Precision medicine, defined as a new model of patient-powered research that will give clinicians the ability to select the best treatment for an individual patient, holds the key that will allow health IT to merge advances in genomics research with new methods for managing and analyzing large data sets. This will accelerate research and biomedical discoveries. However, clinical improvements are often designed to reduce variation. So, how do systems balance tailoring medicine to each patient with standardizing care? The answer is precise registries. For example, using registries that can account for the most accurate, specific patients and disease, clinicians can use gene variant knowledge bases to provide personalized care.
Every hospital and health system has to juggle significant IT needs with a limited budget. In the middle of these demands and possibilities, hospital executives have to prioritize and decide which technology solutions are the most critical to the health of their organization. I call these most critical IT solutions “survival software.” Advanced clinical analytics solutions are the survival software of the near future, as they really hold the key to achieving the triple aim and survive value-based purchasing.
I am one of the brave souls who takes the time to read the report issued each spring by the Medicare Payment Advisory Commission (Medpac). The report shows the numbers of Medicare beneficiaries and claims are growing; healthcare organizations are increasingly losing money on Medicare; payment increases certainly will not keep pace with declining margins; and Medicare policies will continue to incentivize quality and push providers to assume more risk. But the report also reveals that some healthcare organizations—referred to as “relatively efficient”—are making money from Medicare with an average 2 percent margin. How do you become one of these organizations? And how do you target and counter Medicare trends that impact your business?
The Data Operating System (DOS™) is a vast data and analytics ecosystem whose laser focus is to rapidly and efficiently improve outcomes across every healthcare domain. DOS is a cornerstone in the foundation for building the future of healthcare analytics. This white paper from Imran Qureshi details the seven capabilities of DOS that combine to unlock data for healthcare improvement:
These seven components will reveal how DOS is a data-first system that can extract value from healthcare data and allow leadership and analytics teams to fully develop the insights necessary for health system transformation.
Health Catalyst Data Operating System (DOS) is a revolutionary architecture that addresses the digital and data problems confronting healthcare now and in the future. It is an analytics galaxy that encompasses data platforms, machine learning, analytics applications, and the fabric to stitch all these components together.
DOS addresses these seven critical areas of healthcare IT:
Healthcare data management and acquisition
Integrating data in mergers and acquisitions
Enabling a personal health record
Scaling existing, homegrown data warehouses
Ingesting the human health data ecosystem
Providers becoming payers
Extending the life and current value of EHR investments
This white paper illustrates these healthcare system needs detail and explains the attributes of DOS. Read how DOS is the right technology for tackling healthcare’s big issues, including big data, physician burnout, rising healthcare expenses, and the productivity backfire created by other healthcare technologies.
The effort to repeal and replace the ACA in 2017 failed, leaving the industry wondering if bipartisan healthcare reform is possible in today’s political climate. This article explains why it is possible, by taking a close look at why repeal and replace failed, and why the 21st Century Cures Act and MACRA have been successful.
To stand a chance of being successful, proposed bipartisan healthcare legislation will most likely have one (or more) of five features:
Driven by practical need rather than politics.
Focuses on cost control/cost reduction.
Targets areas that are expected to save money.
Doesn’t involve creating new programs.
Stabilizes the ACA.
There are many bipartisan healthcare legislation opportunities, from expanding the use of HSAs to innovation waivers; opportunities that won’t come to fruition unless the proposed legislation tackles practical problems.
The documentary, “A Coalition of the Willing: Data-Driven Population Health and Complex Care Innovation in Low-Income Communities” shows how precision medicine and care management can be effective tools for successful population health. The film highlights three programs that use data to hotspot populations of high-risk, high-need patients, and then deploy unique, targeted care management inventions. The documentary, which initially aired during the 2017 Healthcare Analytics Summit, presents hopeful solutions, scalable across diverse patient populations, that are leading to exceptional results and the future of healthcare transformation.
According to statistician W. Edwards Deming, “Uncontrolled variation is the enemy of quality.” The statement is particularly true of outcomes improvement in healthcare, where variation threatens quality across processes and outcomes. To improve outcomes, health systems must recognize where and how inconsistency impacts their outcomes and reduce unwanted variation.
There are three key steps to reducing unwanted variation:
Remove obstacles to success on a communitywide level.
Maintain open lines of communication and share lessons learned.
Decrease the magnitude of variation.
