Category Archives: Events

HIMSS16 Trends: The Maturation of Population Health


Post by Scott McLeod


Director of Product Marketing, Caradigm

The educational sessions at HIMSS16 serve as a barometer of the progress of population health management as a priority for healthcare organizations.

This year, after three days of attending sessions, I note four key themes—

1) Current economic realities are driving new strategies

The changing market is not just a distant-future consideration. Payment reform from CMS and private payers is already occurring and will accelerate. Local markets—in which healthcare organizations must compete—face shifting roles and demands of employers and consumers. In one local market, a reported 75% of payments are tied to risk contract. Facing the fact that maintaining the status quo is not sustainable in the long term, organizations are setting new strategic directions that balance external forces and internal capabilities to achieve success under commercial and Medicare programs.

2) Collaboration is key

Healthcare organizations must work with others to realize the revenue under value-based reimbursement. This includes building relationships with non-contracted physicians and other (often competing) organizations to form accountable care organizations, clinically integrated networks or performing provider systems to provide the geographic coverage required for an assigned population. In addition, organizations are changing their relationships with employers and payers to seek win-win contractual arrangements that improve the quality of care for patients served and manage the costs for all stakeholders.

For example, Inova Health System and Aetna launched a joint venture to form a new health plan, Innovation Health, working together for improved care, cost and quality. Care coordinators steer members to appropriate programs and provide coaching. High-risk patients are enrolled in care management programs at post-acute facilities, and high-performing skilled nursing facilities (SNFs) are selected for inclusion on the network.

3) Results are starting to show

Population health initiatives seem to be more targeted and organizations are more specific about what they want to measure. The result is that—beyond reports of pilots and early steps—we are beginning to see tangible, positive results from these initiatives. The joint venture cited above has achieved a 17% reduction in the number of unnecessary hospital days after surgery, 15% fewer hospital admissions and 21% fewer hospital readmissions. As another example, Banner Health reported on the successes of its telehealth program: 20% reduction in length of stay, 45% reduction in hospitalizations and a 27% reduction in total cost of care.

4) Health Information Technology (HIT) is necessary for success

As the number of population health initiatives increases, and the number of at-risk lives grows, organizations recognize that HIT solutions are required to achieve the efficiency, effectiveness and scale that the programs demand. Successful organizations employ and rely upon solutions for data aggregation, risk stratification, analytics, interoperability and population health management. Staten Island PPS, for example, reports that each of its 11 DSRIP projects actively underway has unique HIT requirements for success including longitudinal patient records, predictive analytics and utilization management, telehealth and patient registries.

One other theme, that overlays the rest, became apparent during the educational sessions. The journey to population health management will continue, but the routes will change. What works today may or may not work tomorrow as the relationships among the different stakeholders shift.

Caradigm offers population health solutions that offer scalability and adaptability over time. You can have a discussion with a Caradigm representative by leaving a note here.

  1. “Value-Based Models: Two Successful Payer-Provider Approaches.” Clifford T. Fullerton, MD MSc and Mark Stauder. March 1, 2016.
  2. “Volume-based to Value-based Care at a Pioneer ACO.” Julie Reisetter, MS, RN. March 3, 2016.
  3. “Addressing the IT Challenges for a Startup DSRIP Program.” Joseph Conte, PhD(c). March 2, 2016.
  4. “Transformative Payment Models.” Jody White and Brian Sandager. March 1, 2016.

Leaning in on Population Health (Part 2): Caradigm Customer Summit 2015


Post by Christine Boyle


Chief Marketing Officer and Senior Vice President, Caradigm

On Day 1 of the Caradigm Customer Summit (CCS), we heard multiple provider organizations talk about how they are leaning in on population health, and are seeking to build the best practices and health IT to successfully scale their programs. On Day 2, we continued to explore the strategies and tools that can help organizations succeed with new value-based reimbursement models. Here are the highlights from another great day of learning at CCS.

Neal Singh Chief Technology Officer, Caradigm and Kendra Lindly VP, Global Product Management, Population Health and Analytics, Caradigm

Neal and Kendra provided insights into the overall vision of Caradigm’s product strategy as well as the collaborative development approach they take with customers. They also highlighted new applications and features that are in the roadmap across Caradigm’s four pillars of integrated solutions (Data Control, Healthcare Analytics, Care Coordination and Management, and Patient Engagement & Wellness).

