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New Affordable Care Act Initiative to Support Care Coordination Nationwide

The Centers for Medicare & Medicaid Services (CMS) today announced the availability of a new initiative for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. Made possible by the Affordable Care Act, ACOs encourage quality improvement and care coordination through the use of health information technology, helping to move our health care system to one that values quality over quantity and preventing illness over treating people after they get sick.

The new ACO Investment Model is designed to bring these efforts to better coordinate care to rural and underserved areas by providing up to $114 million in upfront investments to up to 75 ACOs across the country.

“The ACO Investment Model will give Medicare Accountable Care Organizations more flexibility in setting quality and financial goals, while giving them greater accountability for delivering quality care efficiently,” said CMS Administrator Marilyn Tavenner. “We are working with these organizations to make necessary investments that encourage doctors, hospitals and other health care providers to work together to better coordinate care and keep people healthy.”

Through the CMS Innovation Center, this initiative will provide up front investments in infrastructure and redesigned care process to help eligible ACOs continue to provide higher quality care. This will help increase the number of beneficiaries – regardless of geographic location – that can benefit from lower costs and improved health care through Medicare ACOs. CMS will recover these payments through an offset of an ACO’s earned shared savings.

Eligibility is targeted to ACOs who joined the Shared Savings Program in 2012, 2013, 2014, and to new ACOs joining the Shared Savings Program in 2016. The application deadline for organizations that started in the Shared Savings Program in 2012 or 2013 will be December 1, 2014.  Applications will be available in the Summer of 2015 for ACOs that started in the Shared Savings Program in 2014 or will start in 2016.

Recently, ACOs in the Pioneer ACO Model and the Medicare Shared Savings Program generated over $372 million in total program savings for Medicare ACOs while also improving the quality care delivered to Medicare beneficiaries.

ACOs are one part of the overall effort provided by the Affordable Care Act to help lower costs and improve care and quality. For example, the Affordable Care Act has helped reduce hospital readmissions in Medicare by nearly 10 percent between 2007 and 2013 – translating into 150,000 fewer readmissions – and quality improvements has resulted in saving 15,000 lives and $4 billion in health spending during 2011 and 2012.

For more information on the ACO Investment Model, please visit: http://innovation.cms.gov/initiatives/ACO-Investment-Model/

ACO Investment Model CMS Fact Sheet: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-10-15.html

October 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

HIMSS Analytics Recognizes Three-State Group of Ambulatory Clinics with Stage 7 Award

CHICAGO (April 11, 2013) – Since 2005, HIMSS Analytics has tracked progress of electronic medical record implementation with its EMR Adoption Model? (EMRAM) for hospitals. Now, HIMSS Analytics announces that 54 Essentia Health ambulatory clinics, located in Minnesota, North Dakota and Wisconsin, have reached Stage 7 on The Ambulatory EMR Adoption ModelSM (A-EMRAM).

Developed in 2011, the EMR Ambulatory Adoption Model provides a methodology for evaluating the progress and impact of electronic medical record systems for ambulatory facilities owned by hospitals in the HIMSS Analytics™ Database.  These facilities include physician practices, clinics, outpatient centers and specialty clinics. Tracking their progress in completing eight stages (0-7), ambulatory facilities can review the implementation and use of IT applications with the intent of reaching Stage 7, which represents an advanced electronic patient record environment.

Stage 7 ambulatory facilities:

  • Deliver patient care without the use of paper charts;
  • Use their EMR and patient portal to drive patient engagement, and thus, improved health status through better health maintenance;
  • Use their vast database of clinical information and evidence based practice guidance to improve  outcomes using business intelligence solutions; and
  • Are able to share patient information through private and public health information exchanges (HIE), which improves communications, speeds up appropriate care delivery, and ultimately, reduces unnecessary consumption.

The validation process confirms ambulatory facilities have reached Stage 7 with a site visit conducted by an executive from HIMSS Analytics and a Chief Medical Information Officer with ambulatory deployment experience to ensure an unbiased evaluation of the Stage 7 environments.  Visiting a representative ambulatory clinic or clinics that deployed the same EMR applications and software, the validation team conducts both a comprehensive system overview and an analytics review to ensure improved health status indicators and understanding of the effectiveness of their patient engagement strategy.

“Having a common electronic medical record that spans our integrated delivery system is a key strategy for Essentia Health.  As we focus on changing models of care, quality initiatives and new payment models, our EMR has been instrumental in allowing Essentia to adapt quickly to these trends,” says Dennis Dassenko, Chief Information Officer, Essentia Health System.

“Rich ambulatory health IT tools and real-time analytics have provided operational and clinical leadership the opportunity to change care models as we become an Accountable Care Organization (ACO).  It also allows us to improve patient care by closing care gaps and improving quality metrics,” says Thomas H. Wiig, MD, FACS, Chief Medical Informatics Officer, Essentia Health.  “Patient involvement on care councils and at medical section meetings has provided valuable feedback about optimizing our secure patient portal and other patient care tools, and adds to our goal of increased patient engagement.”

“Essentia operates in a paperless environment using its fully deployed, multi-specialty EMR as the backbone for its comprehensive analytics program, which is tied to a patient engagement strategy resulting in improved health status in asthma care and congestive heart failure,” says John P. Hoyt, FACHE, FHIMSS, Executive Vice President, HIMSS Analytics. “Serving a wide geographic area over several states, the Essentia clinics have adapted their program to fit a complex environment. With improved documentation, the claims denial rate has plummeted from the mid-teens to only 1 percent.”

