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Archive for the ‘Interoperability’ Category

Includes 4010/5010, Step Up/Step Down, 4010/5010 Remediation, HL7

Infographic: Value-Based Care Transformation

Value-based care and payment reform are prompting hospitals and healthcare providers to more closely manage population health. Hospitals and health systems rely on technology and data to outline the characteristics of their population and identify high-risk patients in order to manage chronic diseases and deliver enhanced preventative care.

While managing data may seem like a simple task, for most health systems it is the exact opposite. Multiple disparate data systems need to be unified to provide a complete patient view and data must be transformed so that it is useful, operationally relevant, insightful and secure. One of the keys to value-based care transformation is being able to generate actionable insights to improve patient care and lower the overall costs of healthcare.

Read the rest of this post »

15 Health IT Standards and Interoperability Rockstars to Know

Health IT standards and health information interoperability are at the forefront of the healthcare industry.  There are many challenges, unanswered questions and interested parties when it comes to the development of health IT standards and interoperability in healthcare. While advocates and leaders of standards and interoperability have their own opinions on the topic, I think we can all agree there is a need for standards and true interoperability is necessary to transcend healthcare. It is nice to see this topic front and center even if everyone isn’t on the same page.

There are many people contributing to the evolution of  health IT standards and healthcare interoperability efforts – above are 15 Health IT Standards and Interoperability Rockstars You Should Know. Some are more active than others on Twitter – follow all 15 of these leaders here.


Included in the list are:


  • Karen DeSalvo, MD National Coordinator for Health Information Technology (ONC); Acting Assistant Secretary for Health Twitter ID: @KBDesalvo
  • Doug Fridsma, MD President and CEO of the American Medical Informatics Association Twitter ID: @Fridsma
  • Keith Boone Standards Geek, GE Healthcare Twitter ID: @Motorcycle_Guy
  • Brian Ahier Director of Standards and Government Affairs at Medicity Twitter ID: @ahier
  • Rasu Shrestha, MD Chief Innovation Officer at UMPC and President, UPMC Technology Development Center Twitter ID: @RasuShrestha
  • Erica Galvez Interoperability Portfolio Manager at Office of the National Coordinator for Health IT Twitter ID: @EricaGalvez
  • Grahame Grieve Principal at Health Intersections Pty Ltd, Melbourne area, Australia Twitter ID: @GrahameGrieve
  • Steven Posnack Director of Federal Policy Division, ONC Twitter ID: @HealthIT_Policy
  • John Halamka CIO of BIDMC, Harvard Medical School Twitter ID: @jhalamka
  • Josh Mandel Lead Architect for the SMART project, Harvard Medical School Twitter ID: @JoshCMandel
  • Charles, Jaffe, MD, PhD Chief Executive Officer, HL7 Twitter ID: @cjaffemd
  • Stanley Huff, MD Chief Medical Informatics Officer at Intermountain Healthcare Twitter ID: @StanHuff52
  • Joyce Sensmeier, RN HIMSS VP of Informatics, President of IHE USA, co-founder and ex- officio chair of the Alliance for Nursing Informatics Twitter ID: @JoyceSensmeier
  • David McCallie, Jr., MD Senior Vice President, Medical Informatics, Cerner Corporation Twitter ID: @dmccallie
  • Gilad Kuperman, MD Director of Interoperability Informatics at New York- Presbyterian Hospital Twitter ID: @GilKuperman


Follow me @KateDTuttle

Don’t Forget About Consumer Experience Amidst The Chaos of M&A


Don't Forget About Patient Experience Amidst the Chaos of M&A

The healthcare industry continues down the path of transformation with the goal to provide higher quality, lower cost care for individuals and overall populations. To meet these new objectives, healthcare providers are entering into newly formed partnerships and entities, which bring regional healthcare providers together with health plans to address population health, integrated care delivery models, and health information exchanges that span outside traditional geographic or organizational boundaries. Merger activity has rapidly increased and is expected to continue for the foreseeable future. A KPMG study suggesting M&A activity will increase seven percent this year. Horizontal and vertical merger activity across health systems, hospitals and other healthcare settings is forecast to continue as larger networks seek to expand their footprint, consolidate services, and ultimately drive toward the financial benefits of increased purchasing power while reducing overall costs. Read the rest of this post »