Nicholas Greif, Project Manager Virtua and Jill Manz, System Integrator Virtua

Nicholas and Jill talked about how Virtua, a leading provider in South Jersey, is using Caradigm’s information security and population health tools to help improve patient care within their VirtuaCare ACO. They explained how over time, Virtua has continued to mature its population health IT infrastructure, and will be delivering actionable predictive analytics such as Sepsis risk scores to clinicians in their native EMR so they can take proactive action.

Federal and State Driven Programs Panel

Vicki Harter, VP of Care Transformation moderated a panel made up of John Supra from Greenville Health System, Scott Anderson from MyCareCoach and Todd Ellis from KPMG. They discussed how to succeed with the variety of Federal and State Funded programs that are available to providers today. The panelists agreed that although providers don’t have to have all the answers right now, they do need to start thinking about who they’re going to align and partner with, and how they’re going to get their hands on the right data and share it.

Michael Robinson SVP, Global Services, Caradigm and Mike Macedo Director, Application Services, Caradigm

The closing presentation was from Michael Robinson and Mike Macedo who talked about how to drive user adoption of new population health technologies. It’s an important consideration for providers when seeking new health IT because acquiring technology is only part of the journey. It takes deep collaboration between a technology partner and a provider to train and engage employees who are learning about new organizational strategies, workflows and IT systems. While it does take much effort to train users and drive adoption, Mike and Mike explained that the payoff is when employees become fully engaged in the process. They talked about the collective excitement that they’ve seen in recent customer deployments that energizes the entire organization. With that level of employee engagement, a provider is well positioned to succeed with their population health initiatives.

Day 2 also included more outstanding peer-to-peer discussion during roundtables on patient engagement, physician engagement and IT security organizational engagement. As mentioned in the Day 1 post, we’ll share best practices from those sessions in a upcoming blog series.

In addition to learning and sharing about population health, CCS is also about having fun and building relationships in the industry. It’s not always sunny in Seattle, but it always seems to be sunny during CCS. Our attendees were treated to a couple of beautiful days of weather on the Seattle waterfront, and were able to relax and get to know each other at evening events.

It was an amazing two days at CCS 2015. Caradigm is extremely proud to be collaborating with so many of the top provider organizations in the country and around the world. We look forward to helping our customers with their key initiatives as they continue to lean in on population health.

Wheel Cropped

The Seattle Great Wheel lit up in Caradigm mulberry.

Leaning in on Population Health (Part 1): Caradigm Customer Summit 2015


Post by Christine Boyle


Chief Marketing Officer and Senior Vice President, Caradigm

We were absolutely delighted to kick-off the 4th annual Caradigm Customer Summit (CCS) at the Bell Harbor Conference Center on the beautiful Seattle Waterfront. As healthcare continues its transformation to value-based care, gatherings like CCS are great opportunities for provider organizations to engage with peers who are on similar journeys to population health. In truth, population health is still so new that everyone is learning together. With over one hundred senior healthcare executives from leading organizations in attendance, CCS is a unique event focused exclusively on population health.

My main take away from the first day was that provider organizations are now further along in their journey to population health and are “leaning in”. The dialogue has matured from “should we do it” to “how do we optimize what we are doing”. The business decisions have been made, technology has been evaluated, and now it’s time to operationalize and scale efficiently. Here are some of the highlights from the day.

Michael Simpson Caradigm CEO Opening Welcome

“Every organization across the U.S. and the globe has to figure out how we make this journey to pop health work. We have a common goal.”

In Michael’s opening welcome, he shared a number of statistics that show that the growth in population health is real and that momentum is building. While technology barriers to population health and threats to information security also continue to be real, Michael talked about how Caradigm customers are progressing, and as a whole are leveraging Caradigm solutions to tap into data from over 150 different systems in over a billion patient encounters.

 

Angelo Sinopoli, MD VP, Clinical Integration & Chief Medical Officer, Greenville Health System

“The discussion used to be with the HR representative. Now the cost of healthcare has gotten so high, the discussion is with the CEO.”

Dr. Sinopoli explained that Greenville Health System views population health as the key strategy that will help them better serve patients while also helping them be a leading provider in the state of South Carolina. He also talked about why they formed their state-wide clinically integrated network, the MyHealth First Network and how they will drive care management best practices through the Care Coordination Institute, which leverages Caradigm’s full suite of solutions including Caradigm Care Management.