As the current data on the A-EMRAM indicates, as of March 30, 2013, HIMSS Analytics has recognized only:

  • 1.10 percent of 19,234 ambulatory facilities at Stage 6; and
  • 0.9 percent of 19,234 ambulatory facilities at Stage 7.

An explanation of each stage appears on the HIMSS Analytics website. Visit the HIMSS Analytics website for more information on the A-EMRAM.

About HIMSS Analytics

HIMSS Analytics is a wholly owned not-for-profit subsidiary of the Healthcare Information and Management Systems Society. The company collects and analyzes healthcare data related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions. HIMSS Analytics delivers high quality data and analytical expertise to healthcare delivery organizations, healthcare IT companies, state governments, financial companies, pharmaceutical companies, and consulting firms.  Visit www.himssanalytics.org/ for more information.

May 28, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

American Sentinel University Details How Cloud Computing Has the Potential to Revolutionize Health Care

– Cloud-based Applications Benefit Nurses and Patients at Point of Care –

AURORA, Colo. – February 12, 2013 – Cloud computing has the potential to revolutionize health care administration by allowing providers to access information from a patient’s medical file at anytime from any where and that means patients receive better and more efficient quality care.

“Everything in health care today is so dependent on computers and cloud computing is the repository for all of these transactions,” says Suzanne Richins, DHA, MBA, FACHE, RN, chair, health information management and health care administration at American Sentinel University.  “Cloud computing benefits nurses at point of care because no matter where the patient has a diagnostic test, the cloud ensures that data is available everywhere.”

The ‘cloud’ is an intangible, but ubiquitous presence in our tech-laden lives, allowing health care professionals to access all patient data across multiple devices and from any location with an Internet connection.

As an IT strategy, cloud computing took the business world by storm, allowing companies to store massive amounts of data virtually, rather than making a huge investment in developing and maintaining their own information system storage. Yet, health care has been a relative latecomer to cloud computing, largely because of the industry’s unique data security, regulatory, and patient privacy concerns.

“Laws require protection of pertinent information to ensure both confidentiality and privacy and before a health care organization contracts with a cloud organization, management needs to ensure that the cloud can meet the requirements of both HIPPA and meaningful use,” says Richins.

The mandate to widely adopt electronic medical records (EMRs), however, is expected to change that and a recent report by research firm MarketsandMarkets projected health care-related cloud computing will become a $5.4 billion global industry by 2017, encompassing both clinical and non-clinical applications.

Health Care Benefits from Cloud Computing
The most significant benefit cloud computing offers health care is data access.

When patient information is stored in the cloud, providers can access lab results, imaging scans and other pertinent test results at anytime and in any place, allowing for improved care coordination and better decision-making.

“As the move toward accountable care organizations (ACOs) drives the need for a better flow of information between primary care providers, specialists and case managers, clinical use of the cloud is likely to expand to include mobile applications that deliver data to tablets and smartphones,” adds Richins.

Most importantly, cloud-based platforms can allow collaboration between providers in real-time, from nearly any device that can connect to the Internet so health care organizations can manage data with more agility when working in the cloud.

Cloud Computing at the Bedside
Cloud computing benefits IT staff, nurse informaticians involved with EMR implementation and even the hospital’s bottom line. But Richins points out that health care will start seeing innovative, cloud-based applications that benefit nurses and patients at the point of care.

One example is Ultimate Caregiver, a nurse call system which merges pull cord technology with the power of cloud computing and mobile devices to allow for wireless paging and generated staff response reports.

When a patient rings for a nurse, the call signal is processed in the cloud and alerts are sent to nurses in the form of texts, e-mails, pages, or phone calls. This allows nurses to be more efficient on the floor, as the closest staff member can respond quickly to the patient and no one is tied to a nursing station to track patient call signals.

The use of cloud computing will also have a positive impact on career nursing opportunities in nursing informatics.

Richins notes that all of the third-party payers, including the government require reporting of quality measures and nurse informaticists are responsible for analyzing the data for reporting to these organizations.

“Nurse informaticists are critical to identification of problems, the root cause and identification of solutions and now that the payers do not reimburse for certain diagnoses, readmissions and hospital-acquired infections, nurse informatics are critical to the process as all decision-making requires evidence that comes from the data,” says Richins.

Cloud-based computing is also a boon to home health nurses, giving them easy access to accurate data, allowing them to document visits and update charts in real-time and freeing them from the cumbersome daily synchronization routine.

Richins notes that health care is in need of nurses who can analyze technologies from both the bedside and IT perspectives.

“Health informatics is the new frontier of health care and one of the fastest growing fields today. Nurses with a nursing informatics specialization will be in high demand to manage health information systems critical to the mission of health care delivery,” says Richins.

She points out that while opportunities in nursing informatics are plentiful, nursing informatics is not an entry-level career.

“RNs who find work in this specialty typically have several years of experience and professional education in both information systems and nursing,” adds Richins.

A registered nurse with an associate degree in nursing can purse a nursing informatics degree by taking the RN to BSN courses or RN to MSN courses. If a nurse already has a BSN, they can enter directly into the MSN program with a concentration in nursing informatics.

American Sentinel University helps prepare nurses for a variety of careers in nursing informatics with an online Master of Science in Nursing, Nursing Informatics specialization degree program that emphasizes understanding the infrastructure necessary to improve practice while safeguarding the security and privacy of data.

Learn more about American Sentinel University’s CCNE-accredited Master’s of Science in Nursing, Nursing Informatics program at http://www.americansentinel.edu/health-care/m-s-nursing/m-s-nursing-nursing-informatics.

