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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

Montefiore Medical Center Attests, Embracing GE Healthcare for Inpatient & Outpatient EMR

GE Healthcare announced Montefiore Medical Center as the first enterprise to implement GE Healthcare’s meaningful use-certified EMR solutions across inpatient and outpatient settings. Through this deployment, Montefiore has met all the criteria for meaningful use and has attested.

Montefiore is a distinguished academic medical center committed to delivering high-quality patient care to a large urban community. The implementation of GE Healthcare’s EMR products (Centricity Enterprise and Centricity EMR) at Montefiore has enabled system-wide coordination of care for all patients. This coordination of care means that, for example, when a patient is admitted to the ER clinicians can have immediate access to a medical history and knowledge that helps enhance patient care through informed decision-making. This doesn’t just matter to clinicians. It matters to patients.

As an increasing number of organizations move towards meeting the criteria to achieve Meaningful Use, Stage 1, Montefiore provides a real-world example of the benefits of this critical integration of technology.

Recent Activations of Centricity* Enterprise and Centricity EMR Position Leading Healthcare System to Support Meaningful Use Stage 1

GE Healthcare, a global leader in healthcare information technology, today announced that Montefiore Medical Center, Bronx, NY, has met all the criteria, and attested, for Eligible Hospital Meaningful Use and is now using Centricity* electronic medical record (EMR) solutions for both inpatient and outpatient settings. The distinguished academic medical center, consistently ranked among America’s best hospitals, is the first enterprise to implement GE Healthcare’s meaningful use-certified EMR solutions across its ambulatory and hospital settings.

By deploying the advanced capabilities of Centricity Enterprise 6.6 and Centricity EMR 9.5, Montefiore is enhancing patient care, while positioning its hospitals and eligible providers to be well-positioned to meet “meaningful use” requirements set by the federal government. Meeting these requirements, including e-prescribing, sharing electronic health records and measuring quality outcomes, makes Montefiore eligible for federal incentive payments.

“We are pleased to announce that Montefiore has successfully completed our `Eligible Hospital Attestation’ using Centricity Enterprise. By achieving meaningful use criteria through the use of system-wide electronic health records to coordinate the care of every patient at Montefiore, we will harness the power of information technology to deliver the highest quality of health care,” said Jack Wolf, Vice President and Chief Information Officer at Montefiore. “We continue to work closely with GE Healthcare as we move forward. These are complicated requirements, and planning our readiness and implementation strategy requires a great deal of collaboration and expertise.”

Looking toward the future, Montefiore plans to implement additional Centricity solutions and partner products to expand its use of secure clinical messaging, in support of its enhanced patient portal services.

Recently, Montefiore was one of 32 health care organizations in the country named by the Centers for Medicaid and Medicare Services as a Pioneer Accountable Care Organization, the first federally-sponsored accountable care program that incentivizes providers to improve health outcomes for patients while also controlling costs.

“Montefiore has long been a leader in the use of information technology to advance care, and shares GE Healthcare’s vision of using care management tools to improve quality, access and outcomes while controlling healthcare costs,” said Jim Corrigan, Vice President and General Manager of GE Healthcare IT, Americas. “We are thrilled that our portfolio of certified EMR solutions is supporting Montefiore’s readiness to receive stimulus reimbursements, while continuing to play a key role in its ability to deliver higher-quality care to a large urban community.”

For more information on Montefiore Medical Center and its attestation, including videos of senior leaders talking about the benefits of Centricity EMR, please visit: http://newsroom.gehealthcare.com/Montefiore-medical-center

Centricity Enterprise is an integrated clinical, financial and administrative solution targeting large hospital systems.  Both Centricity Enterprise 6.6 and 6.9 have attained 2011/2012 ONC-ATCB certification as complete EHRs from the Drummond Group Inc**.

Centricity EMR is an ambulatory electronic medical record solution used by more than 30,000 clinicians around the world.  Centricity EMR version 9.5 is 2011/2012 compliant and was certified as a Complete EHR on October 28, 2010 by the Certification Commission for Health Information Technology (CCHIT ®)***.

CCHIT and The Drummond Group made these designations in their capacities as Office of the National Coordinator – Authorized Temporary Certification Bodies (ONC-ATCBs) in accordance with the applicable eligible provider certification criteria adopted by the Secretary of Health and Human Services (HHS).

2011/2012 certification conferred by these agencies does not represent an endorsement of the certified EHR technology by HHS nor does it guarantee the receipt of incentive payments.

ABOUT MONTEFIORE MEDICAL CENTER:

As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Recognized among the top hospitals nationally and regionally by U.S. News & World Report, Montefiore provides compassionate, patient- and family-centered care and educates the healthcare professionals of tomorrow. The Children’s Hospital at Montefiore is consistently named in U.S. News’ “America’s Best Children’s Hospitals,” and is second among those in the New York metro area. With four hospitals, 1,491 beds and 93,000 annual hospital discharges, Montefiore is an integrated health system seamlessly linked by advanced technology. State-of-the-art primary and specialty care is provided through a network of nearly 100 locations across the region, including the largest school health program in the nation and a home health program. Montefiore’s partnership with Einstein advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. The medical center derives its inspiration for excellence from its patients and community, and continues to be on the frontlines of developing innovative approaches to care. For more information please visit www.montefiore.org and www.montekids.org and follow us on Twitter @MontefioreNews

ABOUT GE HEALTHCARE:

GE Healthcare provides transformational medical technologies and services that are shaping a new age of patient care. Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost. In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implement a successful shift to sustainable healthcare systems.

Our “healthymagination” vision for the future invites the world to join us on our journey as we continuously develop innovations focused on reducing costs, increasing access and improving quality around the world. Headquartered in the United Kingdom, GE Healthcare is a unit of General Electric Company (NYSE: GE). Worldwide, GE Healthcare employees are committed to serving healthcare professionals and their patients in more than 100 countries. For more information about GE Healthcare, visit our website at www.gehealthcare.com.

February 17, 2012 I Written By