Meaningful Use

Archive for Meaningful Use

Health Care Innovators’ Uphill Climb

The Healthcare Innovators Collaborative and Cambia Grove have joined forces to present a series of talks on our evolving healthcare challenges.

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This series was run out of University of Washington last year, and this year’s sessions, subtitled “Under the Boughs” are held at Cambia Grove – where a new Sasquatch In Residence (SIR) ensures that the patient voice is present in the conversations.

September’s session took off with Dr. Carlos A. Pellegrini, Chief Medical Officer of UW Medicine, discussing the shift to value-based care. Pellegrini defined UW’s transformation as a process with 6 key goals:

  1.  Standardization

Standardization improves efficiency and is key to reducing cost and improving outcomes. Today, surgeons performing surgery at different hospitals may have varying tasks per hospital. Patients may receive different instructions depending on which physician or department they interact with. As a result, it is difficult to compare outcomes or optimize clinical workflow without a form of standardization.

      2. Population Health Management

Using system data to anticipate patient needs before they become major problems can both improve care and lower costs.

       3. Medical Home 

Implementing the medical home model can allow providers to be more aware of all of their patients and manage them proactively in measurable groups.

       4. Clinical Technology

Better use of clinical technical systems and of technology generally will enable more efficient and proactive patient care.

Dr. Pellegrini suggested they need to identify which patient was calling and suggesting the care they needed. For example “It’s Linda Smith, and she’s due for a mammogram.”

       5. Risk Management

“The Healthy You” – Sending better information to clinicians can help keep patients healthy, such as regarding activity level for obese patients.

        6. Smart Innovation

In contrast to standardization, consider opportunities to   customize experience/treatment for patients to deliver personalized and targeted care.

Understanding and measuring outcomes is also seen as key to approaching this evolution. Still, it was pointed out that providers, payers, and patients all understand a positive outcome differently. For example, for a provider the outcome is usually functional, for a payer or employer the outcome is financial, and for the patient it is often quality of life.

Only when these three outcomes are considered at once can we have true value-based experiences.

While Dr. Pellegrini and interview Lee Huntsman lamented the fact that US healthcare is ten times as expensive as other models, like the UK’s system, at present only 3% of UW Medicine’s revenue comes from value-based models, and it costs them $200M per year to maintain EPIC.

With numbers like this, the shift to value-based care has some big uphill battles. Keep fighting the good fight everyone, we know that the burgeoning health community in Seattle and the Cambia Sasquatch will!

Posted in: Healthcare Research, Healthcare transformation, Meaningful Use, Outcomes, Patient Advocacy, Seattle

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Does Healthcare Need a “Call to Minga”?

ihi-logoIn the most recent months, I have experienced a lot of “firsts” since I have joined Wellpepper. Although still in healthcare, I have ventured into the patient engagement space which has opened up a whole to new world. This technology is evolving in the marketplace with the charter of quality, value and engagement, specifically around the patient. This is one of the reasons why I joined Wellpepper…..we are about improving the patient experience.

Attending the Institute for Healthcare Improvement National Forum in Orlando (IHI) last week was another “first”. This conference was focused around how we change and improve healthcare for the patient. There was a real sense of community at this conference among the attendees. Everyone was focused on the patient and how to better serve and improve outcomes.

Unlike other conferences I have attended, I was able to participate in several sessions. Even though we exhibited at this forum, attending the sessions provided me with a different perspective on what healthcare professionals are really concerned about and how they are looking to learn from others on how to “fix” it. Again, another “first”.

The atmosphere at the conference was very upbeat and optimistic but there is a transition happening at the helm of IHI. Maureen Bisognano, President and CEO for the last 12 years, she will be retiring after 27 years at IHI. She gave the opening keynote which was very inspirational and echoed the commitment of IHI to improve the quality in healthcare for the better of the patient. Her theme was all about collaboration among the healthcare teams to give care with the patient and not just to the patient. Quality should be everyone’s job and that is why they developed the Breakthrough Collaborative at IHI. This brings together patients, families and health systems to improve the care.

We need to understand what matters to the patient and not what we think matters. In the session, “Thriving in a Value-Based Environment”, Anna Roth, CEO of Contra Costa Health Services, emphasized what matters to patient might not be their health problem but their ability to buy food, pay rent, and job security. So value for that patient goes beyond addressing their health issue but rather access to other life sustaining needs. Furthermore, when you engage with your patients be prepared to act. Lisa Schilling from Kaiser added during this session – “find the problems that really matters and then find an elegant solution”.  This can lead to innovation both from a technology perspective and re-design of care plans for that patient community. As an example, physicians are now prescribing community parks as part of their treatment plans to help address obesity and get their patients moving.