About American Sentinel University
American Sentinel University delivers the competitive advantages of accredited online nursing degree programs in nursing, informatics, MBA Health Care, DNP Executive Leadership and DNP Educational Leadership. Its affordable, flexible bachelor’s and master’s nursing degree programs are accredited by the Commission for the Collegiate Nursing Education (CCNE). The university is accredited by the Distance Education and Training Council (DETC). The Accrediting Commission of DETC is listed by the U.S. Department of Education as a nationally recognized accrediting agency and is a recognized member of the Council for Higher Education Accreditation.

February 14, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Pioneer ACO Atrius Health Focuses on Clinical & Business Intelligence within its Six Practice Groups

CHICAGO (January 31, 2013) – Second in its series on clinical and business intelligence, HIMSS Analytics published a new white paper, “Atrius Health, Pioneer ACO, Clinical Intelligence & Business Intelligence,” released in January 2013.

Atrius Health, one of 32 organizations selected in 2011 by the Centers for Medicare and Medicaid Services for its Pioneer Accountable Care Organization program, is a nonprofit alliance of six multi-specialty medical groups. It was created in 2004 to enable collaboration on new and better ways of delivering care, transform the delivery of health care in eastern and central Massachusetts, while maintaining an emphasis on care for the local community. The staff of over 7,200 employees includes 1,000 physicians and more than 1,425 healthcare professionals who service 3.8 million visits from over one million adult and pediatric patients at some 50 sites cross Eastern and Central Massachusetts.

HIMSS Analytics worked with Atrius Health to present its unique perspective on how the organization approached management and delivery of care to assigned beneficiaries. This white paper provides a benchmark of the approach Atrius took to manage two critical components of its Pioneer ACO: clinical and business intelligence.

Clinical Intelligence with Atrius Health – as a Pioneer ACO: The Atrius Pioneer ACO program has been assigned and services approximately 55,000 Medicare Advantage patients with about 70 percent of its revenues from risk-based patient populations. With that in mind, Atrius developed its own approach to managing these populations.

“We also adopted a relatively unique concept in that we wanted to take care of all of our patients exactly the same, no matter what their funding mechanisms were. So we’ve combined our ACO population with our Medicare Advantage population,” says Dr. Gene Lindsey, CEO, Atrius Health, in the white paper.

The organization has two primary goals for clinical intelligence:

  • To reduce Atrius Health’s cost to two percent under the official Medicare “reference population” trend, allowing Atrius Health access to its earned savings, which bends the cost curve two percent relative to the baseline population; and
  • To effectively report on the 33 quality metrics required of all Pioneer ACOs from the Innovation Center.

With these goals in mind, Atrius hired an ACO Executive Director to coordinate and manage the interaction between participating organizations and facilitate Pioneer ACO efforts. The executive director then established clinical workgroups to focus on four areas:

  • hospital strategy;
  • post-acute facility strategy;
  • home care strategy; and
  • geriatric care model design.

Each workgroup established its own goals, but used common reporting and benchmarking standards to ensure accountability for the workgroup and the overall ACO patient focus. Then, to build and sustain momentum, Atrius Health also established a monthly event called “ACO Day,” where all clinical leaders come together for a half day meeting with updates on current activities, separate workgroup meetings a learning collaborative with best practice presentations and discussions on a specific topic.

Business Intelligence with Atrius Health – as a Pioneer ACO: The provider groups at Atrius Health pay a fee for centralized IT services, thus enabling efficient IT management and economies of scale for pricing and support. As indicated in the white paper, the centralized approach also allows for investment in tools that increase value of the data, a benefit not possible with data and funding segregated by provider practice or facility location.

“Anything that we do clinically has to be supported with the business, both with an operationally efficiency and cost perspective, but as well with patient experience,” says Dr. Joe Kimura Medical Director of Clinical Reporting and Analytics, Atrius Health.

Dr. Kimura thus identified four primary business markets, beyond the 33 quality measures all Pioneer ACOs must report.  Each of these markets – executive team/external partners; director and site-based administrators; physician and line managers; and patients – has a different level of maturity as well as needs for different types of data and access.  The white paper reviews these markets and details current and planned-for business intelligence activities at Atrius Health.

In managing its Pioneer ACO capabilities, Atrius Health has: 1) leveraged its physician practice expertise; 2) developed a centralized and supportive IT department with a complete EMR and supporting data warehouse; 3) used strong communication and internal coordination; and 4) worked with its external partners, including hospitals and skilled nursing facilities, to set consistent standards, for normalized patient care with other organizations, to reach patients wherever they need care.

“The Atrius Health ACO provides a good contrast to our research and publication on how Banner Health approached clinical and business intelligence within the Pioneer ACO program.  The organizations are quite different in focus, size, mission, and of course, the IT capital and resources they can access. Atrius Health uses astute negotiating with care partners combined with simple IT-based care coordination solutions to affect a dramatic, yet practical, impact on their ability to leverage clinical and business intelligence,” says James Gaston, Senior Director, Clinical and Business Intelligence, HIMSS Analytics.

Read Atrius Health, Pioneer ACO, Clinical Intelligence & Business Intelligence,the second white paper in the Pioneer ACO series from HIMSS Analytics.

About HIMSS Analytics

HIMSS Analytics is a wholly owned not-for-profit subsidiary of the Healthcare Information and Management Systems Society. The company collects and analyzes healthcare data related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions. HIMSS Analytics delivers high quality data and analytical expertise to healthcare delivery organizations, healthcare IT companies, state governments, financial companies, pharmaceutical companies, and consulting firms.  Visit www.himssanalytics.org/ for more information.