Talking SMAC: 4 Actions Healthcare CIOs Need to Take

Talking SMAC: 4 Actions Healthcare CIOs Need to Take

The healthcare industry tends to lag behind other industries when it comes to many things, especially the adoption and implementation of new technologies. There are several factors that contribute to this hesitancy, like the need to adhere to strict privacy and security regulations, new initiatives brought on by healthcare reform and consolidation within the industry. As technology continues to evolve, healthcare CIOs need to be able to identify and invest in technologies that will support key industry needs. CIOs should be looking for ways to leverage social, mobile, analytics and cloud (SMAC) solutions as they go through their software selection processes.

Here are 4 of the key actions necessary to leverage the power of SMAC:

Prepare for a hybrid IT environment
Healthcare organizations are facing several industry challenges and are feeling the pressure to transform their organizations in order to adapt to the evolving industry. The pressure to reduce costs, develop population health management capabilities and a shift to value-based reimbursement and payment models are requiring healthcare organizations to look beyond traditional solutions. In many cases CIOs are turning to a hybrid IT environment and leveraging external service providers within their solution architectures. A hybrid IT ecosystem means less and less in house, and puts added pressure on IT leadership because they are still responsible for governance, security and service of the IT systems.

Get in front of interoperability
Interoperability has become front-and-center in healthcare, integration of systems and data from multiple sources is critical to meeting the demands of the transforming healthcare industry. Interoperability is essential to leveraging social, mobile, analytics and cloud (SMAC) capabilities. Healthcare CIOs need to establish a strong interoperability foundation in order to take advantage of SMAC. Robust integration and health information exchange (HIE) are required to meet the demands of the transforming healthcare industry and integration of SMAC must be part of the interoperability roadmap.

Leverage social media to engage consumers and patients and promote your patient portal
When it comes to patient portals, many healthcare CIOs are focused on meeting the requirements of Meaningful Use, rather than creating an engaging portal. Healthcare organizations need to look beyond Meaningful Use and create a patient portal that engages and empowers their patients. CIOs need to include market-driven patient portal features like: dynamic scheduling, gamification and telehealth to meet the demands of the market. Learn more about the 7 Features of a Market-Driven Patient Portal here.

Simplify your architecture
We have all heard many times that less is more and this is good advice to follow when it comes to healthcare IT. Oftentimes, healthcare organizations have the opportunity to make room for innovation by retiring their legacy systems and applications. CIOs need to prioritize their legacy systems based on several factors including but not limited to: costs of maintenance and support, complexity and compliance. Industry consolidation has added to the complexity and increased the number of systems within healthcare organizations. Simplifying the architecture can be challenging but the improved patient care, efficiencies gained and overall results make it well worth it.

The transforming healthcare industry is putting additional strain on healthcare executives to provide high-quality care at an affordable cost. Utilizing technology to improve operational performance and enhance patient care is critical to the success of healthcare organizations. Digital transformation in healthcare is happening as we speak. Healthcare consumers are demanding transparency and convenience  – what better way to connect and empower consumers than through the use of SMAC (social, mobile, analytics, cloud).

Tackling ACO Data Challenges

How do we engage patients, coordinate care, improve quality, lower costs and share savings all at Tackling ACO Data Challengesonce? A group of Accountable Care Organizations (ACOs) will be in Baltimore this week discussing this and other topics on establishing and sustaining ACOs.

One of the challenges of forming and sustaining ACOs is establishing shared goals and shared knowledge. I was involved in the airline industry earlier in my career and was part of the team who automated the On-time Departure and other performance metric bonuses at then Continental Airlines. Prior to this, I had dabbled in Change Management and Quality Assurance topics but this was my first real experience with “what you measure is what you improve” or “pay for performance”.

