Archive for the ‘Data Analytics’ Category

Guest Post: Value-Based Care is Dying—But Longitudinal Patient Data Can Revive It

November 16th, 2017 by William D. Kirsh, DO, MPH, CMO at Sentry Data Systems

In 2013, Harvard Business Review (HBR) called value-based care “the strategy that will fix healthcare.” And the concept goes back even further than that—Michael Porter and Elizabeth Teisberg introduced the value agenda in their book, Redefining Health Care, in 2006, accord to HBR. Yet years later, value-based care is still struggling to survive, still in limbo, not quite breathing on its own. At this point, you might say it’s in critical condition.

More than a decade after Porter and Teisberg’s book, the industry is still talking about the “transition” to value-based care. In January of this year, CMS and HHS’ Office of the National Coordinator for Health IT (ONC) issued a vision for the continued shift to value-based care. In April, CEOs from Kaiser Permanente, Medtronic, Novartis and others, along with the Netherlands’ health minister, the head of England’s National Health Service, and Harvard economics professor Michael Porter (author of the 2006 book mentioned above) called for a new approach that would embrace patient-centered care and focus on outcomes.

Also in April, the World Economic Forum, in collaboration with The Boston Consulting Group, released a report, Value in Healthcare: Laying the Foundation for Health-System Transformation. Why are we still seeing words like “a new approach” and “laying the foundation” after all the time we’ve had, as an industry, to embrace value-based care?

After much wandering, it’s apparently a destination we still haven’t found on the map.

Resisting Change

According to a report from professional services organization EY (Ernst & Young) in July, about a fourth of 700 respondents (chief medical officers, clinical quality executives and chief financial officers at U.S.-based healthcare providers with annual revenue of $100 million and higher) polled said they had no value-based reimbursement initiatives planned for 2017. And that’s despite figures stating that healthcare spending in the United States “has now risen to 17.8 percent of GDP,” as the EY report says. So, what’s stopping physicians and hospitals from acting on value-based care?

As Modern Healthcare notes, the EY report points to “the escalating cost of care, a lack of standardization in how quality is defined, a disengaged workforce that leads to more medical errors, and a lack of trust and transparency between providers, payers and regulators,“ as some of the barriers. A 2016 article from Deloitte Insights adds that physician compensation may be part of the problem, stating, “Currently, there is little focus on value in physician compensation, and physicians are generally reluctant to bear financial risk for care delivery…86 percent of physicians reported being compensated under fee-for-service (FFS) or salary arrangements.” Deloitte recommends, “At least 20 percent of a physician’s compensation should be tied to performance goals. Current financial incentive levels for physicians are not adequate.”

But financial incentives alone are not enough. “Regardless of financial incentives to reduce costs and improve care quality, physicians would have a difficult time meeting these goals if they lack data-driven tools,” Deloitte says. “These tools can give them insight on cost and quality metrics, and can help them make care decisions that are consistent with effective clinical practice.”

Achieving Quality Outcomes

The EY report seems to come to the same conclusion as Deloitte about the lack of metrics and data. “Clinical outcomes and healthcare quality are often measured inconsistently by healthcare providers — if they are measured at all,” EY says. One way for hospitals to change that—a vital step in the value-based payment model—is through access to and analysis of longitudinal patient data, which is data that tracks the same patients over multiple episodes of care over the course of many years.

The problem is that hospitals and physicians often do not see the outcomes of particular treatment protocols (prescriptions, diagnostic tests, surgeries, etc.) for a long time, and capturing clinical data with this level of accuracy has historically been the industry’s blind spot. Without having a comparison population, each institution can only compare its data to real-world experience within their own data depository. A critical need is to use a de-identified real-world census population to compare protocols, best practices or specific utilization by National Drug Codes to help identify patterns of interventions that create value consistently across multiple systems, physicians, and patients. To truly answer these challenging questions about value in a meaningful way, hospitals need a comparison longitudinal patient data set.