February 8, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Large Pioneer ACO Outlines Role of Clinical & Business Intelligence in Value-Based Care

CHICAGO (November 15, 2012) – As patient care models evolve to value-based care, clinical and business intelligence (C&BI) tools are playing a central role for organizations operating under new payment models. HIMSS Analytics published a new white paper titled “Banner Health Network Pioneer ACO Clinical Intelligence & Business Intelligence Approaches” that looks at how Banner Health Network is designing and implementing C&BI to effectively operate in a value-based care model.

Headquartered in Phoenix, Ariz., Banner Health Network (BHN) is one of 32 organizations selected in 2011 by the Centers for Medicare and Medicaid Services for its Pioneer Accountable Care Organization program. BHN stood out as a Pioneer candidate since it had experience coordinating care across multiple patient care settings. BHN expanded an existing ACO relationship with Aetna to include full technology and analytics support for its ACO patient populations. The report covers the results of in-depth interviews with BHN executive staff to explore the organization’s progress and multi-layered approach to C&BI.

Banner Health Network – the Organization: With the overall mission to provide excellent patient care, BHN followed three key drivers, identified as the “triple aim,” from the Institute for Healthcare Improvement. BHN had an existing infrastructure to support claims payment, medical management, customer service and other health-plan-like activities, which gave it several critical components needed to support the Pioneer ACO model. In addition, senior leadership viewed existing healthcare fee-for-service payment models as unsustainable. As noted in the white paper, “We are moving from an acute care system to a more comprehensive delivery system that is more viable and stable,” says Dr. Tricia Nguyen, Chief Medical Officer.

Clinical & Business Intelligence in Action: Because BHN is transitioning from fee-for-service payment and incentive methodology to a value-based methodology, physicians must receive the right information at the right time to drive more efficient patient care that results in higher quality outcomes.  Adhering to this philosophy, BHN used C&BI to:

  • Implement payment codes that encourage and reward physicians to spend more time reviewing patient risk scores and profiles based on data gathered from BHN information systems that inform physicians about the status of their patients.
  • Manage and refine communication with specialists to help motivate them to follow processes that align and coordinate patient care with BHN standards.
  • Leverage business intelligence to track gaps in care, healthcare risks, communication plan effectiveness, and to benchmark progress toward the desired change in physician and patient engagement.
  • Establish executive level support and leadership through a Business Intelligence Data Governance program, managed by the Executive Steering Committee, with clearly defined roles and responsibilities for each level of data governance to avoid information silos.

“Our research with Banner Health Network provides valuable insights into how this health system leverages clinical and business intelligence in transitioning to a new model of accountable care.  The BHN executive team supports the use of C&BI tools to better understand patient populations and offer patient-level care coordination with high-quality, standardized information,” says James E. Gaston, Senior Director, Clinical and Business Intelligence, HIMSS Analytics.

Collaboration for a Technology Solution:  At Banner Health Network, the distinction between clinical and business intelligence often overlaps, impacting business performance and optimizing patient care.  To better manage C&BI efforts, BHN expanded its existing ACO relationship with Aetna to include technology to better support its value-based care models and patient populations. This support covers population health management and patient services for more than 200,000 Banner Health Network patients, including more than 50,000 Medicare fee-for-service patients who are part of the Pioneer ACO savings program.

The Aetna Accountable Care Solutions (ACS) technology helps physicians see patient data at the individual and population level, and predict risk and opportunities for health and wellness programs. It also enables them to track, monitor, coordinate and report on patient health outcomes.  BHN provides physicians a comprehensive care management model supporting Pioneer ACO efforts so that patient engagement happens in a more meaningful way, including nursing home and palliative care. Using the Aetna ActiveHealth technology care management programs and outreach, BHN is at the early stage, but leading edge, of building and designing true population-based health management tools.

“Value-based care requires physicians to understand and impact the health of individuals and populations of patients, particularly those with chronic disease where intervention and management is key to better health outcomes and cost. The range of technologies from our Aetna companies complements Banner Health Network’s technology to empower full clinical integration and intelligence,” said Charles D. Kennedy, chief executive officer, Accountable Care Solutions from Aetna.

Read “Banner Health Network Pioneer ACO Clinical Intelligence & Business Intelligence Approaches” at www.HIMSSAnalytics.org/research on the HIMSS Analytics website. Contact James E. Gaston at James.Gaston@HIMSSAnalytics.org for more information on this research.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 37.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services and health information technology services. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com.

About HIMSS Analytics 

HIMSS Analytics is a wholly owned not-for-profit subsidiary of the Healthcare Information and Management Systems Society (HIMSS).  The company collects and analyzes healthcare information related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions.  HIMSS Analytics delivers high quality products, services and analytical expertise to healthcare delivery organizations, healthcare IT companies, state governments, financial companies, pharmaceutical companies, and consulting firms.  Visit www.himssanalytics.org for more information.

November 18, 2012 I Written By

Health Information Exchange Formation Guide Named HIMSS Book of the Year

Authored by executives from Mosaica Partners, a nationally recognized HIE consulting firm, the award-winning book is considered the essential guide to HIE formation and planning

ST. PETERSBURG, Fla. – March 21, 2012 – The Healthcare Information Management and Systems Society (HIMSS) has named The Health Information Exchange Formation Guide its 2011 Book of the Year.

The book and its co-authors, well-known health information consultants Laura Kolkman, RN, MS, FHIMSS and Bob Brown of Mosaica Partners, were honored on Feb. 23 at the HIMSS Awards Banquet, part of the 2012 Annual HIMSS Conference and Exhibition.

