Data-Driven Approach Successfully Engages Orthopedic Surgeons in Decreasing Opioid Use

Community Health Network (CHNw) was keenly aware of the impact that opioid prescribing patterns have on potential opioid misuse and set a focus on decreasing opioid prescriptions; however, it lacked access to meaningful data that could be used to understand the volume of opioids that were prescribed postoperatively. CHNw created an orthopedics guidance team and leveraged data within its analytics platform to gain insight into prescribing habits over time.

Physician Burnout and the EHR: Addressing Five Common Burdens

So far, the EHR hasn’t delivered on its original intent to improve patient care with more efficiency and personalization and lower cost. Instead, physician users blame the systems for worsening their experience and the quality of their care in significant ways:

1. Less time for patient interaction and worsened quality of interaction.
2. An extended workday.
3. Poor design (difficult to use).
4. Demands of quality measures.
5. Cost and maintenance.

Despite these challenges, the EHR is likely here to stay. Health systems have invested heavily in their electronic reporting systems and are now focused on making these technologies and processes work for the benefit of patients and providers. CIOs are working towards better aligning digital health goals with physician experience for an environment where EHRs enable smarter, not harder, work.

Weekly News Roundup: May 17, 2019

This week's news roundup is all about ACOs: the past, present, and future of ACOs and CINs; why some provider groups want to make the next generation of ACOs permanent; the reason some ACOs stay in the MSSP; and why half of ACOs are likely to exit MSSP due to new downside risk requirements.

ACOs and CINs: Past, Present, and Future

Accountable Care Organizations (ACOs) and clinically integrated networks (CINs) are two types of organizations working to address the problem of rising costs. As ACOs and CINs continue to evolve, organizations moving into value-based care (VBC) face an ever-changing landscape. This article looks at the evolution of the ACO and CIN models, what new tools ACOs employ today to promote success, and lessons learned from organizations that have succeeded in alternative payment models. It also explores what healthcare experts believe the future of alternative payment models will look like and competencies to develop to meet those changing demands.

Weekly News Roundup: May 10, 2019

This week’s news roundup focuses on improvement opportunities and digital solutions for payers: how healthcare analytics is helping payers thrive with increased financial risk; trends in healthcare payments; how health insurers and pharmacy benefit managers are falling short when it comes to medication access for autoimmune diseases; why communication is key for out-of-pocket patient costs; and more.

Healthcare Analytics for Payers: How to Thrive Through Shifting Financial Risk (Executive Report)

To stay in sync with healthcare’s transition to value-based care, payers today must develop the analytics capability to support alternative payment models and drive more value to their members. Payers can follow an analytics roadmap to develop a strategy that extends their data, analytics, and risk management expertise to meet growing demands. The analytics roadmap helps the payer meet these common challenges of establishing a data-driven culture:

• Recruiting and retaining high-quality providers in a competitive market.
• Managing increasing numbers of high-risk/high-cost members with limited resources.
• Efficiently reacting to federal and state legislative and payment changes.
• Controlling the rising costs of healthcare services and pharmaceuticals.

Healthcare Analytics for Payers: How to Thrive Through Shifting Financial Risk

To stay in sync with healthcare’s transition to value-based care, payers today must develop the analytics capability to support alternative payment models and drive more value to their members. Payers can follow an analytics roadmap to develop a strategy that extends their data, analytics, and risk management expertise to meet growing demands. The analytics roadmap helps the payer meet these common challenges of establishing a data-driven culture:

• Recruiting and retaining high-quality providers in a competitive market.
• Managing increasing numbers of high-risk/high-cost members with limited resources.
• Efficiently reacting to federal and state legislative and payment changes.
• Controlling the rising costs of healthcare services and pharmaceuticals.

Analytics Helps Population Health Coordinators to Better Treat Chronic Conditions

Improving the management of chronic diseases for patients is crucial for reducing expenses and improving health outcomes. Newton-Wellesley Hospital, a member of the Partners HealthCare system, adopted the population health coordinator role and utilized analytics to help identify variations in chronic disease management across practices and develop standardized best practices aimed at reducing costs through better outcomes for patients.

Why Healthcare Costing Matters to Enable Strategy and Financial Performance

In this webinar Steve Vance, SVP, Professional Services, Health Catalyst will explore different costing methodologies and discuss why activity-based costing is the preferable method to manage margins because it directly ties services to their costs. Many healthcare organizations base their costs on generalized drivers such as relative value units (RVUs) through their chargemaster rather than on specific activities associated with their services, leading to inaccurate assumptions and poor decisions. Attend this webinar to learn:

• Why activity-based costing should be your core tool for improving financial performance.
• The differences and implications between costing methodologies.
• How to leverage data from an Electronic Data Warehouse (EDW) and automate processes while improving accuracy.
• Ways that you can make strategic decisions using clinical and operational data when tied to costing data.
• Activity-based costing use cases such as:
  • Contract negotiations
  • Pricing decisions
  • Population Health Management (PHM)
  • Process improvement efforts

The Top Six Examples of Quality Improvement in Healthcare

In order to thrive in an increasingly challenging healthcare environment, undertaking quality improvement projects is more important than ever for healthcare systems’ continued survival. However, health systems need to tackle the right projects at the right time to maximize the impact to their organization. This article shares both clinical and financial and operational examples of quality improvement in healthcare that may help others as they tackle improvement projects. Some examples shared include:

• Pharmacist-led Medication Therapy Management (MTM) reduces total cost of care.
• Optimizing sepsis care improves early recognition and outcomes.
• Boosting readiness and change competencies successfully reduces clinical variation.
• New generation Activity-Based Costing (ABC) accelerates timeliness of decision support.
• Systematic, data-driven approach lowers length of stay (LOS) and improves care coordination.
• Clinical and financial partnership reduces denials and write-offs by more than $3 million.

