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GE Healthcare Camden Group Insights Blog

New Download: Building the Information Management and Data Governance Strategy for Value-Based Care

Posted by Matthew Smith on Aug 6, 2015 10:37:35 AM

This new download from GE Healthcare Camden Group focuses on how successful organizations:

  • Identify current information technology solution needs and challenges
  • Categorize existing issues in capturing and aggregating data as well as translating this information into clinical workflows
  • Create the blueprint for an information management and data governance strategy
  • Document and prioritize steps related to the "future state" information technology solutions framework and management strategies needed to support current and future business needs.

To download the PDF document, please click the button below to access the download page.

Data Governance, Value-Based Care, Population Health

Topics: Value-Based Care, Population Health, HIT, HealthIT, Data Governance

Building the Data Governance Strategy for Effective Population Health Alliances

Posted by Matthew Smith on Aug 5, 2015 12:42:52 PM

By Tara Tesch, MHSA, Senior Manager, GE Healthcare Camden Group

This is the third of three articles in the Population Health Alliances series. The first article examined physician engagement strategies and detailed specific strategies that have proven successful for alliances. The second article focused on the value of true care redesign.

High-performing organizations possess robust information technology ("IT") infrastructure and associated tools to deliver, track, and document patient-centered, evidence-based care at the point of service and can disseminate actionable and meaningful data quickly and transparently. IT infrastructure implementation is an iterative process and rarely do organizations have a “fully baked” IT solution at the onset of implementation.

There is no single vendor that can provide a comprehensive data analytics solution to meet all needs (see graphic below) at this time.


 Future State CI Network Platform

Population Health, Data Governance

© The Camden Group 2015


In order to truly impact how care is delivered, end users must have actionable information in real time to support care redesign efforts. Providing patient-relevant decision support at the point of care can improve provider effectiveness in delivering appropriate and necessary interventions, furthering the organization’s goals of improving individual and population health. Too many organizations stall in developing their IT infrastructure by letting “great get in the way of good.” IT should support the care not drive it, therefore, systems and tools must translate and support care redesign. Too much data that is not well organized or analyzed can simply create confusion and cloud the necessary focus required to impact population health.

It is critical for population health alliances to have a well thought-out IT strategy and data management plan that will provide connectivity between members. The strategy should call for a means to collect the data, offer a robust tool to aggregate the data, and support reporting that will translate information into behavioral change and allow providers to more effectively communicate with and engage patients. The key factor for success: build your strategy beginning with the end in mind.


 Data Governance Strategy Build

© The Camden Group 2015


Success begins with the development of an information management and data governance strategy, which includes a data governance structure (who is going to own it, clean it, analyze it), organizational structure (what resources and types are required), and core data needs (reportable, transactional). An objective of the strategy is to take data and create meaningful information that leads to action-oriented knowledge. Out of the strategy, capabilities will be identified that drive interoperability and analytics requirements. These requirements should provide the criteria for selecting health information technology (“HIT”) that support the business and clinical needs of the alliance. Avoid buying the tool then trying to create a strategy around it; this will inevitably fail.

Defining Objectives

Designing the data strategy requires a sophisticated understanding of the alliance’s business and clinical objectives, clinical guidelines and care processes, and requirements of analytics to support these activities. First, define the end goal (outputs) such as care management or value-based contracting, and identify the data sources that will be used (i.e., EHR, claims, ADT, etc.). Next, determine how the data will be used to support the outputs; will it be reportable and retrospective (e.g., risk stratification, predictive modeling, scorecards) or transactional and action-oriented (e.g., point of care, gap closure, alerts, real time analysis to support decision-making).

To be successful, this planning process must include clinical/operational leadership (e.g., chief medical informatics officer, care management leads), in addition to finance and the member organization chief information officers. Staffing should include a data architect and a clinical informaticist able to translate the data into clinically meaningful information.

Once the strategy has been defined, identify the data requirements and associated capabilities. This may include standard processes and reporting templates – tools to automate the current state and optimize care delivery. Next, select a vendor that either has the ability to grow with your organization as it evolves or decide to pursue a “plug and play” vendor approach. Either way, the vendor must support the alliance’s CIN data requirements and capabilities.

In the end, it is critical to maintain strong, positive relationships with clinicians during the design and development of these key technology capabilities. Clinicians drive the clinical care of patients and care models to support the delivery of clinical protocols. Organizational and individual needs will evolve based upon initial successes and challenges, and clinicians will bring forth a multitude of suggested and needed changes after the initial “go live.” Technology is the tool to support the clinical requirements, and developing ongoing processes to solicit clinician feedback for continued improvement is an important contributor to long-term success.

