WPHN

Upheaval and Adaptation: The Realities of Today’s Healthcare Landscape

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Author Name Ronald Razmi | Date March 2014

As a driver of change, the Affordable Care Act (ACA) is having a significant impact on today’s healthcare landscape. The move towards value based payments, mandatory quality reporting, wide-spread adoption of Electronic Health Records (EHR), and formation of Accountable Care Organizations (ACOs) are all a result of the ACA. Because of these changes, ACOs and providers are quickly adopting technologies that help them succeed in transforming their care models.

However, healthcare delivery has not fundamentally changed—yet. The ACA’s regulatory overhaul is leading to seismic shifts in the healthcare ecosystem. These shifts will ultimately translate into changes in the business models of most medical centers. While delivering patient care has always been the primary goal of health care organizations, financial outcomes have long been the metric by which success is measured. Increasingly, however, health care leaders are being held responsible for both medical and financial outcomes. As a result, healthcare executives and providers must understand the elements of organizational effectiveness—strategy, finance, operations and leadership.

Over the last ten years, large medical centers have acquired independent physician practices as they move away from a fee-for-service reimbursement system to a pay-for-performance system that focuses on quality outcomes and cost-containment. Through this consolidation, medical centers aim to secure referrals to their facilities and prepare for a financial-flip: soon outpatient revenues will exceed inpatient revenues. In an effort to encourage integration, many of these medical centers have installed enterprise EHRs to:

  • Facilitate information exchange between all of their providers, clinicians and labs
  • Improve patient outcomes and reduce readmissions
  • Increase efficiencies by:
    • Reducing redundant diagnostic testing
    • Capturing each patients’ complete medical history
    • Lowering the risk of medical errors
    • Exposing and preventing  safety issues

Read the full Western Pennylvania Healthcare News article here

mHealthNews

Above the EMR: Care Teams Use the Cloud to Close Gaps

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Author Name Eric Wicklund | Date March 5, 2014

Two Indiana physician practices are using a cloud-based platform to “connect the dots” in patient care, enabling clinicians in different locations to pull in patient data and coordinate a care management plan on tablets.

The practices, part of the 22-hospital St. Vincent Health system, are piloting the population health platform from Acupera to “provide transitional care management to patients leaving institutional care, identify and proactively manage patients with complex chronic conditions and transition to patient-centric team care.”

Bruce Bethancourt, chief medial officer for the St. Vincent Medical Group, says the platform gives clinicians the freedom to pull information from various locations and connect the care team in real-time. That’s quite a change from the “day-prior huddle” method, in which physicians met in one location and tried to collect all the files and test results they’d need.

“You’re getting information that you need at the point of care,” he said. “Things aren’t siloed any more.”

Ron Razmi, chief executive officer of San Francisco-based Acupera, says the company’s population health analytics and clinical workflow management platform meets a glaring need among healthcare providers who are trying to transition from fee-for-service to accountable care. The platform pulls in care data from various locations, identifies care team members and assigns tasks based on their roles. Razmi sees the Acupera platform as a dynamic workflow tool sitting atop whatever EMRs the provider may have, pulling out information that the care team needs at the point of care. Bethancourt – whose organization is now undergoing a change of EMRs – agreed.

Read the full mHealthNews article here

HiTechAnswers

Taking a Look into the Future of Health IT

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Author Name Ronald Razmi | Date February 5, 2014

What’s in Store for Health IT in 2014?

EHRs Will Go Under the Microscope
In 2014, many large health systems will continue to re-evaluate their enterprise Electronic Health Record (EHR) systems. They will also be increasingly willing to scrap those investments and start over with EHRs that better support population health management, can integrate with practice management and billing, and offer more integration of outpatient with inpatient systems.

Health systems will also need guidance on how to use the data they have to improve their business and comply with increasingly punitive federal reporting requirements. Since many health systems organizations don’t have these capabilities in-house, they will look to technology companies that offer effective solutions without being too disruptive to their current IT architecture.

The Affordable Care Act Effect
Under the Affordable Care Act, the number of Americans who enroll in healthcare plans will continue to increase. The influx of previously uninsured Americans into the healthcare system presents a unique opportunity for health IT companies to help providers become more efficient.

The prospect of increased revenues will force health systems to look for ways to increase their capacity. This might mean the acquisition of additional physician practices, increased use of physician extenders (such as Nurse Practitioners), and the use of more digital health tools.

Organizations Will Continue their Slow Shift to Value-Based Care
Healthcare providers will continue to adopt value-based contracts, but at a slower pace than predicted. The delays will be caused by the need to create an IT infrastructure that supports value-based care, and the need to alter workflows that embrace this new model.

At the same time, providers will continue to resist drastic changes to their clinical workflows and will only take incremental steps towards new practice models. This, coupled with shortage of healthcare IT specialists, will mean that health systems will need to undertake additional work and Fee-for- Service will continue to be the dominant payment model for years to come.

iHealthBeat

Health IT Business News Roundup for the Week of January 24, 2014

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Author Name iHealthBeat Staff   |   Date January 24, 2014

Contracts

Novo Nordisk will deploy Trialbee‘s electronic patient recruitment software for its clinical trials…NorthBay Healthcare in San Francisco has selected Health Catalyst‘s data warehousing and analytics system…Healthstat, a provider of onsite primary care and chronic care management programs, will deployeClinicalWorks‘ EHR system…St. Vincent Health in Indiana will deployAcupera‘s population health analytics and clinical workflow management tools…Urology Austin in Texas will implement CareCloud‘s cloud-based revenue cycle management software.

Geisinger Health System in Pennsylvania has selected BESLER Consulting‘s revenue recovery services…Blood Systems, a U.S.-based blood bank, will implement Hewlett-Packard‘s workflow and data storage tools…NASA has entered into a five-year licensing agreement with Vantage Health, a mobile health technology firm, to commercialize NASA’s patented technology-based mobile health products…the Center for Diagnostic Imaging in Minneapolis will implement Merge Healthcare‘s clinical workflow and interoperability tools.

Are Providers Ready For This Tsunami?

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We recently discussed the impact of all of the changes going on with payment models on the providers. We discussed that the evolution to payment models that reimburse for quality and outcomes rather than volume of visits and procedures will have significant impact on the providers. This is no trivial change! Physicians have practiced the same way for thousands of years. Patients with medical issues come to them and receive care. Now, they have to take on a whole new set of activities. They need to make sure that the patients take their medications so they can achieve their treatment goals. They need to make sure patients follow lifestyle instructions so their chronic diseases don’t deteriorate, resulting in bad outcomes. How could they possibly take this on and continue to see patients? if anything, with all of the new insured people, physicians will need to see more patients.

The answer is that in order for physicians to achieve these goals, they need to go to new models of care. This means that they will need to start leveraging a team supporting them far more effectively. They need to use technology to get more done with the same resources. Their practice patterns need to shift to incorporate new tools to get to better results.

Early experience suggests that although there is some movement in this direction by the providers, it’s slow going. Many of the physicians are close to retirement and are not interested in turning their practices upside down. Younger physicians are worried about the impact on their bottom lines during the transition and are proceeding cautiously. What is clear is that the solo and smaller practices will have a much tougher time with this. That’s because they have more limited resources to embark on this journey. That’s why more and more of them are open to selling their practices or forming partnerships with institutions.