 

Marian Lowe, SVP of Payer and Employer Strategies USPI and Ashley Wise, VP of Strategic Systems USPI

“Population health for us is about how do we create a meaningful network of providers that improves patient care.”

Marion and Ashley detailed USPI’s journey to population health. As one of the largest network of surgical centers in the country, USPI realized that as their national network of partners started moving towards clinical integration and value-based care, USPI had to build the capabilities to support those activities. USPI then formed a clinically integrated network and an accountable care organization and are using Caradigm’s solutions to support those efforts with data aggregation and analytics.

 

Matt Stevens Advisory Board – Population Health and the Retail Revolution

“Providers are trying to provide the right care in the right location – achieve meaningful geographic reach and clinical scope.”

Matt Stevens from the Advisory Board shared industry insights about how the retail revolution in healthcare aligns with the movement towards population health. He explained that providers must win at two points of sale: 1) they must secure enrolled lives and 2) win share of volumes. In order to do so, they must form the right strategic network and gain the health IT infrastructure that can lower costs, manage populations, increase access and improve the patient experience.

 

Regina Holliday, Patient Advocate

“We are all patients in the end. This is where I take my stand.”

Renown patient advocate, Regina Holliday capped off Day 1 with a moving presentation about the patient information challenges her family faced while trying to receive care for a sick family member. As provider organizations seek to transform care models and improve the patient experience as part of population health efforts, Regina asked providers to take a patient-centered approach and include patients in the care team in order to best serve their populations.

Also on the agenda were several roundtable sessions where attendees engaged in peer-to-peer discussions on topics such as analytics, care and chronic condition management as well as health data privacy and security. In future blog posts, we will share some of the best practices that came out of those sessions. Thanks to our phenomenal guest speakers and customer attendees, it was an inspiring day of learning on the first day of the Caradigm Customer Summit. Check back tomorrow for a recap of Day 2!

Innovations in Population Health Management – a discussion at iHT2


Post by Michael Simpson


Chief Executive Officer, Caradigm

I had the pleasure of participating on a population health panel at an IHT2 conference held recently in Seattle.

As you’d expect, moderator Mark Hagland, Editor-in-Chief of Healthcare Informatics, drew on a variety of perspectives – primary care, public health, IT – from a variety of healthcare providers and vendors – to discuss what’s happening in population health management today and where we’re headed.

Some of the key Population Health points covered were:

  • Moving from episodic, single-patient care to managing the health of populations represents a seismic shift that will require many years and tremendous patience to achieve, despite widespread industry commitment and focus. It’s going to take many years, for example, for physicians to change their way of thinking from operating as individual problem solvers to serving as members of a broader care team. They’ll need evidence that team-based care works.
  • The ongoing debate about the pros and cons of electronic medical records underscores the need to significantly streamline clinician workflows and deliver IT solutions that work in a practical way. While a paper-based system might not measure up in terms of data quality, it’s a highly efficient way of capturing information. We need to find a way to maintain that level of efficiency with technology while improving data capture and quality.
  • Success in population health requires looking holistically at the lives of patients and populations – factoring in their social, economic and physical environments, not just clinical data. Time spent between a patient and a doctor in a clinic or hospital is extremely limited. The vast majority of what impacts a patient’s health happens elsewhere. We need to put the patient at the center, engage the patient in his/her care through creative approaches and incentives like games or competitions, and establish a comprehensive community health record, not just a personal health record or EMR. We need to make that community health record easily accessible by the entire care team, including the pharmacist, the behavioral health specialist, the care manager, the primary care provider, and equally important, the patient.
  • To make progress in population health management, healthcare organizations need to start small, focus on making an impact in a discrete area, and expand on that success. For example, a provider in Canada began their population health efforts by focusing on HIV-positive individuals. They set up one central resource to identify all treatment associated with HIV patients, connected databases, and proactively tracked when patients were diagnosed, how quickly they were linked to care, when they were put on Antiretroviral Drugs, etc., and helped them with housing needs.  Their approach can serve as an effective blueprint for managing the health of other populations.
  • Success in population health begins with collecting the right data and performing analytics to identify not just those patients that are costing your organization the most time and money today but those patients of highest risk of costing your organization the most next year. Once that risk has been identified, the extended care team can work together to address those patients’ needs proactively and keep them out of the high risk, high-cost category. Those analytics capabilities exist today.
  • Last but not least, while we’re all concerned about identifying and addressing gaps in care to achieve the highest level of quality possible, we also need to focus on revenue. If an organization can identify revenue opportunities, it can invest more in care optimization going forward. “Without income there are no outcomes.”