There are countless questions about patient cohorts that physicians might want answered as they seek to make the best treatment decisions: What treatment protocol will result in the highest quality outcomes for a 50-year-old female diabetic patient with kidney failure? Which medications most effectively keep children with asthma from repeat visits to the ER? What comorbidities and symptoms are seen among patients with acute myelocytic leukemia (AML) in their earliest visits to the ER, and how can that information result in earlier diagnosis or different treatment options down the line? Quality historical longitudinal patient data may answer all these questions.

“Market forces are moving the industry toward a new paradigm; one in which delivering the highest value is an organization’s defining goal,” notes the EY report. “Optimizing patient experiences across the continuum of care while industrializing quality requires more than episodic effort.” This is the crux of value-based care. The only way to bring all stakeholders together and keep value-based care alive is by leveraging real-world, longitudinal patient data and using that information to make actionable treatment and prescribing decisions that lead to overall wellness and financial value, instead of focusing on just acute-care treatment.

William D. Kirsh, DO, MPH, CMO at Sentry Data Systems

About the Author: William D. Kirsh, DO, MPH, is chief medical officer at Sentry Data Systems and a practicing physician, clinically certified in family practice, geriatrics, hospice and palliative medicine. Sentry Data Systems, a pioneer in automated pharmacy procurement, utilization management and 340B compliance, is leading the healthcare industry in turning real-time data into real-world evidence through Comparative Rapid Cycle Analytics™ to reduce total cost of care, improve quality, and provide better results for all.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Healthcare Hotwire: Blockchain Technology and AI in Healthcare

November 9th, 2017 by Melanie Matthews

Blockchain technology and artificial intelligence are healthcare game-changers.

Blockchain technology is a game-changer with the potential to impact not one or two industries, but the complete landscape of how business is done. When 200 healthcare executives were recently surveyed by IBM, 16 percent expect to have a commercial blockchain solution at scale sometime this year.

And artificial intelligence (AI) and robots that support, diagnose and treat people are already in homes, workplaces and clinical environments all over the world, according to PWC.

Still in their infancy, early adopters of these technologies are starting to report promising results.

In the new edition of Healthcare Hotwire, you’ll learn more about the patient benefits of blockchain technology, how AI is being used to identify high-risk colon cancer patients and improve medication adherence and other healthcare blockchain and AI trends.

HIN’s newly launched Healthcare Hotwire tracks trending topics in the industry for strategic planning. Subscribe today.

Data Analytics, SDOH Screenings Flag Disengaged and 12 More Patient Engagement Trends

October 5th, 2017 by Patricia Donovan

More than 70 percent of healthcare organizations have created formal patient engagement initiatives, according to 2017 benchmarks from the Healthcare Intelligence Network.


To identify individuals that are poorly engaged in their health, nearly two-thirds (63 percent) of healthcare organizations mine clinical data analytics, according to the 2017 Patient Engagement Survey by the Healthcare Intelligence Network, while 37 percent screen patients for social determinants of health related to housing, care access, transportation, nutrition and finances.

Patients who screen positive for social determinants of health (SDOH) and individuals with diabetes are typically the most difficult populations to engage, according to 2017 survey benchmarks.

Thirty-five percent of respondents to the September 2017 survey said the presence of SDOHs, which the World Health Organization defines as “conditions in which people are born, grow, live, work and age,” pose the greatest challenge to health engagement, while 26 percent said a diabetes diagnosis presents the top clinical challenge to engagement interventions.

One-quarter report some resolution of SDOH factors resulting from engagement efforts.

To improve engagement, 75 percent of respondents rely on education of patients, family and caregivers, supported with telephonic outreach (13 percent) and home visits (13 percent).

Efforts by 71 percent of respondents to create a formal patient engagement program underscore the critical role of engagement in healthcare’s value-based care and reimbursement models, particularly in regards to chronic illness.

In other survey findings:

  • Patient experience rankings are the most reliable measure of engagement program success, say 43 percent.
  • For one quarter of respondents, patient engagement is the primary domain of case managers.
  • Eighty-three percent saw quality metrics improve as a result of patient engagement efforts.
  • Half attributed a drop in hospital emergency room visits to their patient engagement interventions.

Download an executive summary of the 2017 Patient Engagement Survey.