Data Governance, Value-Based Care, Population Health


Ms. Tesch is a senior manager with GE Healthcare Camden Group in the clinical integration practice with more than 18 years of experience as a healthcare leader and strategist. Ms. Tesch specializes in value-based care delivery strategic planning, CIN development and implementation for commercial, Medicare, and Medicaid populations, health information technology data governance and analytics strategy, as well as care management strategy, design, and implementation. She has worked with a variety of healthcare providers, including integrated delivery networks, academic health centers, regional referral centers, rural community providers, and national non-profit and faith-based health systems. She may be reached at [email protected]

Topics: Population Health, HIT, HealthIT, Data Analytics, Population Health Alliance, Tara Tesch, Data Governance

10 Key Indicators of Clinical Integration Success

Posted by Matthew Smith on Jun 23, 2015 10:14:10 AM

As healthcare organizations are looking for strategic initiatives to transport them into the future, clinical integration is often the plan. Clinical integration is the answer for provider practices and/or systems that are ready to move into the “new normal.” However, clinical integration requires more than organizational realignment and a commitment to the Triple Aim. Developing an effective clinically integrated network demands commitment and investment in a complete clinical care model redesign focused on team-based, patient-centric care along with the necessary infrastructure to enable this change. Clinical integration requires several key components for success. When is an organization ready to take this next step toward clinical integration? Below are ten key indicators that an organization’s efforts are poised for success.

1.  Primary Care Geographic Coverage of the Target Market

When considering a clinically integrated network, the expansiveness of the primary care network is a critical component. In a clinical integration model, primary care is a pivotal access point to the system, and the primary care physician works alongside the patient to drive the care plan. Geographic coverage not only refers to an adequate number of primary care physicians, but also to the presence of extended hours sites, urgent care clinics, or telephonic triage services.  All of these access sites can assist in directing patients, who may otherwise access the emergency room inappropriately or not access care at all, to the right care at the right place at the right time. 

2.  Affiliation or Ownership of Services Along the Continuum

A fully integrated care model with services across the continuum is a central tenet for success. Gaps in coverage along the continuum can lead to insufficient knowledge transfer among physicians, poor hand-offs, and a high risk for complications during transitions in care. The delivery network must include ambulatory, acute care, and post-acute services through ownership or affiliation. Additionally, the network should be linked with community agencies that can provide psychosocial supports, preventive care, and education, as well as integrating these services into the care planning when necessary.

3.  Scalable Care Models and Information Technology (“IT”) Systems

A clinically integrated network must maintain an infrastructure that can adapt as the network grows. Patient workflows, care models, and staffing models must be developed such that they are scalable as the network continues to grow. Similarly, the IT systems in place to enable these work flows should be able to mirror the growth of the delivery network. Interoperability, cost, and ease of implementation should all be considered. The IT should support the needed care models across the continuum.

4.  Established Quality Improvement and Process Improvement

Clinical outcomes, patient satisfaction, and patient safety are critical to the success of the clinically integrated network. Value-based payment models utilize process and outcomes-based metrics to determine reimbursement. To continuously improve in these areas, a clinically integrated network relies on ongoing quality improvement initiatives with an established framework for process improvement. 

5.  Population-Based Reporting On Clinical Quality and Financial Outcomes

In order to educate members of the network on their performance, the network should have the capability to conduct analytics and reporting for both patient and population management. Clinical integration relies on clinical model transformation; clinical transformation can only occur with enough data to produce information that will drive this change. Physicians need information on their clinical outcomes, adherence to protocols, and value-based metrics. Transparency in these reports (including the financial results) is critical to physician behavior change. 

6.  Providers and Facilities Across the Continuum With Aligned Incentives and the Same Strategic Goal

In the past, physician and hospital incentives have not always aligned. Clinical integration requires a re-wiring of these incentives. Trust must exist between providers and facilities. In a clinically integrated network, all providers are working towards the same organizational goals. Providers must work together towards the Triple Aim and develop mutual respect – and rewards – for everyone’s involvement and input in this effort. 

7.  Established Evidence-Based Guidelines

Evidence-based guidelines are key to reducing variability among physician practice patterns. Established guidelines and protocols ensure that providers are following standards that result in the high-quality care – consistently across the network. Additionally, these guidelines eliminate unnecessary utilization of healthcare services. Evidence-based guidelines should be embedded in the technology tools that physicians utilize. Physicians must lead the charge in developing, utilizing, and monitoring adherence for the use of guidelines and protocols. Reports of non-adherence should be made available to the clinically integrated network’s leadership, and processes for remedial action need to be established for providers who routinely vary from the established protocols. 