iHT2 Michael Simpson on Panel

2014 Caradigm Customer Summit Day 3: Demonstrating Progress with Population Health Management


Post by Christine Boyle


Chief Marketing Officer and Senior Vice President, Caradigm

On the final day of the 2014 Caradigm Customer Summit (see Day 1 and Day 2 recaps), we heard  customer speakers say that it’s critical to show progress quickly on your way to the strategic goal of population health management. First, Virtua Healthcare shared how they used Identity and Access Management to improve clinician access to data. In one specific workflow, they reduced the number of clicks needed from 60 to 13, which will have enormous impact given how many times every day that workflow is repeated. Provisioning of new users that used to take days can now be done in hours. These measureable results have driven higher clinician satisfaction scores and built momentum for additional projects that will continue to improve security, HIPAA compliance and patient safety.

We also had a great panel of providers share thoughts and recommendations from their experiences with population health. Everyone agreed that prioritization is challenging, but essential because no one has unlimited resources. You need to show quick wins to your leadership team as you progress to an overall vision. Data consolidation is often a logical starting point and viewed as a major win by leadership because of the known complexity around that. After that, the data can start to have an impact and you can choose between specific initiatives that fit your needs such as streamlining CMS quality improvement reporting, automating care management workflows, risk stratifying your patients, lowering readmissions, etc.

The transformation to population health management is not easy, but the promise of rewards is great. The good news is that you will be able to celebrate many smaller successes on the iterative journey to population health. Dr. Edelstein, CMO of Elsevier Clinical Solutions said on the first day of CCS that he entered healthcare to deliver quality. That’s what population health management and our industry is ultimately about, which is a vision worth striving for together.

It’s been a gratifying three days at CCS 2014. I thank our customers, guest speakers, and partners who traveled great distances to collaborate around population health here in Seattle. I look forward to celebrating the new success stories and learnings at the Caradigm Customer Summit one year from now.

Panel

“Innovations in Population Health Management” Panelists

2014 Caradigm Customer Summit Day 2: There Are Many Paths to Population Health


Post by Christine Boyle


Chief Marketing Officer and Senior Vice President, Caradigm

On Day 1 of the Caradigm Customer Summit (CCS), we heard about the journey to Population Health Management, and the collaboration that’s needed.

On Day 2, we explored in greater depth the variety of paths that healthcare delivery organizations can take to begin that journey. Population Health is not one size fits all. You need to tailor your strategy to your organization’s particular goals and areas of strength.

We heard presenters at the summit describe different paths to Population Health Management:

  • A clinically integrated network, Rush Health, talked about how they formed their Population Health strategy in response to their rapidly expanding network and organizational belief in differentiating on quality.
  • An integrated delivery network (IDN) with a high throughput care management team needs to get more efficient in order to improve quality and manage an even larger case volume in the future.
  • A multi-state organization, Healthcare Corporation of America, talked about the challenge of protecting immense amounts of data that needs to move frequently and yet still be easy to access for a growing network of clinicians.
  • An organization taking on risk for a population for the first time needs safeguards for overutilization.

These organizations share similar initiatives on their paths to Population Health. For instance, they have valuable data from a lot of different sources, but are looking for ways to get that data back into the EMR to help physicians at the point-of-care. In addition, many are considering a patient portal for Meaningful Use attestation, and are interested in new strategies that can actually work to modify patient behavior in a patient-centric model. Yesterday, we also heard about other specific initiatives such as data aggregation, readmissions management, predictive analytics, and quality improvement measures.

It’s no longer a question of whether you need a Population Health strategy, but rather which Population Health strategy will give your organization the best chance for success. The journey will vary from those who want to “dip their toe” into the population health waters to those who take a bigger plunge. Regardless, Caradigm has apps that can help your strategy succeed, show progress quickly and expand over time.