“Each year, the HIMSS Book of the Year award recognizes a book that offers outstanding practical guidance and/or strategic insight for healthcare information and management systems professionals,” said Fran Perveiler, vice president of communications, HIMSS. “Congratulations to authors Laura Kolkman and Bob Brown, winners of the 2011 HIMSS Book of the Year Award for their book, The Health Information Exchange Formation Guide: The Authoritative Guide for Planning and Forming an HIE in Your State, Region, or Community.”

Published by HIMSS in February 2011, The Health Information Exchange Formation Guide has received national acclaim for its practical approach to forming state-, regional- or community-based HIE organizations. The book leverages the insights Kolkman and Brown gleaned from their work with clients, as well as from extensive research and interviews with recognized HIE pioneers.  It provides the knowledge and tools that emerging HIE initiatives need to develop a framework for long-term sustainability.

“HIEs play a significant role in ACOs and new emerging care models and are a catalyst for transforming the nation’s healthcare system,” said Kolkman. “The problem is that many organizations and individuals do not know where to begin when planning an HIE. This book, based on our proven HIE Formation Methodology, gets them on the right path.”

“Over the past decade, we have learned about HIEs through the successes and failures of the front runners in exchange initiatives,” Brown added. “By applying these lessons, emerging HIEs can dramatically increase their odds of success, and establish their role in improving the overall efficiency of the healthcare delivery process, enhancing patient outcomes and significantly lowering costs.”

The HIE Formation Guide has garnered industry-wide praise for its structured approach that incorporates leading practices in the planning, formation and operational stages of HIE initiatives. In addition to a high-level history of HIE and in-depth discussion of its importance and role in transforming healthcare, the book includes a step-by-step guide, numerous case studies, examples, checklists and references.

The Health Information Exchange Formation Guide provides an excellent and diverse grouping of ‘pearls’ from recognized leaders within our industry,” said Dick Thompson, CEO of Grand Junction, Colo.-based Quality Health Network. “I recommend it for nascent as well as more mature organizations, since one never knows where one may find a pearl of wisdom that is applicable to a specific business problem.”

Adds MedVirginia CEO Michael Matthews: “This is an exciting and extremely critical time for health information exchange. The Health Information Exchange Formation Guide provides practical, real-world guidance on important issues facing HIEs today.”

The Health Information Exchange Formation Guide is an excellent resource for professionals and executives that are starting, developing or implementing HIE networks,” said Jeff Blair, director of health informatics at LCF Research, New Mexico Health Information Collaborative. “The Guide is so well-organized that it can be used as a comprehensive textbook, a reference to relevant case studies, or a quick reference guide to specific HIE topics. “

The Health Information Exchange Formation Guide is available for purchase in the HIMSS online store and as a HIMSS eBook. For more information, including the table of contents and chapter summaries, helpful downloadable figures and checklists, visit www.himss.org/hieformationguide.

About Mosaica Partners

Based in the Tampa Bay, Fla. region, Mosaica Partners (www.mosaicapartners.com) is a nationally recognized management consulting firm providing strategy, business planning, development and process optimization services related to health information exchange. Mosaica provides its services to the federal government, states, regions and communities as well as public and private companies with interests in healthcare informatics and health information exchange. In addition, Mosaica provides advisory services to hardware and software firms that are interested, or actively involved, in the health informatics or HIE market space.

March 27, 2012 I Written By

NHIN University is Now NeHC University!

National eHealth Collaborative dramatically expands education program

WASHINGTON, DC (May 9, 2011) – *Social Media News Release* – National eHealth Collaborative (NeHC) today unveiled NeHC University, a revamping and substantial expansion of its NHIN University program. NeHC University will move beyond the Nationwide Health Information Network, allowing stakeholders to explore the broader health IT (HIT) landscape and gain a more comprehensive understanding of the impact of HIT in transforming the American healthcare system.

“NeHC University classes will now range from introductory programs to in-depth programs and interactive briefings. We hope NeHC University will be a great forum for raising awareness of innovations and success stories in HIT,” said NeHC CEO Kate Berry.

NeHC University will offer:

  • HIT Orientation: NeHC presents an introduction to the HITECH Act, initiatives sponsored by the Office of the National Coordinator for Health IT (ONC), and a high-level view of the current HIT landscape in the U.S. This quarterly class is designed for stakeholders who are new to the HIT field, new to NeHC University, or just need a refresher on some of the HIT basics.

·       HIT Trends: NeHC will be joined by HIT expert and trends tracker Michael Lake to deliver a quarterly briefing on innovations, new developments, and trends in HIT. From discussions of major business and policy developments to updates on health information exchanges and HIT initiatives and how they are transforming healthcare financing and delivery, HIT Trends provides stakeholders with the opportunity to stay on the cutting-edge of the evolving health IT ecosystem.

·       HIT Policy and Standards Committees Quarterly Updates: NeHC will host a quarterly presentation by ONC staff to provide an update on the activities of the Federal Advisory Committees and workgroups. Classes will also serve to provide deep dives into particular topics of interest or aspects of the regulatory process. This class will encourage audience Q&A and actively solicit participant feedback.

·       Spotlight Learning Series: Each quarter, NeHC will offer two different three-class series designed to provide stakeholders with an in-depth examination of specific initiatives or issues in HIT. Each series will kick off with an introduction to the spotlight topic followed by more detailed discussions.

The opening Spotlight Learning Series will explore the vision for a Learning Health System, beginning with an overview of the vision and continuing to detailed discussions of the policy and technology frameworks necessary to bring a participatory rapid learning system to fruition.