8.  Regular Education for Providers and Staff

The healthcare environment is changing at a rapid pace. Clinically integrated networks must continually educate their physicians and staff on these changes. Rigorous training programs focused on standards of practice should occur regularly. Changes in reimbursement, care models, coding requirements, IT systems and capabilities, and organization-wide goals should be regularly distributed with timely education sessions. Care management staffs need significant training to ensure they are providing adequate support to providers and are working to the top of their license.

9.  Interdisciplinary Care Teams

To continuously improve quality and patient satisfaction, clinically integrated networks require interdisciplinary teams to provide care to their highest risk patients. The use of an interdisciplinary team could include the involvement of primary care physicians, specialists, care managers, social workers, pharmacists, dieticians, or any other ancillary provider. The team works together towards a single care plan for the patient. 

10.  Aligned Vision that Focuses On the “We” Not the “Me” 

Clinical integration requires significant cultural change. It is a mindset based on accountable care, where the entire care team is responsible for providing high-quality care. The vision for clinical integration must be ingrained in all physicians and staff as they work to achieve a common goal. No longer can physicians be worried only about their individual performance but rather the care of their patients across the continuum. The clinically integrated network needs to concern itself with its population of patients and how appropriate interventions and utilization of care can improve the health of the population. 

Topics: Clinical Integration, Population Health, HealthIT, Care Continuum

Infographic: Physician Adoption of Health IT

Posted by Matthew Smith on Sep 25, 2014 11:06:00 AM

Infographic, Health DirectionsThe Deloitte Survey of U.S. Physicians provides data-driven insights on physicians’ perceptions of the health care system and their thoughts on health care reform. Research conclusions include their perspectives and attitudes about health care reform, the future of the medical profession, and HIT. As they have done in past years, the Deloitte Center for Health Solutions conducted a survey and compiled the findings in an infographic, below.

The survey polled a nationally representative sample of up to approximately 600 U.S. primary care and specialist physicians to understand their perspectives and attitudes about health care reform, the future of the medical profession, and HIT.

Most U.S. physicians are concerned that the future of the medical profession may be in jeopardy and consider many changes in the market to be a threat. They believe that the performance of the U.S. health care system is suboptimal, but the Affordable Care Act is a good start to addressing issues of access and cost.

Key takeaways:

  • Nine out of 10 physicians are interested in mobile health technology; those who are not tend to be older and have long-established solo practices.
  • Users of the technology outnumber non-users in favoring its benefits for accessing clinical information, researching diseases and treatments, and pursuing continuing education.
  • Three out of four physicians say EHRs increase costs and do not save time.
 
To view a larger version of the HealthIT infographic, click here

Infographic, EHR, EMR, HealthIT, HIT, Health IT

Topics: EHR, EMR, HIT, Health IT, HealthIT, Infographic, Mobile Health, mHealth

HIMSS: Revenue Cycle, Financial Modeling Draw Hospital Interest

Posted by Matthew Smith on May 7, 2014 2:19:00 PM

Revenue Cycle, KPI, Health Directions

Revenue cycle and financial modeling applications are positioned for accelerated growth among hospitals, according to data from the HIMSS Analytics Essentials of the U.S. Hospital IT Market, Spring 2014 Edition. The Spring 2014 report evaluates the health IT applications most used by hospitals across the United States.

Using data from the HIMSS Analytics® Database, the report profiled 26 operational applications being used in hospitals across the U.S. and conducted a matrix analysis of their market penetration (saturated, mature to maturing) against their projected sale volumes (decelerating, marginal to accelerating). Bed management, ERP and financial modeling technologies were observed as notable opportunities for health IT vendors, having both a maturing market penetration status and an accelerated projected sales volume.

“The first-time sales outlook for these three operational applications is grounded in the industry’s ongoing efforts to create a cost-efficient and clinically effective environment,” said Lorren Pettit, Vice President of Market Research for HIMSS Analytics. “The fact that the three applications represent varied aspects of a hospital’s operations suggests providers are looking for efficiencies in a multiplicity of ways.”