Infographic: How Digital Healthcare Transformation Powers the Internet of Things

August 30th, 2017 by Melanie Matthews

Data is coming at healthcare organizations in massive waves, from computing devices (such as smartphones and tablets) to connected devices (like smart refrigerators and wearable health monitors). Enterprises that collect, store and analyze this data effectively can use it to drive innovations through the Internet of Things (IoT), according to a new infographic by CDW.

The infographic details how IoT enables capabilities such as data analysis for predictive insight and better decision-making, as well as automation to improve the efficiency and productivity of far-flung operations.

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: Harnessing the Power of Unstructured Healthcare Data

August 25th, 2017 by Melanie Matthews

Finding meaning in patient care data will require looking beyond the 20-30% that is “structured” and stored within the EHR/EMR. A complete patient record is 80% unstructured data. From imaging to lab results, photos to findings—unstructured data management, sharing, workflow and analysis will power decisions and inform outcomes. Harnessing this data and turning it into actionable intelligence is a goal of a handful of leading HIT teams, according to a new infographic by Clarity Quest.

The infographic highlights the rapid growth of unstructured content and its impact on downstream analysis and provides a listing of enterprise imaging, workflow and analysis leaders.

2016 Healthcare Benchmarks: Data Analytics and IntegrationThe 2016 Healthcare Benchmarks: Data Analytics and Integration assembles hundreds of metrics on data analytics and integration from hospitals, health plans, physician practices and other responding organizations, charting the impact of data analytics on population health management, health outcomes, utilization and cost.

2016 Healthcare Benchmarks: Data Analytics and Integration examines the goals, data types, collection processes, program elements, challenges and successes shared by healthcare organizations responding to the January 2016 Data Analytics survey by the Healthcare Intelligence Network. Click here for more information.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: Reducing Clinical Variation Through Analytics

August 11th, 2017 by Melanie Matthews

Some 42 percent of wasteful healthcare spending in the United States is attributed to clinical variation, according to a new infographic by Qlik.

The infographic looks at the financial and social cost of clinical variation and how to advance positive outcomes using analytics.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare’s aggressive migration to value-based payment models and MACRA’s 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS’s 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

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Service Action Teams Turn Front-Line Staff into Patient Experience Ambassadors

August 8th, 2017 by Patricia Donovan
Patient Experience

Increasingly, patient satisfaction scores figure into payors’ healthcare reimbursement formulas.

UnityPoint Health is so invested in the concept of patient experience that it charges each member of its organization, whether healthcare provider or not, with a set of basic behaviors designed to improve it.

These four foundational behaviors, rooted in courtesy and common sense, drive the manner in which patients, families and visitors are greeted and assisted at all times.

“We know there are dozens of initiatives and tactics that can be used to help improve patient experience,” said Paige Moore, director of patient experience at UnityPoint Health-Des Moines, “But the four we chose were driven by patient and visitor comments and feedback.”

Ms. Moore shared these behaviors, as well as an inside look at her organization’s patient experience improvement plan, during Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a July 2017 webinar now available in on-demand and training formats.

Having established this system-wide coda for all employees, UnityPoint Health next looked at further enlisting its frontline staff in efforts to improve the patient experience. To do so, it created a set of seven service action teams, with two more in the works.

Each service action team is composed of at least 50 percent of that department’s frontline staff, rounded out by an executive sponsor and team lead.

“We want all of our team members to be actively engaged in the projects, to take responsibility for them, to be ambassadors and patient experience champions throughout the organization,” explained Ms. Moore.

Each team reviews results from HCAHPS® and Press Ganey® patient experience surveys to identify department priorities, such as nurses’ narration of care, physicians’ use of clear language, or discharge or transfer processes.

UnityPoint Health launched its first service action team in 2014 for outpatient services. “This was our largest volume for surveys and it also had some of our lowest patient experience performance. We really wanted to get in and see what could we do to make the biggest impact on the highest number of our patients.”

Once that team developed some tactics to improve patient privacy concerns, wait times and registration processes, it saw improvements in those areas.

During the program, Ms. Moore outlined priorities and shared results from each service action team.