Weekly News Roundup: May 3, 2019

Patient safety is always an important and timely topic. In this week's news roundup: a CMS proposed rule to strengthen oversight of accrediting organizations; using event reporting and predictive analytics to make patients safer; EHRs as the cause of treatment delays and safety and communication issues between patients and providers; and, using data to improve quality and patient safety.

Using Analytics to Improve Patient Safety Surveillance Makes Patients Safer

Medical errors account for 10 percent of all deaths. To improve patient safety, Allina Health utilized its machine learning, analytics platform, and a trigger-based data-driven surveillance tool to identify and investigate a broader base of harm events, enabling the organization to:

Bridging the Data and Trust Gaps: Why Health Catalyst Entered the Life Sciences Market

Why would a healthcare data warehousing and analytics company partner with the life sciences industry? Because trust and collaboration across the industry—between life sciences, healthcare delivery systems, and insurance—is the only path to real healthcare transformation. Health Catalyst recognizes an industrywide improvement opportunity in collaborating with life sciences to build mutual trust, integrate data, and leverage analytics insights for a common interest (i.e., patient outcomes). By aligning themselves around human health fulfillment, Health Catalyst, their provider partners, and life sciences will advance important healthcare goals:

1. Improving clinical trial design and execution.
2. Stimulating clinical innovation.
3. Supporting population health.
4. Reducing pharmaceutical costs.
5. Improving drug safety and pharmacovigilance.

How to Use Data to Improve Quality and Patient Safety

Healthcare organizations have worked hard to improve patient safety over the past several decades, however harm is still occurring at an unacceptable rate. Though the healthcare industry has made efforts (largely regulatory) to reduce patient harm, these measures are often not integrated with health system quality improvement efforts and may not result in fewer adverse events. This is largely because they fail to integrate regulatory data with improvement initiatives and, thus, to turn patient harm information into actionable insight. Fully integrated clinical, cost, and operational data coupled with predictive analytics and machine learning are crucial to patient safety improvement. Tools that leverage this methodology will identify risk and suggest interventions across the continuum of care.

Agnostic Analytics Solutions vs. EHRs: Six Reasons EHRs Can’t Deliver True Healthcare Interoperability

As enterprisewide analytics demands grow across healthcare, health systems that rely on EHRs from major vendors are hitting limitations in their analytics capabilities. EHR vendors have responded with custom and point-solution tools, but these tend to generate more complications (e.g., multiple data stores and disjointed solutions) than analytics interoperability. To get value out of existing EHRs while also evolving towards more mature analytics, health systems must partner with an analytics vendor that provides an enterprise data management and analytics platform as well as deep improvement implementation experience. Vendor tools and expertise will help organizations leverage their EHRs to meet population health management and value-based payment goals, as well as pursue some of today’s top healthcare strategic goals:

1. Growth.
2. Innovation.
3. Digitization.

Weekly News Roundup: April 26, 2019

The Office of the National Coordinator for Health Information Technology (ONC) recently released a proposed rule to implement provisions in the 21st Century Cures Act and proivdes for a public comment period that ends June 3. This week's news roundup focuses on the the ONC's proposed rule: information blocking practices defined and explained, industry concerns about the proposed interoperability rules, and the push for use of open APIs.

Agnostic Analytics Solutions vs. EHRs: Six Reasons EHRs Can’t Deliver True Healthcare Interoperability

As enterprisewide analytics demands grow across healthcare, health systems that rely on EHRs from major vendors are hitting limitations in their analytics capabilities. EHR vendors have responded with custom and point-solution tools, but these tend to generate more complications (e.g., multiple data stores and disjointed solutions) than analytics interoperability. To get value out of existing EHRs while also evolving towards more mature analytics, health systems must partner with an analytics vendor that provides an enterprise data management and analytics platform as well as deep improvement implementation experience. Vendor tools and expertise will help organizations leverage their EHRs to meet population health management and value-based payment goals, as well as pursue some of today’s top healthcare strategic goals:

1. Growth.
2. Innovation.
3. Digitization.

Predictive Analytics: Making Patients Safer Through Event Reporting and Prediction

For patients, safety in hospitals and health systems remains a serious concern as medical errors are now the third leading cause of death in the U.S. Determined to improve patient safety, Allina Health turned to predictive analytics to standardize and expand safety event reporting.

Exceptions to Information Blocking Defined in Proposed Rule: Here’s What You Need to Know

Information blocking practices inhibit care coordination, interoperability, and healthcare’s forward progress.  The ONC’s proposed rule ushers in the next phase of the Cures Act by defining information blocking practices and allowed exceptions. To make the final rule as strong as possible, exceptions should be narrowly defined. In proposed form these include the following:

1. Preventing Harm.
2. Promoting the Privacy of EHI.
3. Promoting the Security of EHI.
4. Recovering Costs Reasonably Incurred.
5. Responding to Request that are Infeasible.
6. Licensing of Interoperability Elements on Reasonable and Non-discriminatory Terms.
7. Maintaining and Improving Health IT Performance.

This article covers each of these exceptions and discusses what to watch for in the final version of the rule.

Weekly News Roundup: April 19, 2019

Physician burnout has been linked to an increase in medical errors, lower quality of care, and reduced work satisfaction. This week's news roundup focuses on physician burnout, the top burdens facing physicians today, interventions that are helping, and how the digitization of healthcare has exacerbated the problem.