Evidence-based medicine is an important model of care because it offers health systems a way to achieve the goals of the Triple Aim. It also offers health systems an opportunity to thrive in this era of value-based care. In specific, there are five reasons the industry is interested in the practice of evidence-based medicine: (1) With the explosion of scientific knowledge being published, it’s difficult for clinicians to stay current on the latest best practices. (2) Improved technology enables healthcare workers to have better access to data and knowledge. (3) Payers, employers, and patients are driving the need for the industry to show transparency, accountability, and value. (4) There is broad evidence that Americans often do not get the care they need. (5) Evidence-based medicine works. While the practice of evidence-based medicine is growing in popularity, moving an entire organization to a new model of care presents challenges. First, clinicians need to change how they were taught to practice. Second, providers are already busy with increasingly larger and larger workloads. Using a five-step framework, though, enables clinicians to begin to incorporate evidence-based medicine into their practices. The five steps include (1) Asking a clinical question to identify a key problem. (2) Acquiring the best evidence possible. (3) Appraising the evidence and making sure it’s applicable to the population and the question being asked. (4) Applying the evidence to daily clinical practice. (5) Assessing performance.
Precision medicine processes, while involving genomics, are not confined to working with data about an individual’s genes, environment, and lifestyle. Precision medicine also means putting patients on the right path of care, taking into consideration other individual tolerances, such as participation and cost. Precision medicine processes incorporate data beyond the individual, pulling in socio-economic data, as well as relevant internal and external data, to create an entire patient data ecosystem. With reusable data modules, this information is processed within a closed-loop analytics framework to facilitate clinical decision making at the point of care. This optimizes clinical workflow, thus leading to more precise medicine.
U.S. healthcare is one of the most technologically advanced industries in the world, yet it has such a difficult time transforming some of its most mundane problems (cost, quality, and service). With these problems, we are not so different from many other industries, so we should be able to learn from the individuals and industries that have succeeded in finding answers. At the same time, we need to recognize that healthcare is incredibly complex, so we need to search within for barriers that prevent disruption and innovation. The future of healthcare lies in technology, but more importantly, in our ability to pave the way for its implementation starting right now.
Healthcare financial leaders will encounter a myriad of challenges and improvement opportunities in 2016.
2016 will force health system financial leadership to focus and prioritize, with challenges including increased healthcare spending, continued momentum toward value-based care, and the need to reexamine the revenue cycle after years of focusing so intently on ICD-10.
But 2016’s financial healthcare trends include more than just challenges; exciting opportunities abound, from using technology to engage patients to a national focus on population health.
Engaged healthcare financial leaders—particularly those with the characteristics of effective leaders (resilient, collaborative, and inspirational)—are positioned to stay ahead of the curve in 2016.
Healthcare organizations from Hamburg to Gothenburg to Boston are realizing the future of care delivery through a value-based approach, as portrayed in this video documentary featuring professor Michael Porter of the Harvard Business School. Measured Outcomes: A Future View of Value-Based Healthcare explains how value-based care is a methodology that involves standardizing outcome measurements, tracking them over the long term, and putting clinical teams in place with the longevity needed to build a sustainable program. More importantly, it is healthcare that matters most to patients because they report and track their own quality measurements, giving them a say in their own healthcare experience. Providers are winning, patients are winning, and the results for the organizations showcased in this video are remarkable, such as an 88 percent prostatectomy success rate for the Martini-Klinik in Hamburg, Germany, compared to a 32.8 percent rate for the rest of the country. And with just 10 surgeons on staff, they are doing more volume than any other facility in the world, by far, all attributable to their value-based approach.
Investment and innovation in healthcare is driven by health system providers partnering with entrepreneurs. During my time at venture capital companies, I saw how sharing risk could marry the concept of innovation with pragmatism. Health Catalyst uses Pragmatic Innovation as an operating principle. This is evident on a company-level and in the risks we take with our client-partners, such as Allina Health. Earlier this year, Health Catalyst and Allina Health announced an exciting innovation in healthcare: a true partnership to improve outcomes. Each party took a risk, and each will share in the improvements derived.
We sat down with Senior Vice President of Strategy, Dale Sanders, and asked him about healthcare reimbursements, risk models, and how physicians are handling these changes. Dale explains that reimbursements aren’t changing very fast. And in today’s risk models, there isn’t a lot of risk for providers or insurance companies. Good data and a strong culture around change are the best predictors of success. Federal ACOs have invested far more than they’ve recovered and few are willing to re-enroll in the ACO program unless major changes are made. As for looking at high-risk patients, most of the high-risk interventions have focused on preventable readmissions, motivated by CMS penalties. There seem to be two root categories for interventions: provider-centric (better discharge planning; scheduling follow-up visits at the time of discharge) and patient-centric (the socio-economic factors like transportation to care and lifestyle challenges). Finally, when data is introduced into a physician’s practice, most are surprised by how little they actually use evidence-based best practices.