Day 2 of CCS was fantastic. Thank you to our fabulous roster of Day 2 guest speakers:

  • Hospital Corporation of America – Bobby Stokes, AVP Identity Management and Development Services
  • Rush Health – Theresa Burkhart, VP Data Management & Business Intelligence
  • Rush Health – Cynthia Jones, RN, MSN, MBA – Performance Improvement Nurse
  • Beacon Partners – Wendy Vincent, National Practice Director, Strategic Advisory Group
  • Elsevier Clinical Solutions – Dr. Peter Edelstein CMO
Bobby S

Bobby Stokes, AVP Identity Management and Development Services at Hospital Corporation of America

2014 Caradigm Customer Summit Day 1: Population Health Collaboration


Post by Christine Boyle


Chief Marketing Officer and Senior Vice President, Caradigm

Day 1 of the Caradigm Customer Summit is in the books and the message of the day was that population health management is about collaboration. Working together is critical for anyone looking to succeed in population health and transform healthcare. With 75 of the country’s leading healthcare delivery organizations in attendance, representing the care of 50 million patients, it was a remarkable group to collaborate with as presentations organically turned into discussions. Here are some highlights from the day.

Caradigm – Michael Simpson CEO Opening Keynote

“We’re on a journey together.”

Michael set the tone for the day and the summit by recognizing that population health is about collaboration. Healthcare organizations need to collaborate internally, with patients and with strategic technology partners. Population health technology partners need to collaborate not only with customers, but with other technology vendors in order to provide a complete, best-of-breed solution.

Billings Clinic – Chris Stevens CIO and Dr. Karen Cabell Associate Chief of Quality

“We picked Caradigm as a strategic partner, and that means something to us.” – Chris Stevens

It was great to hear the confidence in a collaboration partner from Billings Clinic, a recognized innovator in clinical quality, ranked number one in patient safety by Consumer Reports. Chris Stevens said that their organization found legacy systems like EMRs to be functionally immature for population health management. They could not provide a single source of truth and the data was constantly questioned.  Dr. Cabell talked about how the Caradigm Quality Improvement application is helping get “actionable and manageable” data in front of employees so that they can focus on quality, drill down to identify opportunities for improvement and lead process improvement initiatives.

Geisinger Health Plans – Janet Tomcavage RN, MSN – SVP and Chief, Value-Based Care Strategic Initiatives

“If you’re the best performing, patients will come. Let’s see who can deliver.”

Janet spoke about Caradigm Care Management, an application that Geisinger helped shape in partnership with Caradigm. The app gives them the opportunity to infuse different types of data across the care continuum to fuel a care plan. Janet said care managers can’t help but appreciate how the app helps them deliver better care to patients faster and with less effort on their part. The app has been rolled out to Geisinger’s entire 160 person case management team.

Elsevier Clinical Solutions – Dr. Peter Edelstein CMO

“I entered healthcare because I wanted to provide quality.”

Dr. Edelstein said physicians need more than just data collection. Data collection by itself is not going to improve the quality of care. Physicians are open to partners who can guide them to drive better care. At the end of the day, better healthcare should cost less.

The agenda also featured Caradigm’s talented product managers going deeper into specific population health apps such as Risk Management, Quality Improvement, Readmissions Management and Identity and Access Management, as well as laying out the roadmap into the future. Day 2 will feature even more apps, and we will be exploring each of these in the coming weeks on the blog.

The evening event was held at the Olympic Sculpture Park on the Seattle waterfront. With a lovely sunset and a view of Puget Sound as the backdrop, a good time was had by all.

A giant thank you to our phenomenal guest speakers. We’ll see you back here tomorrow for a recap of Day 2!

CCS_sculpturepark

Evening Event at Olympic Sculpture Park

2014 Caradigm Customer Summit Opens


Post by Christine Boyle


Chief Marketing Officer and Senior Vice President, Caradigm

We are absolutely thrilled to kick off the 3rd annual Caradigm Customer Summit today in beautiful, sunny Seattle. Over one hundred leaders from the top healthcare delivery organizations in the country are gathering to discuss and share ideas on the biggest ideas in healthcare: Population Health and Identity and Access Management. Given the amount of change and risk that healthcare organizations face today, we hope the Summit will help attendees chart the best path forward based on peer experiences and best practices.

Population Health in particular will be top of mind as a new and dynamic force helping healthcare transform from fee-for-service to value-based care. We are proud to have customers sharing their experiences about their journey through population health and discussing the applications they are using today. To cap off each evening, we’ll be hosting special events taking place on the picturesque Seattle waterfront.

Stay tuned over the next few days as we post daily recaps from the Summit.