Importantly, there are two support service action teams: a measurements team to educate employees on the relevance of patient experience scores and their role in them, and a communications team to convey information on patient experience activities throughout UnityPoint Health. The health system also recently launched an “Excellence in Patient Experience” awards program.

And rounding out the program is the placement of patient experience directors like Ms. Moore throughout the organization, each supported by a physician champion.

Physician education in patient experience is ongoing, she added, whether during rounds or mandatory one-on-one shadowing and coaching for patient experience for all new hires.

Listen to an interview with Paige Moore on UnityPointHealth’s four foundational behaviors.

Infographic: The Prescription for Getting ROI From Analytics

July 26th, 2017 by Melanie Matthews

As the amount of patient data increases, healthcare organizations are investing in healthcare analytics solutions, according to a new infographic by IBM. To allow organizations to draw complex data insights from intricate, personal and rapidly changing data, healthcare organizations can benefit from a complete business intelligence (BI) solution.

The infographic looks at the trends driving this investment in analytics.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare’s aggressive migration to value-based payment models and MACRA’s 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS’s 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Guest Post: Analytics-Backed Wearables Provide Value Through Actionable Health Insights

July 18th, 2017 by John Valiton, CEO of Reemo Health

wearables for seniors

Analytics-enabled wearables offer opportunities for chronic disease management and delivery of value-based care.

The wearable market has experienced a growth rate of more than 20 percent and is estimated to reach over 213 million units shipped worldwide by 2020, according to IDC. These numbers likely don’t come as a surprise, as wearables have become an everyday tech accessory for nearly every generation — children, Millennials, Gen X, and even seniors. In fact, research by Accenture found that 17 percent of Americans over the age of 65 use wearables to track fitness — a percentage right on track with the 20 percent of those under the age of 65 that use wearables similarly.

But, while the value of utilizing wearables to track health has been tapped for the everyday consumer, it has yet to reach its full potential. Wearables can go far beyond heart rate monitoring and counting steps — especially for seniors. These devices, when connected with a data analytics platform, can provide the valuable insights needed to not only track health in real time, but predict potential threats and optimize care according to need. And the analytic insights, integrated with previous health records, not only benefit the senior, but give professional and family caregivers a deeper look into the behavior that can improve long-term health, streamlining delivery of care by mitigating the need for trial-and-error treatment planning.

With over 50 million seniors in the U.S., this offers a huge opportunity for care facilities to provide real value to the patients they serve, whether in a senior care facility where residents are monitored on an hourly basis, or still living independently where facilities provide data insights at scheduled check-ins. But, as more facilities adopt wearable and analytic solutions, they must acknowledge the importance of using the wearable-enabled analytics platform to keep users engaged by providing value through actionable insights, rather than simply mining data and pushing it out. If there are not real benefits for both the senior and care provider, that wearable device is likely to end up in a drawer in a matter of months.

As caregivers dive into these valuable insights, they can be applied to assist with everything from chronic disease management and health event recovery to reduce the chance of post-acute readmission, to predicting potential threats based on irregularities in activity levels and vitals — allowing providers to truly delivery value-based care. For example, through the analysis of activity data, caregivers can follow the pathway to a potential fall for a senior, and proactively take steps to avoid this often traumatic event. Additionally, urinary tract infections (UTIs) are a large risk for seniors, and often occur after a 72-hour period where light activity such as walking becomes increasingly painful and trips to the restroom increase. By tracking a senior’s activity levels through a wearable device, caregivers can strategically treat those with potential UTI issues.

Through these kind of applications, truly actionable wearable data can provide immense value for both seniors and the caregivers tasked with keeping them on the pathway to a positive aging experience. And for those still living independently, the integration of response systems — such as push-of-a-button 911 dialing — within the wearable devices can provide additional value in their daily life by providing peace of mind to the senior and their loved ones, and functionality in the case of an emergency.

