communications – electronic or instant message, for example, and secure physician to patient communications. As an individual patient having to deal with multiple patient portals today for communicating with my healthcare providers, there is a real concern to address this issue sooner rather than clean up confusion later.

Can we define collaboration in a way that traverses healthcare’s landscape of emerging connectivity?

The Problem with Health IT is in the Definition

There has been a lot of debate around the challenges within the healthcare industry. Much of the discussion stems from the fee-for-service model and the focus on services and reimbursement rather than the patient. Health information technology has its own set of challenges when it comes to addressing healthcare issues. The Problem with Health IT is in the Definition

If we truly want to put the patient at the center of their own healthcare experience than we need to take a step back and look at the relationship of the patient and the entire healthcare ecosystem. Healthcare should focus less on the products and services and more on the patient and provider relationship. Furthermore, health IT should support these relationships, however, by its own definition it doesn’t.

By definition,  Health information technology (IT) encompasses a wide range of products and services—including software, hardware and infrastructure—designed to collect, store and exchange patient data throughout the clinical practice of medicine.

The definition does not mention the patient and provider relationship and the emphasis is on products and services, software and hardware and does not reflect on the benefits of patient data exchange.

A better health IT definition: An automated approach that facilitates the relationship between the patient and the healthcare system through the accurate and secure electronic exchange of data, ensuring the right data is available at the right time for everyone that is engaged in the patient’s care.

This definition includes 3 critical components:

  • The importance of the patient relationship with the healthcare system
  • The importance of accurate and secure electronic data exchange
  • The benefits of data exchange in regards to patient care

A new definition will not solve the challenges of the healthcare industry, but it is a good place to start. It may be enough of a push to ensure technology developers are developing meaningful applications that improve patient outcomes, which should be the ultimate goal of health IT.

ACA and QRS – Shoot for the Stars Part 3

In ACA and QRS – Shoot for the Stars Part 1, I laid out the overall domains that are going to be used to score QHP plans offered through the Marketplace. In Part 2, I discussed some factors to consider for the data derived measures. In this blog, we will take a closer look at the survey derived measures and what factors a QHP issuer should consider to achieve high scores.

surveyAgain, for reference all 43 of the required measures can be found on the CMS website (click here).

Now let’s take a look at some factors to keep in mind when dealing with the Enrollee Satisfaction Survey (ESS) derived measures:

Leverage CAHPS Processes
As mentioned in Part 2, it was required to get Health Plans Accredited to offer on-market. In addition, CMS aligned required QRS ESS measures with current CAHPS measures that are typically required during accreditation. And just as an organization should leverage HEDIS for data, make sure to leverage current investments in CAHPS to keep initial costs low while jump starting ESS efforts.
Read the rest of this post »