Senior Vice President of Sales Steve Shihadeh with some happy attendees

Observations from iHT² Atlanta


Post by Sameer Bade, MD


Vice President of Clinical Solutions, Caradigm

The 2014 iHT² Health IT Summit in Atlanta was a great opportunity to share / learn about the current state of population health management experiences from a number of amazing health systems and their leaders in the southeast US.  Below are a few of my observations and take-aways:

Focused on delivering the Triple Aim, the participating organizations are managing risk in different ways (ranging from pay for performance, bundled payments, shared savings, ACO arrangements and capitated risk). Represented at the meeting were Integrated Delivery Networks, post-acute care organizations, telehealth service providers, the CDC, CMMS, and vendors providing various software, infrastructure, and consulting services supporting population health. Dr. Kevin Fickenscher’s keynote set the tone of the meeting, declaring ‘Profession-Centric’ (the ‘guild’) healthcare delivery is being replaced by a systems-centric approach to healthcare delivery. Clearly, a new era of multi-disciplinary teams managing the care and wellness of populations (‘Team-Based Care Continuum’) is emerging as a replacement.

Some key observations presented during the panels, talks, and group discussions reflect the increasing experience of healthcare organizations as they deliver on the objectives of the Triple Aim:

1. Analytics are necessary (gaps in care, prospective, predictive, risk, etc.), come from many different sources (several are external to the EMR), and need to be easily accessible. Some analytics are based on claims, others are purely based on clinical EMR data, and a few are emerging from combined data sets. Unfortunately, with all of these different sources, there is not a single analytical view of a patient. Furthermore, to access these analytics, providers and care managers have to examine multiple ‘lists’ from multiple different analytic and reporting tools. Health system leaders from Carilion, BayCare and Carolinas, all expressed a requirement that gaps in care, risk, and cost data need to be easily accessible by clinicians. Dr. Kristyn Greifer, VP of Population Health Management for WellStar, also observed that access to real time analytics are a necessary part of care delivery.

2. Patient Centered Medical Homes have been deployed to ensure the best care is being delivered to patients with single or multiple chronic diseases. However, there is an experience that the use of registry tools in conjunction with the EMR can lead to increased utilization without major changes in clinical outcomes. To achieve the necessary outcomes, health systems need to identify patients who need/can benefit from comprehensive plans of care coordinated by care managers. Carilion Clinic has invested extensively in EMR infrastructure, registries, an EDW, and multiple analytic tools. Dr. Stephen Morgan, Sr. Vice President and CMIO, shared their approach of investing in more care managers and the arduous task of crafting care plans within the EMR. An interesting discussion with the audience explored that pursuing population health activities can have a definite impact on hospital volumes and profitability. Clear challenges exist in the transition from fee for service to fee for value, but one thing is clear, Carilion Clinic is working to deliver on their Triple Aim oriented Vision 2017 of “We are committed to a Common Purpose of Better Patient Care, Better Community Health and Lower Cost.”

3. Traditional patient portals are good, but there is a need for deeper engagement. Groups of patients are wanting to understand their plan of care, message their providers, and participate in programs to monitor their chronic conditions. The adoption of “Blue Button” is increasing and there is a need for shared decision-making tools, patient reported outcomes, and access to specific types of analytics. These types of tools could help to increase patient engagement. Another key issue identified was ‘portal sprawl’ or ‘portal fatigue.’ Some health systems are now just saying ‘no’ to the portals that health plans wish to deploy as part of an ACO arrangement and prefer to stick with a single portal experience for their patients.

4. Health Information Exchanges are evolving. Some of the organizations are now in their second and third rounds of participating in health information exchanges. Baptist Pensacola is participating in a truly unique exchange with a local competitor, the military, the VA (opt-in), and a local Skilled Nursing Facility. The Baptist CIO, Steve Sorros, shared that the exchange is helping ambulatory clinics deliver more informed care to our uniformed personnel and veterans. Future business drivers to create sustainability for local exchanges will leverage the ‘last mile connectivity’ created as a result of this exchange (results delivery, sharing care plans within a clinically integrated network, payer participation for sharing data, alerts, etc.).

5. Telehealth – One provider of remote care services, the Global Partnership for Tele-health, provided more than 140,000 remote encounters last year (focused in Georgia and Alabama) and is anticipating that number to exceed 200,000 this year. That’s starting to approach the number of in-person ambulatory encounters seen by smaller health systems. Cleveland Clinic has integrated home monitoring devices with traditional care programs, and is considering further expansion using Microsoft HealthVault-connected devices. In a note of caution during his presentation on ‘big data,’ Dr. Ryan Uitti, Deputy Director of the Mayo Clinic Kern Center for the Science of Health Care Delivery, shared findings from a 2012 study of 205 elderly patients with multiple co-morbidities which showed “no difference in combined hospitalizations and ED visits between patients receiving tele-monitoring vs. usual care.”1 He also shared information on a new application Mayo has developed called “AWARE” to support active surveillance and situational awareness of critical care patients. The initial evaluation of the application indicates a decrease in cognitive overload for clinicians, a decrease in errors, and a decrease in the amount of time spent looking for data or performing tasks. These varied experiences indicate that additional technologies (and services) need to be applied to the right populations, at the right time, and with the right supporting clinical programs.

