Monthly Archives: April 2015

HIMSS15 Day 3 Recap


Post by Azam Husain


Senior Product Manager, Caradigm

After three jam packed days of activity inside and outside our booth, HIMSS15 came to a close. Our final panel presentation of the week focused on the important topic of healthcare data privacy and security. Marianne Kolbasuk McGee, Executive Editor of Information Security Media Group (ISMG) moderated and shared information from ISMG’s annual information security study. Also on the panel were Steve Shihadeh, Senior Vice President of North America Sales Caradigm, Mac McMillan, Chief Executive Officer CynergisTek, and Shane Whitlatch, Executive Vice President FairWarning. The survey results that Marianne shared were really interesting because they showed that despite the high profile breaches that have occurred over the past couple of years, there’s still plenty of room for healthcare organizations to give information security greater focus. Some of the statistics shared were:

  • Only about half of organizations indicated that preventing and detecting breaches is a top priority in 2015.
  • Just 31 percent of healthcare organizations have “high” or “somewhat high” confidence in the security controls of their business associates and subcontractors.
  • Nearly 80 percent of organizations rely on usernames and passwords as the dominant method of authentication used for on-site and remote access to clinical data with use of more advanced forms of authentication still rare.
  • 51 percent of organizations reported having no breaches of any size in 2014 compared to 37 percent in 2013.

The panelists advised that healthcare organizations need to guard against complacency in order to stay ahead of security risks. Everyone should be doing more because of the continuous presence of insider threats and increasing hacking threats that are targeting healthcare heavily because of the value of the data and intellectual property. The panel also stressed the importance of tools to help control identity and access management and ongoing workforce training that needs to be put into greater context for how employees do their jobs.

Another very cool event that took place today was that patient rights advocate and renowned artist, Regina Holliday was in the Caradigm booth painting a mural on population health to raise awareness for the Society for Participatory Medicine. The mural is inspired by the idea that healthcare needs powerful and disruptive change and was completed in a single day. To learn more about Regina’s patient advocacy, I recommend reading her blog and following her on Twitter.

 

Regina HIMSS

 

HIMSS15 Day 2 Recap


Post by Vicki Harter, BA, RRT


Vice President, Care Transformation

I value my time spent at HIMSS. It allows me to reconnect with long-time colleagues, meet new people, and check the pulse of the industry in a few short days. This year, I’ve noticed a shift in the types of conversations I’m having on population health management. Healthcare organizations have a more mature interest in discussing the opportunities and challenges of value-based care and the IT solutions that can help. An increasing number of providers are looking to take the next step with population health, scaling programs they have implemented over the last couple of years. It’s exciting to hear that the question has shifted from “should we make the shift?” to “how can we do it more efficiently and effectively?”

Caradigm had another superb day of educational presentations in our booth. I participated on the panel entitled “DSRIP Program – Enabling Participation for Performing Provider Systems.” The panel included several other experts on the program: Todd Ellis, Managing Director KPMG, Wendy Vincent, National Practice Director Beacon Partners, and Paul Contino, Chief Technology Officer NYC Health & Hospitals Corporation.

Todd Ellis kicked things off by providing an overview of the Delivery System Reform Incentive Payment (DSRIP) program. DSRIP aims to improve the Medicaid program, improving the quality of care for the underserved while better managing the more cost of that care. He claimed that the goal can be reached through an increased focus on primary care, preventive measures and patient engagement; together they can reduce the need for high-cost hospital services. Given the billions of dollars that are available to participants in the program, DSRIP represents a significant opportunity to build the systems needed to truly transform care delivery, and implement the IT solutions that can make it happen.

Succeeding within the DSRIP program, however, does present some significant challenges. Paul Contino shared his perspective of a provider that is leading a large Perform­ing Provider System (PPS). Paul outlined two of the most important things to get right: 1) gathering and sharing data across a large number of providers using a variety of different systems and 2) developing standardized and integrated workflows. He reminded the audience that this change won’t happen overnight as it takes a significant, long-term investment of time and resources.

As one who has helped clients structure and prioritize their DSRIP programs, Wendy Vincent added a consultant’s perspective. She stressed that a PPS needs clear transparency and communication among all its partners. They need to agree on goals and processes before implementation. As providers often participate in several population health initiatives, she recommends that they take a step back and take a holistic view of all their programs to find areas of improvement and synergies that cut across multiple activities.