The other Spotlight Learning Series this quarter will provide a comprehensive discussion on Accountable Care Organizations (ACOs), including an overview of the Affordable Care Act, an investigation of ACO core competencies and potential pitfalls, and a discussion about models for ACO implementation, pilot ACO lessons learned, and the future ACO environment.

·       Industry Leader Briefings: NeHC will host bi-monthly interactive discussions with leading HIT experts on hot topics and timely issues. These hour-long lunchtime seminars will feature high level discussions on key initiatives and offer stakeholders the opportunity to dialogue directly with some of the foremost thought leaders in HIT and health information exchange.

·       Guest Lectures: NeHC University will also offer special one-time programs on timely and relevant issues in health IT. Guest lectures will feature topics ranging from special industry announcements to discussions of recent policy or regulatory recommendations and decisions.

·       NHIN University: National eHealth Collaborative’s popular NHIN University, an ongoing webinar series focused on the Nationwide Health Information Network, will continue to be a premiere feature of NeHC’s education efforts. The NHIN University 300 series will continue as scheduled as part of the new NeHC University programming.

NeHC has recruited a number of renowned HIT thought leaders to serve on an Advisory Council for NeHC University. The Advisory Council will assist NeHC in identifying topics, and will serve as and help to engage faculty. “The expansion of NeHC’s education program is a welcome and exciting announcement given the rapidly evolving world of HIT,” stated Advisory Council member Adam Clark, Ph.D., a member of the ONC Health IT Policy Committee and Director of Scientific and Federal Affairs at FasterCures. “Education is a critical part of accelerating the adoption and implementation of health IT. The Advisory Council is proud to work with NeHC on this program and looks forward to assisting in the development of new classes.”

In order to support the continued expansion and production of high-quality education programs, some NeHC University classes will be offered for a nominal fee. Government employees and ONC grantees should contact NeHC at university@nationalehealth.org for special rates.

NeHC invites stakeholders to check out some of the new NeHC University offerings free of charge, including the first HIT Orientation: Welcome to NeHC University and the first Spotlight Learning Series – Spotlight on the Learning Health System.

For a full class schedule, detailed descriptions of upcoming classes, and information on how to register, please visit the NeHC University website at www.nationalehealth.org/NeHCUniversity.aspx.

About National eHealth Collaborative

National eHealth Collaborative (NeHC) is a public-private partnership that enables secure and interoperable nationwide health information exchange to advance health and improve health care.  Working in conjunction with its partners, NeHC engages stakeholders in a collaborative and consensus-driven way to realize common goals that lead to transformative change.  NeHC reaches broadly into all sectors of healthcare and health IT, employs open and inclusive methods, and makes its outcomes broadly available for continued improvement.  This philosophy and approach allows NeHC to offer a uniquely balanced perspective that leverages diverse points of view and provides the essential public-private platform for collaboratively pursuing solutions to universal trusted and effective health information exchange. NeHC is a cooperative agreement partner of the Office of the National Coordinator for Health IT (ONC) in the U.S. Department of Health and Human Services (HHS).

About NeHC University

National eHealth Collaborative’s NeHC University is a web-based education program designed to provide stakeholders with timely and relevant information on health information technology and health information exchange in the United States. By offering introductory programs focused on providing an orientation to health IT, as well as deep dives into specific health IT topics, NeHC University provides unique opportunities for interested stakeholders to learn about multiple health IT initiatives, programs, and trends all in one place.

May 11, 2011 I Written By

Patient-Centered Primary Care Collaborative, Commonwealth Fund, Dartmouth Institute release landmark consensus document on ACOs, medical homes

Better to Best represents unprecedented accord among stakeholders

 

Washington, D.C. March 30, 2011– New models of care, such as patient centered medical homes and accountable care organizations, must emphasize value-driving elements of advanced primary care–enhanced access, better care coordination, use of health information technology to support care transformation, and payment models that reward coordinated care. For the first time, stakeholders across a range of sectors have reached a consensus on how to make this happen.

The Patient-Centered Primary Care Collaborative, in partnership with The Commonwealth Fund and the Dartmouth Institute for Health Policy and Clinical Practice,has released Better to Best: Value-Driving Elements of the PCMH and ACO. The report was funded by the Milbank Memorial Fund.

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This document represents a powerful demonstration of solidarity among thought leadersfrom health plans, physicians, academics, employers, federal payers and consumers on how to make the medical home and ACO support better care forindividuals; foster better health for the community; and help reduce or control costs.

An advance media copy of the report is available for download here.

Better to Best was almost a year in the making and represents collaboration among some of the brightest minds across the public and private sectors. The collaboration culminated ina one-day gathering at a Consensus Meeting hosted Sept. 8, 2010, by the PCPCC and sponsored by The Commonwealth Fund and the Dartmouth Institute.The meeting fostered frank dialogue and robust discussion among its diverse participants-purchasers, providers, thought leaders and consumers of health care. By the end of the day, those gathered arrived at the core areas of consensus illuminated in the report, including:

  • The goals of both the medical home and accountable care organization are better care, better health and lower costs.
  • Improvement must be considered both in terms of lower costs and value to the consumer of care.
  • There is a critical role and need for ongoing reportable measurements that address these goals.
  • Payment systems need to change and a range of payment models should be tested.
  • Learning collaboratives and rapid learning environments are needed to establish an evaluation framework around these issues.

Each point of consensus includes specific recommendations and action items around policy, research and features to embed in federal demonstration projects. While some require development of new structures for measurement and evaluation, many build uponexisting efforts, such as aligning future iterations of federal Meaningful Use standards with health IT requirements associated with medical home recognition and future ACO regulations.The group has agreed to continue to work together in support of these shared goals.