Following closely behind the three applications slated for the highest growth opportunities, the report found that the sales outlook is also positive for two additional applications in the financial decision support category: contract management and financial data warehousing/mining. Medical necessity checking content applications, which belong to the revenue cycle management category, also fall within the same ranking – mature in terms of market penetration with an accelerating projected sales growth. The relatively low market penetration for all of these applications suggests that opportunities for vendors in this area are very positive.

The 26 applications observed, most of which can be characterized as standard business tools, are divided into the following six categories:

  • Business Intelligence
  • Financial Decision Support
  • General Financials
  • Human Resources
  • Revenue Cycle Management
  • Supply Chain Management

The report also covered the popularity of each application in the marketplace at more than 5,000 U.S. hospitals tracked by HIMSS Analytics. The popularity assessment for each application is determined by its frequency of installation.

Revenue Cycle, Key Performance Indicators, KPIs,

Topics: HIT, HealthIT, HIMSS, Financial Modeling, Revenue Cycle

NCQA: Health IT Can Be Tapped To Support Patient Engagement

Posted by Matthew Smith on Apr 28, 2014 3:58:00 PM

NCQA, National Committee for Quality Assurance

Successful integration of patient engagement tools into health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system," according to a new report from the National Committee for Quality Assurance (NCQA), EHR Intelligence reports. 

However, the report noted that there is not yet a complete framework for boosting patient engagement through health IT systems.

Details of Report

In a survey, the report authors identified six common themes of "opportunities and challenges" related to patient engagement through health IT:

  • Patient engagement is an untapped opportunity with major potential, especially among marginalized groups;
  • Health IT should adopt a user-based model that originates from the needs and preferences of patients;
  • There is a dearth of evidence on the effectiveness of such tools;
  • Patient-engagement tools should be integrated into overall health care IT systems;
  • Patient and consumer trust needs to be fostered; and
  • Leadership and collaboration among stakeholders are necessary to realize the full potential.

The report also detailed four activities that will help the industry identify and develop a cohesive strategy for patient engagement through health IT, including:

  • Developing joint principles that will facilitate the design, creation and adoption of health IT tools that boost patient care, improve overall population health and lower health care costs;
  • Creating and implementing an evaluation framework that focuses on investment and prioritizes consumer choice;
  • Facilitating the creation of a unified health data integration strategy focused on patient engagement; and
  • Demonstrating innovative ways to use IT tools for patient engagement.

Comments

In the report, the authors wrote that "[h]ealth IT tools for patient engagement are often disconnected from the health care system and in need of full integration across all opportunities for engagement." However, the report added that successful integration of patient engagement in health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system."

NCQA President Margaret O'Kane said the "core idea" of the report is that health IT "should be designed around the needs and preferences of patients." She added that "the question of how to link [health IT] and patient engagement is an area where a unified strategy is most needed" (Murphy,EHR Intelligence, 4/23).

Patient Engagement, Patient Service

Topics: HIT, Health IT, HealthIT, Patient Engagement, Health Information Technology

HealthIT Infographic: Inside the Mind of the Healthcare CEO

Posted by Matthew Smith on Apr 25, 2014 9:47:00 AM

Infographic, Health DirectionsTechnological Progression in Healthcare today is a desire, but not always an outcome according to the 17th Annual Global CEO survey from PWC of 81 healthcare CEOs. 

The vast majority (86%) of healthcare CEOs believe technology will fundamentally transform their business within the next five years. However, a large majority also feel unprepared for the coming change, according to a 

CEOs have plans to adapt to the changes: 89% plan to improve their organization's ability to innovate, 93% plan to change their organization's technology investments and 95% are investigating new ways to use big data.

However, few of these plans have been realized. Just 25% have started or completed changes to make their organizations more innovative, 33% have altered their technology investments, and 36% have made progress in dealing with big data.

This has caused 57% of respondents to confess to feeling worried about the speed of technological change within the industry. Almost half (41%) feel their IT departments are unprepared, 31% believe their research and development arms to be unprepared and 63% are concerned they will be unable to find additional staffers with the right skills to help them best capitalize on technology-based opportunities.

Infographic, HealthIT, HIT

 This infographic was created by ICE Technologies, Inc., a health care IT service firm, focused on optimizing IT operational effectiveness for community hospitals. 

Topics: HIT, HealthIT, CEO, Data

Let's Kick Off HIMSS Week With a Health IT Social Media Infographic

Posted by Matthew Smith on Feb 24, 2014 9:26:00 AM

HIMSS, HIMSS2014, HealthIT, HITHIMSS14 (the annual meeting for the Healthcare Information and Management Systems Society) is upon us. For those of us who rely on social media for breaking HIT news from the conference, there will be no shortage of information coming from the conference.