This theme echoed with the other keynote speakers such as Earvin “Magic” Johnson. He was on course with his message of bringing together a sense of community to improve healthcare access and services in the urban cities. He stressed people can make a difference if we just listen to what matters to the community. He has engaged with many charities to address the food deserts that plague our urban cities.  Providing better options to fruits and vegetables will result in healthier communities.

However, the keynote from Craig Kielburger really hit home for me. Craig is the co-founder of Free the Children, an international charity; Me to We, an innovative social enterprise; We Day, a signature youth empowerment event. His journey to where he is today started when he was 12 years old. He was touched by a tragic event with a young Pakistani boy by where he felt compelled to make a difference in children’s lives. Today, he is building schools and empowering our young to make a difference.

So what has this got to do with a “Call to Minga” and healthcare? Craig experienced a “Call to Minga” for the first time more than a decade ago when he and his brother Marc (co-founder of Free the Children) went to Ecuador to build a school with volunteers. Given unforeseen obstacles such as transportation for building materials was difficult and the time to transport was longer than anticipated, his team was falling short of completing the school….in fact, they didn’t even get a chance to start it.  They were two days from traveling back to North American when he and his brother had to explain to the Chief of the village that they would not be able to complete their task. At that moment, the Chief went outside her hut and called “Minga”. The next day, people from surrounding villages ascended upon this village and began to work on building the school and completed it. The “Minga” was a call to action. It is a community coming together to work for the benefit of all.

This is what was happening at IHI, a call to action. We must come together as a healthcare community and work to improve healthcare for patients and overall, our country. Our community consist of caregivers, educators, innovators and the patient. With all the resources available to us, we can have a “Minga” moment. Here at Wellpepper, our “Minga” moment is now. Health systems are hearing the call to action to engage their patient in a fashion that supports their live style along with the technology they use every day.  Our technology allows patients to personalize their care plans that will drive ownership and improve outcomes because we are able to provide them with what matters. This is a “first” for the patient!

Since this is probably my last blog post of 2015, I invite you to consider your call to Minga at your organization for 2016. There is so much we can do together!

Posted in: Health Regulations, Healthcare Disruption, Healthcare motivation, Healthcare Policy, Meaningful Use, Outcomes, Patient Satisfaction

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HIMSS Federal & Stage Public Policy Update

Speaker:  Jeffrey R. Coughlin, MPP
Senior Director, Federal & State Affairs
HIMSS North America

This luncheon appropriately took place in the relatively new and beautiful Alder Commons Auditorium on the University of Washington Campus. Jeff briefed me (I cannot speak for others in the room) on Meaningful Use current events (what CMS expected upon inception and the reality of now) and the new incentives to push interoperability. I graduated from UW with a degree in Clinical Informatics in 2011 when CMS was just rolling out EHR incentive program, now 4 years later it is an interesting perspective, the positivity outlook I once saw is fading. In 2011 CMS estimated by 2019 that 100% hospitals and 70% professionals would be utilizing EHRs. As of June 2015 537k eligible professionals and 48 hospitals registered for Medicaid/Medicare incentives; a whopping 31 billion incentives were paid out. With all that money paid, it raised question of what was actually bought with those dollars with only 48 hospitals registered. I am sure Congress and the House will try very hard to find this out exactly!

I know that the carrot and stick approach to EHR incentive payments are producing results in regards to getting eligible professionals and hospitals to get on board with Meaningful Use (MU), I am more drawn to the value of care improvement I can see myself in the works; interoperability. Jeff talked about this subject as well with more interest and I sat up in my chair. After the slides he presented on numbers/facts interlaced with disappointment that CMS is no doubt feeling over MU and EP/Hospitals are actually frustrated by, the subject matter of interoperability I was very happy to see. The Office of the National Coordinator for Health IT (ONC) defines interoperability “… as the ability of systems to exchange and use electronic health information from other systems without special effort on the part of the user.” I believe that EHRs are worthless without the ability to follow patients throughout their lives; we are no longer born, live and die in the same town, even less so go to the same doctor, hospital or clinic our entire lives. Therefore it is more important than ever for the 2015 Interoperability Standards Advisory to “…coordinate the identification, assessment, and determination of the best available interoperability standards and implementation specifications for industry use toward specific health care purposes.” Please check out this wonderful graphic that very nicely lays things out.

Jeff’s closing remarks were centered around how important it is for us to advocate the role Health Information Technology has on creating a healthcare system based upon patient centered care and with National Health IT week coming up October 5-9 what better time to knock on your senators door. Also the HIMSS policy summit is October 7-8 and you can sign up for early bird registration until Sept. 10th.

Posted in: Health Regulations, Healthcare Policy, Healthcare Technology, Interoperability, Meaningful Use

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