I spent a few weeks this summer creating a documentary of the work of Dr. Devi Shetty. One of the most memorable moments of this experience was when I talked with Dr. Shetty himself while he was performing a heart operation on an 18-month-old boy. It was an enlightening and amazing time, where I fully learned why Dr. Shetty deserves the title bestowed on him by the WSJ, the “Henry Ford of healthcare.” His ultimate goal is to reduce the cost of heart surgery from $3,000 to $800 by evaluating each cost component. He has opened hospitals all across the world offering low-cost, high-quality care. Could this model work for the U.S.? It’s a wonderful thing to hope for.
Healthcare organizations are facing unprecedented challenges to improve quality and reduce waste. The traditional encounter-based delivery model is overwhelmed due to aging Baby Boomers and the increasing prevalence of chronic disease. To tackle these challenges, more disruptive innovation is needed in healthcare. We already have development of new diagnostic procedures, therapies, drugs, and medical devices, but healthcare needs more innovation around prevention and personalized care. Sensors, wearable technology, and big data offer ways for healthcare to start exploring new possibility and opportunities in this realm.
Vast new pools of patient data will become available to physicians over the next few years. This data will change our understanding of health and disease, providing a rich new resource to improve clinical care and maximize patient health and well-being. Three ways physician will use this data to drive transformation include: 1. Efficient and effective operations (reducing wasteful spending); 2. Manage population health; and 3. New technology-enabled care and personalized medicine. The impact of new data on healthcare costs will be immense.
Do you remember the inspirational documentary From the Heart? Well, Health City Cayman Islands is at it again doing free…
In April 2003, the Human Genome Project was completed and scientists gained the ability to read the entire genetic blueprint for human beings. Since that time, the cost of gene sequencing has fallen from $100 million to $1,000. By 2020, the cost is expected to be mere pennies. Using the power of genomes scientists have found genomic defects for more than 5,000 inherited diseases and are on track to uncover 4,000 more. The implications for treatment of disease are also vast. In the future, clinicians will be able to use genomic-powered personalized medicine to treat patients on an individual basis knowing exactly how their genes will react to treatments and what the best course of action will be.
The U.S. healthcare system faces a multitude of challenges, from an unprecedented growth in demand to widespread waste to serious quality issues. The healthcare resource consumption rate is expected to rise to almost 20% of the national GDP by 2022, threatening the nation’s economy. These realities mean that healthcare must emphasize value production and use more efficient care models to complement the traditional encounter-based care model. New technology-enabled care models are allowing care providers to remotely manage health problems and create better outcomes for patients with chronic conditions. Wearable sensors can collect information about a patient’s physiological condition, activity, behaviors, and environment and transmit it to providers, who can act proactively on health concerns before they become a bigger problem. All of this new type of data will require health systems to build analysis of Big Data into their core competencies.
Through a series of happy coincidences, when Dale Sanders was looking for the next move in his career, he ended up at the Cayman Islands Health Services Authority, and started on the path of an amazing story that we’ve decided to share through a documentary. You see, six months after starting as the CEO, he met Dr. Devi Shetty and his team from Narayana Health System in India. They had a unique proposition: built a 2,000-bed hospital, medical school, and long-term care facility in the Cayman Islands, based on the ground-breaking ideas that had worked in India, that could meet the need for high-quality, low-cost healthcare . In spring of 2014, Dr. Shetty and his team, in collaboration with the Cayman Islands government, Ascension Health in the U.S., and prominent businessman, Gene Thompson, opened the doors on the first phase of the project, a 200-bed hospital specializing in cardiothoracic and orthopedic surgery. The documentary describes how they are using many innovative approaches and data to drive out significant costs while maintaining high standards of quality, leading to what many are calling a truly “breakthrough” model for healthcare. Our mission at Health Catalyst is to transform healthcare, hence we wanted to share the amazing work Dr. Shetty and his team do in India, and now, in the Cayman Islands. Health Catalyst funded, produced, and directed this documentary, From the Heart, with no financial relationship and nothing to gain. We simply believe it is a story that must be told.
Technology is growing at an exponential rate and while healthcare has experienced some effects of this, nowhere is this more evident than in the field of health sensors. The Internet of Things is the idea of an ecosystem of devices that connect to software giving feedback and analytics on the person or object using the device. Clinically, this can mean improved monitoring of vital signs, infusions, etc. Outpatient care is also affects by sensors and has the potential to lower the annual costs of managing chronic diseases.
We are now experiencing the beginning of a true data-driven improvement revolution in healthcare. From germ theory in the 1870s to the use of randomized control trails in the 1970s, approximately every 50 years healthcare undergoes a revolution that fundamentally changes patient care and the way physicians practice. We are overdue to another revolution, but it’s starting with the trend toward the use of advanced analytics and the systemization of care.
Would customers go to a restaurant where they didn’t how much they owed until 90-days after finishing dinner? From workflow to customer service, see how a restaurant would operate if it were run by healthcare. Then ask yourself – why do we put up with this in healthcare if we don’t have to?