6. Retooling your People – West Georgia Health’s CIO, Sonya Christian, their CFO, Paul Perrotti, and Director of Nursing, Tracy Gynther, made one thing very clear: Their people (employees, nurses, and doctors) are their most important asset as they improve and evolve their services. Despite providing 85% of the care in their market, the health system is investing in re-tooling their staff, increasing staff participation, promoting new efficiencies through the application of lean production methods, a system-wide focus on patient safety and multi-disciplinary teams.  Five years without a single Ventilator Acquired Pneumonia episode required a relentless multi-disciplinary collaboration between physicians, nurses, and respiratory therapists. As health systems prepare to embark on increasing population health activities, the engagement (and collaborative ownership) of all staff across multiple settings of care is required for success.

What has your organization done in these areas? Are you integrating external analytics into your EMR? What types of tools are you using for performing care coordination and care management? In future blog posts, we’ll explore each of these areas in more detail.

iHT2 Cropped

(1) Takahashi, Paul; Pecina, Jennifer; et al, “A Randomized Controlled Trial of Telemonitoring in Older Adults With Multiple Health Issues to Prevent Hospitalizations and Emergency Department Visits.” Arch Intern Med. 2012;172(10):773-779.

Emerging Themes at HIMSS14


Post by Scott McLeod


Director of Product Marketing, Caradigm

I attended the annual conference of the Health Information Management Systems Society (HIMSS) in Orlando, Florida. Boasting 38,828 attendees, HIMSS is the largest health IT show in the country.

Attending educational sessions and touring the mile-long exhibit floor, one could identify the concerns and priorities of providers and vendors. Key drivers discussed included accountable care, big data and business and clinical intelligence; many vendors made claims of “population health” solutions, if they could address even a small part of a customer’s needs.

I believe the industry will have a bit of a shakeout as the market identifies those vendors that deliver the data control, broad analytics and care solutions needed to succeed in population health.Two emerging themes, in particular, caught my interest—an emphasis on patient engagement and a gap separating population-health pioneers and vendors from the market majority.

In presentations and through Twitter (HIMSS reported 63,839 tweets during the show) attendees discussed various aspects of patient engagement. One thread discussed the provision of more information—presenting quality and cost delivered by organizations—to enable and prompt consumers to make better healthcare decisions. Another thread discussed the need to support family caregivers—the least expensive healthcare providers we have. What struck me is the emerging expectation that consumers must shoulder the twin burdens of making appropriate cost/quality decisions and an increased reliance on self-management or family care for their health. For a population that has looked to providers to make healthcare decisions and deliver care, this change may run into resistance—and, according to a HIMSS Leadership Survey, only one percent of organizations identify “Consumer Healthcare Solutions” as a top IT priority over the next two years.

While signage on the exhibit floor promoted solutions for population health and advanced analytics as the solutions de jour, the topics of many educational sessions communicated a different place on the path to value-based care. A few sessions presented the learning of accountable care organization (ACO) pioneers. Many others, however, discussed other priorities—Meaningful Use, quality measures, health information exchange, electronic health records, HIPAA compliance and ICD-10 transition. This is consistent with the HIMSS Leadership Survey which identified “Achieve Meaningful Use” (25%), “Optimize Use of Current Systems” (19%) and “Complete ICD-10 Conversion” (16%) as three of the top four IT priorities over the next two years. “IT Support for Risk-Based Contracting” placed in a distant sixth place with only 3% of organizations naming it a priority.

What this shows is that healthcare delivery organizations have more on their plates than a transition to value-based care. When they have the capacity to make that transition, and make the IT investments necessary to support population health, a role will exist for analysts and vendors and pioneers to help guide that transition. As one presenter stated, “the success or failure of a nationwide transition to value- based care hinges on the ability of hundreds of ACOs to learn very quickly from others.”

HIMSS14 Convention Center