According to this infographic by Lauren C. Still, the HIMSS Twitter conversation has grown 540% (6 fold) since 2010. She also provides a valuable set of hashtags that can be used throughout the week to tag specific Tweets.

HIMSS, HIMSS14, HealthIT, HIT, mhealth

Topics: HIT, HealthIT, HIMSS, HIMSS14

Infographic: Realizing the Value of Health IT

Posted by Matthew Smith on Aug 1, 2013 11:56:00 AM

Health IT, HIT, H.I.T.

The value of health information technology is demonstrated in many ways.  Many organization are seeing the positive influence HIT can bring to their health system.

For instance, El Camino Hospital dropped readmission rates by 25% by combining the use of data analytics and telecommunications.  

The infographic created by HIMSS highlights the five kinds of values health IT creates for patients, healthcare providers and communities:

  1. Satisfaction
  2. Treatment/Clinical
  3. Electronic Information/Data
  4. Prevention/Patient Education
  5. Savings

Topics: EHR, EMR, Meaningful Use, CMS, HIT, HealthIT, ONC, HITECH, Eligible Providers

ONC to Congress: EHR Adoption, Meaningful Use Rising Steadily

Posted by Matthew Smith on Jun 28, 2013 3:52:00 PM

United States, Meaningful Use, EHRIn its latest official report to Congress, the Office of the National Coordinator (ONC) praises the nation’s progress in health IT adoption, including EHR implementation and participation in the EHR Incentive Programs.  Physician EHR adoption has increased from one in five in 2009 to more than 40% in 2012, due largely to meaningful use requirements and the availability of better technology.

“Information is widely recognized as the lifeblood of modern medicine,” the report says.  “By enabling health information to be used more effectively and efficiently throughout our health system, health IT has the potential to empower providers and patients, make health care and the health system more transparent, enhance the study of care delivery and payment systems, and drive substantial improvements in care, efficiency, and population health.”

As a result of the federal focus on speeding health IT adoption, nearly three-quarters of office-based physicians had started using some form of EHR system by 2012, up from 42% in 2009.  Forty percent used a “basic” EHR, which has advanced capabilities like patient history and demographics, problem and medication lists, and computerized order entry.  That figure is nearly double the 21% of physicians using a basic EHR in 2009.

Despite this measurable progress, the ONC notes that many barriers remain in the quest for universal EHR use.  “Expanding interoperability remains a challenge,” the report admits. “Enabling exchange will involve reducing the cost and complexity of electronichealth information exchange, ensuring trust among the key participants of exchange and encouraging exchange of information, particularly during transitions of care.”  The ONC has been working tirelessly to promote interoperability to vendors and providers, including releasing a request for information to the industry to gather new ideas for boosting health information exchange (HIE) and widely-adopted data standards.

In addition to addressing the technical challenges of HIE, the ONC and CMS have been making a concerted effort to illustrate the business case for data exchange, including the potential to reduce healthcare costs by eliminating repeated tests and procedures, reduce the administrative burden on providers, and foster more coordinated, accountable care.

“As both public and private payers take concrete steps to change the incentives for paying providers, health IT can provide the infrastructure and the data analytics necessary to improved care coordination, better quality, and lower costs,” the report concludes.  “Continued adoption of EHRs and health IT can enable the transformation of health care delivery in order to reduce health care costs and improve the well-being of Americans.”

In its latest official report to Congress, the Office of the National Coordinator (ONC) praises the nation’s progress in health IT adoption, including EHR implementation and participation in the EHR Incentive Programs.  Physician EHR adoption has increased from one in five in 2009 to more than 40% in 2012, due largely to meaningful use requirements and the availability of better technology.

“Information is widely recognized as the lifeblood of modern medicine,” the report says.  “By enabling health information to be used more effectively and efficiently throughout our health system, health IT has the potential to empower providers and patients, make health care and the health system more transparent, enhance the study of care delivery and payment systems, and drive substantial improvements in care, efficiency, and population health.”

As a result of the federal focus on speeding health IT adoption, nearly three-quarters of office-based physicians had started using some form of EHR system by 2012, up from 42% in 2009.  Forty percent used a “basic” EHR, which has advanced capabilities like patient history and demographics, problem and medication lists, and computerized order entry.  That figure is nearly double the 21% of physicians using a basic EHR in 2009.

Topics: EHR, Meaningful Use, Health IT, HealthIT, ONC, Congress, IT

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