The PCMHmodel incorporates the best evidence and the best ideas to drive value in the health care system. But the momentum propelling thePCMH cannot be explained by new ideas or new evidence alone. What is historic is the magnitude of the collaboration, said Paul Grundy, MD, M.P.H., IBM’s Global Director of Healthcare Transformation and president, Patient-Centered Primary Care Collaborative.

“It’s really powerful. It’s the first time there’s beensuch a broad agreement on a set of principles. There’s an understanding from providers about what they want to provide and a consensus among buyers that they want to buy what the providers are offering,” he said.”It is a national consensus across the broadest possible range of playerson a journey toward care that’s comprehensive, integrated, coordinated and accessible, versus care that’s episodic, dis-integrated, uncoordinated, inaccessible.”

“With passage of the Patient Protection and Affordable Care Act, we have entered a new era that will ensure health care security for all Americans by improving access, quality and efficiency in our system,” said Commonwealth Fund President Karen Davis. “This report indicates that key stakeholders are in agreement on the need to promote patient-centered, coordinated care through changes in the way we pay for and deliver care, and development of medical homes and accountable care organizations are mutually reinforcing models for achieving these goals.”

A time for action

Of the four value-driving elements identified in the report, two–enhanced access and care coordination–are elements of health caredelivery that require urgent overhaul to maximize health outcomes at lower costs. The others, health information technology and payment reform, areessential tools, without which widespread implementationof new care delivery models will not succeed.

The questions are: where and when. The answers that emerged from the September 8 meeting are clear: here and now.

Better to Best, and the consensus it reflects, lays the groundwork for achieving the Triple Aim: Improve the health of the population; enhance the patient experience of care; and reduce, or at least control, the per capita cost of care, said co-author Elliott S. Fisher, MD, M.P.H., whose 2006 article introduced the concept of the accountable care organization. “If we remain true to the agreement made in September and formalized in this document, we have the opportunity to help create an accountable, patient-centered system that not only enhances quality of patient care but controls costs.”

No longer is health care transformation simply an academic discussion; the evidence of success of the medical home combined with the need for accountable delivery system reform demands action, Grundy said. And Better to Best presents a call to immediate action. Just as important, it represents a new covenant between the buyer and provider, he said. “As a result, care is going to be better.”

To download a copy of the report, sign up here. Frequently asked questions are answered here.

About The Patient-Centered Primary Care Collaborative

The Patient-Centered Primary Care Collaborative is a coalition of more than 700 major employers, consumer groups, organizations representing primary care physicians, and other stakeholders who have joined to advance the patient centered medical home. The Collaborative believes that, if implemented, the patient centered medical home will improve the health of patients and the health care delivery system. For more information on the patient centered medical home and a complete list of the PCPCC members, please visit http://www.pcpcc.net.

 

April 12, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Sandlot to Debut Quality Reporting and Measures Application at HIMSS11


Community Quality Reporting and Measures Delivered

To Physicians at the Point-of-Care

Fort Worth, TX, Feb. 22, 2011 – Sandlot, LLC, a healthcare solutions company founded by practicing physicians, will debut SandlotQRM®, a quality reporting and measures application at HIMSS11, the prestigious annual conference for the Healthcare Information and Management Systems Society in Orlando, Fla. (Feb. 20 – 24, 2011). SandlotQRM helps physicians integrate care delivery and “move the needle” on quality as they transform their clinical practice in the new era of accountable care.

With SandlotQRM, physicians will have the tools they need to improve quality outcomes before, during, and after the patient’s visit. Physicians and other clinicians can:

  • Prospectively track patients falling outside care guidelines
  • Deliver care recommendations based on the patient’s electronic, longitudinal community health record at the point of care
  • Retrospectively monitor performance through the lens of HEDIS, PQRI, EHR Meaningful Use, and other measures.

SandlotQRM is integrated with SandlotConnect®, a health information exchange (HIE) solution developed and supported by Sandlot, LLC. SandlotConnect is a unique point of care solution – a blending of HIE technology with quality management tools – enabling healthcare providers to integrate care delivery and achieve measurable improvement in quality outcomes. SandlotQRM can integrate with any source of patient clinical information, including: HIEs, claims systems, or electronic medical records.

Until now, physicians and healthcare organizations relied on fragmented retrospective reviews of patient data to manage care. SandlotQRM will help ensure that doctors exceed their quality objectives by presenting patient-measures that are important to their specialty. The web tool enables physicians to determine what patients are not meeting the measures of quality care and allows doctors to take immediate action, such as: scheduling a diagnostic test, a procedure, e-prescribing or ordering a laboratory test. This will enhance the physician’s ability to treat patients more successfully at the point-of-care and increase patient satisfaction rates.

Sandlot’s quality module will also serve as a vital benchmarking tool for physicians. Doctors can determine how successful they are in meeting their quality objectives compared to national targets and other physicians utilizing Sandlot’s HIE application, SandlotConnect. This will be beneficial for doctors in helping them develop alternative protocols to provide better overall treatment plans and cost effective care for their patients. The current Centers for Medicare & Medicaid Services (CMS) incentive program in place will create increased demand for SandlotQRM.  Payments are rewarded to those physicians who satisfactorily report their specified measures during a reporting period.