The ACO challenge is similar to the challenges of Performance Management within the diverse units of a hospital but it is complicated by the many different types of organizations (and communication languages) that may be partnering. I’m really looking forward to learning more about ACOs and how we can apply clinical analytics to costing solutions to measure and report shared savings.

Stay tuned for updates!

Follow me on twitter @teriemc

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.


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

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



2015 Healthcare ACO Trends and The Key to Success [Infographic]

Accountable Care Organizations (ACOs) as a model to deliver high-quality, cost-effective care across the continuum and improve population health management (PHM) has significantly increased. In an ACO, healthcare providers take responsibility for the health of a defined population, coordinate care across the continuum, and are held to benchmark levels of quality and cost. In 2015 ACOs will continue to be on the rise! 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?

Hospital Price Transparency – Step 1: Understand True Cost

Is there a correlation between price transparency and cost? I read an article in the HFMA Strategic Financial Planning Newsletter recently about this and I can relate my personal experiences to it wholeheartedly. My observations are that hospitals segregate these two activities but I believe they are explicitly linked. I know there are many factors that influence Hospital Price Transparancyprice setting, not the least of which is the federal government (Medicare/Medicaid), but I suspect the reason that hospitals don’t more closely link pricing to margins is that they lack visibility into their own data.

When I first started working in healthcare in the late 90’s, my only prior exposure to revenue cycle automation came from the airline industry where pricing is tightly linked to both demand and yield.   I was part of the team that helped Continental Airlines transition into the era of de-regulation. It didn’t take industry leaders very long to identify the metrics that truly informed pricing once the government was taken out of the equation. This taught me very valuable lessons about analytics and instilled in me a drive to use data to improve operations.

To understand and achieve sufficient transparency and maintain a proactive approach to maintaining margins, hospitals must be capable of correlating costs for supplies and drugs, etc. with the cost of providers and overhead costs. Then they must compare this with the payments from payers, individuals and other purchasers. While we certainly can’t take the federal government out of the equation for hospitals, recent expectations have been set for quality performance that may help the affected organizations begin to take a more margin focused view of pricing. Bringing together the necessary data is not simple and definitely should be approached iteratively using a configurable set of analytic tools that can provide the right data to the right individuals in the organization who manage operations and continue or create new services. Read the rest of this post »

Patient Information Really Doesn’t Matter

We live in a world of information, everywhere we turn someone is collecting information about us. The technology advancements over the last 10 years are mind-boggling, but new technology is usually escorted by apprehension as our privacy continues to diminish and security is anything but secure. From cookies on Patient Information Really Doesn't Matterthe internet to a basket analysis at the supermarket, “big brother” is always watching.

The healthcare industry is no different. Healthcare organizations are surrounded by data: clinical, operational and financial; internal and external; structured and unstructured. There is so much information that healthcare providers don’t know what to do with it. The problem with healthcare is not a lack of information. The problem is healthcare organizations often have disparate systems that lack continuity. The absence of interoperability within IT infrastructures ultimately means that the right information is not available to the right people at the right time. Healthcare organizations can have all the information in the world, but if the information is not cohesive and can’t be used efficiently to improve clinical outcomes than information really doesn’t matter.

In order for healthcare organizations to improve outcomes, communication between systems is paramount. Despite industry standards such as EDI/X12, HL7 and CDA, information delivery is not effective. Most healthcare organizations understand the importance of untangling the interoperability web, but those same organizations don’t know where to begin.

Government regulations such as Meaningful Use Stage 2 (MU2) are putting additional pressure on healthcare organizations to improve the quality of care, coordination of care and population health management. A strong interoperability backbone that provides system connectivity is the key to attaining MU2. Interoperability transforms information into key insights that drive better clinical outcomes and improve the lives of individuals and communities.

Do you understand the importance of interoperability but not sure where to start? Perficient will be teaming up with technology partners IBM and Oracle to bring you 2 complimentary webinars:

Tackle Healthcare Interoperability Challenges and Improve Transitions of Care
Thursday, September 25th @ 12 CT
Learn More and Register

Engage Patients, Reduce Manual Processes and Drive Key Insights with Interoperability
Tuesday, October 2nd @ 2 CT
Learn More and Register