Lastly, the panel also talked about solutions that are needed to ensure success with DSRIP initiatives. I believe that providers must take a long-term view as they try to improve the health of a population. They need tools that are both flexible and extensible. As Paul stated, transformation will not happen overnight. Programs will change and evolve over time, and what works for one provider may not work for another. As opposed to point solutions not intended to scale beyond a narrow focus, end-to-end enterprise population health solutions give providers the flexibility and extensibility they need.

If you’re at HIMSS15 and would like to talk more about your DSRIP or other state funded strategies, then please stop by our booth #7307. You can also drop us a note here to schedule a conversation at another time.

 

Tuesday Panel 3PM

 

HIMSS15 Day 1 Recap


Post by Scott McLeod


Director of Product Marketing, Caradigm

It’s always enjoyable to be at the Health Information Management Systems Society (HIMSS) Annual Conference, which kicked off today in Chicago. The sheer volume of people (around 38,000+) who come from all over the world to learn about and discuss innovation in healthcare is amazing, and makes HIMSS the industry gathering.

Caradigm had a bustling opening day in the exhibition hall as we hosted the first two of a series of outstanding interactive panel sessions to be held in our booth this week. Here are the highlights from today’s panels:

Population Health Trends and Insights Panel

Panelists were Ken Kleinberg, Senior IT Analyst from The Advisory Board Company, Dr. Peter Edelstein, Author and Patient Advocate, Brian Drozdowicz, Caradigm SVP of Global Population Health and Patty Enrado, Senior Editor, HIMSS Media who served as the moderator. To initiate discussion among the panelists, Patty shared preliminary results from a HIMSS Analytics population health research study and asked the panelists to respond. It was a lively discussion centered around where organizations are today with population health and where they are headed in the future. Some of the key points that came up in the discussion were:

  • 22 out of 25 respondents said population health would be a high organizational priority by next year. The panelists agreed that we have reached the tipping point for organizational awareness of population health, but are not there yet on execution because population health is complicated and requires new tools.
  • Respondents indicated that the top challenges providers are having are related to data aggregation, change management, and budget constraints. While the panel agreed that budget and resource constraints are common, providers can mitigate the challenge by honing in on programs and tools that can help them achieve quick wins such as data aggregation.
  • Initial successes in population health are coming from a variety of different areas such as patient engagement and outreach, building IT infrastructure and care and case management. The panelists commented that experimentation with different population health programs is an effective approach until a provider learns what strategies are working for them. Aligning on goals and how to measure success is important to establish before implementing a program.
  • To further mature population health strategies, respondents indicated that they need to keep bolstering their IT infrastructure, form more partnerships and affiliations to expand coverage, and be adaptable. The panelists talked about how providers should take the long view and build infrastructure that can scale. An ACO that manages a few thousand lives today needs a clear technology and strategy path forward to grow to hundreds of thousand lives managed.

Succeeding In Accountable Care Panel

Panelists were Wendy Vincent, National Practice Director Beacon Partners, Sameer Bade, Caradigm VP of Clinical Solutions and myself as the moderator. This panel was an excellent follow up to our earlier pop health session as the conversation centered on specific foundational strategies ACOs should be considering to drive quality and lower costs. Some of the recommendations discussed included:

  • Start by obtaining a deep understanding of your population, and use predictive modeling to identify patients who are most likely to become high risk in the coming year in order to prioritize interventions.
  • Build a strong foundation of primary care and patient centered medical homes (PCMH) that can help improve outcomes for a targeted population.
  • Establish strong physician leadership in the ACO and also restructure physician compensation to align provider incentives with value-based care.
  • Remember that you can’t manage population health with an EHR alone. As providers scale programs and form clinical networks, the amount of data that needs to be aggregated from disparate systems multiplies very quickly. Providers also need a higher class of population health analytics and workflow tools to help them drive results.

If you’d like to receive the complete research reports from the panels today, send us a note here. Also, check back tomorrow for a recap of Tuesday’s activities as Caradigm will be hosting three more panel presentations in booth #7307.