The emerging era of accountable care induces hospitals and health systems to reduce costs and improve long-term financial objectives by participating in an accountable care organization (ACO). Based on the Patient Protection and Affordable Care Act (PPACA), an ACO is described as collaborations that include groups of healthcare providers, hospitals, and others. SandlotQRM is the cornerstone of an ACO because of the prospective, point-of-care, and retrospective quality measurement reporting that will support a profitable and sustainable patient care organization.

From a health plan perspective, Sandlot’s quality module will help insurers meet their business objectives. Insurers can meet their Med-Loss Ratio (MLR) requirements by utilizing its sophisticated data analysis and population reporting capabilities so they can be defined as a medical cost. To assist health plans in reaching CMS Five-Star status, SandlotQRM also provides analytical data on HEDIS measures. NCQA publishes the top 20 private health plans, with similar lists for the top 10 Medicaid and Medicare plans each year. HEDIS scores are a significant factor in ranking each plan.

SandlotQRM, will be available for limited live demonstrations February 20-24th at HIMSS11. iPhone and iPad applications will be available for clinical use once SandlotQRM is generally available March, 2011.

About Sandlot LLC

Based in Fort Worth, TX, Sandlot, LLC is an innovative healthcare solutions company founded by practicing physicians who pursue ways to make better clinical decisions at the point-of-care and collectively share clinical information. Sandlot focuses on advancing healthcare by using technology, process and people working together. It is a wholly owned subsidiary of North Texas Specialty Physicians (NTSP). The company’s innovative HIE, SandlotConnect® launched in 2008, is based on Lawson Technology and is currently interoperable with many of the market’s leading EHR systems, including Allscripts, NextGen, and eClinicalWorks.   For more information, visit www.sandlotsolutions.com.

February 22, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Senticare, Inc. Receives FDA Approval For New Pillstation Telehealth System

Senticare, Inc. Receives Fda Approval For New Pillstation Telehealth System Developed To Combat Congestive Heart Failure (Chf) & Other Chronic Disease Related Hospital Readmissions

Company’s New PillStation Medication Adherence System to Be Launched At Annual HIMSS Conference in Orlando From February 20 – 24

Southborough, MA, February 15, 2011 – SentiCare, Inc. today announced FDA approval for their PillStation, a revolutionary new Medication Adherence Telehealth System designed to reduce re-hospitalization and doctor visits. Developed with a focus to significantly lower complications and improve health by assuring medication compliance with significant cost savings for the healthcare industry, PillStation is designed to combat CHF and other chronic disease related hospital readmissions. Using patent pending technology, PillStation transmits images of patient’s medications from within their PillStation and works with patients on complicated medication regimens to be sure that patients can self-administer the correct medications at the correct time. The companies new system will be showcased this month at the 11th annual HIMSS conference and exhibition (Booth #4005) in Orlando, Florida from February 20 – 24.

The only telehealth system developed which aggregates a list of patient’s prescription drugs, and provides direct visualization of medication, PillStation’s unique technology platform provides clear images of the medications being loaded and takes up-to-date images of the prescriptions after each use. The images, along with other critical data, are sent to the SentiCare Advisor Center for medications management and monitoring 24 hours a day, seven days a week. Additionally, PillStation provides secure web access for real-time information regarding adherence and integrates with EMR/PHR services.

Studies show that approximately 29 – 47% of elderly patients with CHF are readmitted within three to six months of discharge and that approximately 125,000 Americans die each year due to Medication Non-Adherence, while almost 60% of the prescription Medication Non-Adherence problems could be prevented. Using proprietary hardware, software and call center protocols, SentiCare’s state-of-the-art technology is uniquely developed to address healthcare issues related to Medication Non-Adherence.  These issues, which result in rising cost and risk, especially with patients managing CHF and other chronic conditions, include:

• Forgetting to take medication

• Discontinuing or taking medication prematurely

• Not filling or refilling a prescription

SentiCare Receives FDA Approval Release / Pg. 2

• Taking incorrect medication

• Taking incorrect dosage

• Taking the right medication at the wrong time

• Double dosing to make up for a skipped dose

• Combining medication with inappropriate food or beverage

PillStation trials have achieved adherence levels on multiple medications of approximately 98%, compared to an expected baseline in equivalent patients of 40%.  Economic modeling shows that cardiovascular conditions such as CHF are especially likely to benefit from PillStation in terms of both quality and dramatically lowered cost. SentiCare’s new telehealth system offers substantial cost savings, which could result in saving millions of dollars per year, for hospitals, Accountable Care Organizations (ACOs) and physician groups.

“With recent healthcare reform and the advent of new models for healthcare delivery, including the establishment of ACOs, Medication Adherence and remote patient monitoring are emerging as some of the most important areas of healthcare innovation,” stated company co-founder, Yogendra Jain.  “IT models like PillStation, support new health care delivery systems like ACOs, where the exchange of data is critical,” he added.

Check out our website for an online product demo video or for more information or a real time demo on SentiCare’s new PillStation, stop by Booth #4005 at the HIMMS conference in Orlando from February 20 – 24, or call 603-929-6664 to schedule an interview.  HIMMS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare.

About SentiCare

Founded in 2008 and located in Southborough MA, SentiCare has developed a unique, solution to the serious and costly problem of Medication Non-Adherence.  Using proprietary hardware, software and call center protocols, SentiCare works with patients on complicated medication regimens to be sure that patients take the correct medications at the correct time.  Proper adherence leads to improved health outcomes, reduced hospitalization, reduced re-admission within 30-90 days after discharge, and significant cost savings for Healthcare and Senior Housing Providers.  SentiCare’s approach is unique and targets eight identified attributes that are the root cause of non-adherence. The PillStation product and service are in full production.  www.senticare.com

February 16, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.