The use of wearables in everyday life doesn’t have to be limited to tracking a morning walk or getting reminders to stand up when you’ve been sitting for too long. If used alongside a powerful analytics platform, these devices can truly improve seniors’ quality of life, while strengthening connections with caregivers through increased visibility into seniors’ daily activities and peace of mind for loved ones. And while the wearable revolution is sweeping the nation, it truly should be about more than wearables for seniors. Wearables, backed by powerful data analytics, can become invaluable for our aging generation while providing unmatched insights for both personal and professional caregivers.

John Valiton, CEO, Reemo Health

John Valiton, CEO, Reemo Health

About the Author: John Valiton is CEO of Reemo Health, a senior health technology solution designed to empower caregivers with actionable insights to improve the aging experience. As a 20-year business development veteran and entrepreneur, Valiton has developed partnerships with many national and international companies. He has been an avid technology enthusiast since an early age, and applied his interest in all things tech at the intersection of IoT, wearable technology, healthcare and data science through his position as a strategic advisor, chief revenue officer and now chief executive officer for Reemo.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

In Montefiore Social Determinants of Health Screening, Patients’ Needs Shape SDOH Workflow

July 11th, 2017 by Patricia Donovan
 Clinical factors drive 15 percent of a patient's well-being; social determinants of health like finances drive the rest.


Clinical factors drive 15 percent of a patient’s well-being; social determinants of health like finances drive the rest.

In Dr. Amanda Parsons’ twenty-something years in healthcare, she has never implemented a program as widely embraced as Montefiore Health System’s Social Determinants of Health (SDOH) screening.

“It was one of the few times in my career that I didn’t encounter physician resistance,” said Dr. Parsons, Montefiore’s vice president of community and population health. The health system’s screening assesses patients for a host of SDOH factors that drive 85 percent of their well-being, including housing, food security, access to care or medications, finances, transportation and violence.

Following assessment, the goal is to connect individuals who screen positively for SDOHs with assistance from the area’s robust network of community organizations.

Dr. Parsons outlined her organization’s SDOH screening process, findings, challenges, and future plans during Assessing Social Determinants of Health: Collecting and Responding to Data in the Primary Care Setting, a June 2017 webcast by the Healthcare Intelligence Network now available for rebroadcast.

To get started, Montefiore piggybacked on the efforts of a few provider sites already screening for SDOHs. It then offered providers a choice of two validated screening tools, the first developed at a fifth-grade reading level, the second a more sophisticated “stressor” screen. Thirdly, it built a two-tiered triage system that leveraged social workers for individuals with very high SDOH needs, and community health workers to assist with lower-level needs.

Referrals would come from existing data banks or a host of new online referral tools, many of which Dr. Parsons mentioned during the webcast.

Interestingly, while Montefiore is fully live on an EPIC® electronic health record, SDOH screenings are currently conducted on paper, noted Dr. Parsons. This decision was one of multiple considerations in workflow creation, including respect for patient privacy.

For the time being, each Montefiore provider site selects a unique population to screen—or opts not to screen at all, if staffing is lacking. For example, one site screens all patients scheduled for annual physicals, while another screens patients recently discharged from the hospital.

In an initial readout of both screens, SDOH positivity was highest for housing and finances.

By the end of 2017, Montefiore expects to have completed more than 10,000 screenings. The health system, which serves some 700,000 patients, also plans to boost its ranks of community health workers, broadening its referral network.

Looking ahead, Montefiore will address a number of key administrative and emotional barriers. Some patient issues, like overcoming the stigma of seeing a social worker, can be minimized with a simple scripting change. Others, like alleviating an individual’s financial pain or putting a roof over a family’s head, are much more complicated.

Also needed is a process to confirm a patient has “gone that last mile” and obtained the recommended support, Dr. Parsons added.

As it expands SDOH screening, Montefiore is banking on that swell of engaged providers. As part of its mission to provide comprehensive, ‘cradle-to-grave’ care for its mostly Medicaid and otherwise government-insured population, Montefiore “intervenes even when there is no payment structure for that work,” said Dr. Parsons.

Falling into that category is SDOH screening. “Much of the Social Determinants of Health work is not very billable in the traditional paper service model, but it is incredibly important to do, regardless.”

Listen to an interview with Dr. Parsons on adapting SDOH screenings for different populations.
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