 

Caradigm HIMSS

Advisory Board National Meeting Day 2: Redefining the Value Proposition


Post by Scott McLeod


Director of Product Marketing, Caradigm

I recently had the opportunity to attend the second half of the Advisory Board’s two-day national meeting in Seattle where the presentations went deeper on the central theme of how health systems must adapt to the shift in how they are paid. These systems face four imperatives necessary for success in the new world—competitive unit prices, total-cost control, geographic reach and clinical scope, and clinical and service quality. These are the attributes necessary for providers to succeed by, as noted in David Lee’s blog, winning at two distinct points-of-sale:

1) They must be the network chosen in risk-based agreements with payers and employers

2) They must be chosen by patients who need healthcare services

One requirement to winning the first point is assembling a low-cost, high-quality network. Recruiting the appropriate providers is dependent on the evaluation of clinical performance data, e.g. mortality rate, complication rate and readmission rate, making sure that providers included in the network can deliver the high-quality care expected by payers and employers. Other factors for evaluation include their per-capita cost of care, efficiency of care utilization and care experience—helping to make sure that the providers included also can deliver low-cost care.

Assembling the appropriate network is also critical to building the geographic reach and clinical scope to provide healthcare access that meets the demands of patients. In addition to competing on price (driven by increased price transparency) and convenience (offering services that meet diverse patient demands), health systems can differentiate themselves from their competitors by offering enhanced management. Increasingly, employers are purchasing health management solutions for their workforce, and patients are opting for direct primary care and concierge services. Successful networks need providers who can deliver services such as preventive screening, disease treatment and lifestyle management.

Once assembled, it is important to continuously monitor and manage the network. Quality analytics are required to identify gaps in care or measures and surface them to providers so the gaps can be closed. Performance analytics are necessary to measure the behavior of providers and evaluate patterns of activity for areas of improvement. Utilization analytics are needed to monitor network leakage and promote appropriate steerage—driving patients to seek care within the network of low-cost, high-quality providers.

The Advisory Board meeting provided a good perspective on the state of the industry leading in to HIMSS15. Caradigm will be hosting several panel discussions in our booth (#7307) that will feature industry experts as well as the sharing of third-party survey research related to population health, ACO best practices, DSRIP and Data Privacy and Security. You can check out the full schedule of Caradigm events at HIMSS here.

Advisory Board National Meeting Day 1: Balancing Population Health and Fee-for-Service


Post by David Lee


Product Marketing Manager, Caradigm

I had the pleasure of attending the Advisory Board’s national meeting recently in Seattle where the central theme was how healthcare must adapt to the channel disruption it is facing with value-based reimbursements. The shift to value-based reimbursements has changed the fundamental mechanics of healthcare, which in turn has changed the rules for success. It’s really channel disruption on the scale of what Amazon did to retail and what Netflix did to video rentals.

One of the biggest takeaways from the meeting was that healthcare organizations can benefit from rethinking their value propositions as they operate in both a value-based and fee-for-service (FFS) environment. It doesn’t have to be an either or proposition. In fact, providers that can identify the sweet spot between them can achieve the greatest success in terms of being innovators of quality, serving the most people in their region and in achieving financial growth.

Here’s how the two models can co-exist. For providers to succeed, they have to win at two distinct points-of-sale:

1) They must be the network chosen in risk-based agreements with payers and employers

2) They must be chosen by patients who need healthcare services

To succeed in the first point of sale, providers need to extend their reach through new partnerships or clinical integration, and establish strong population health management capabilities – data control, healthcare analytics, care coordination and patient engagement. They can then leverage these capabilities to become a low cost, high quality and high access provider that gets selected for more public and commercial contracts. The addition of new contracts plus the ability to generate shared savings from those contracts is an attractive proposition for providers.

To succeed in the second point of sale, providers have to innovate by appealing to patients as consumers of healthcare services. Providers can increase utilization of preventive and other necessary services by considering patient needs and solving the dissatisfaction with how they obtain healthcare services today. There’s many different ways a provider can approach this such as by offering telehealth services, or creating specific packages tailored towards certain conditions such as diabetes management that includes blood tests, exams and nutritional services. It can be as simple as communicating better with patients and reminding them to come in for regular exams. Providers that appeal to patients as customers can build loyalty, which is critical because it’s often easy for patients to change where they get their health services.

The Advisory Board national meeting was a great check in on the pulse of the industry leading in to HIMSS where I look forward to continuing the discussion. Caradigm will be hosting several panel discussions in our booth (#7307) that will feature industry experts as well as the sharing of third party survey research related to population health, ACO best practices, DSRIP and data privacy and security. You can check out the full schedule of Caradigm events at HIMSS here.