If you attended the 2015 Annual Conference, you can now access all of the presentations by logging in and selecting the files of interest below to download them.
Accountable Care: Facilitating an Open Discussion
Dana Alexander, Divurgent, LLC
The future of healthcare is inevitably leading into the widespread development of Clinically Integrated Networks (CLIN) and Accountable Care Organizations (ACO), which are designed to promote better delivery and quality of care, at a more affordable cost for the population and providers alike. Large CLINs, such as Vanderbilt University Medical Center (VUMC), St. Vincent’s Health Partners, and BayCare Physician Partners, are already developing across the United States, and seeing great success. For 2015 and beyond, Divurgent’s Clinical Transformation Team is focused on sharing and templatetizing blueprints with clients who have already, or are in the early stages of, forming CLINs and ACOs. We will provide in-depth approaches and pros and cons for each strategy, and facilitate an open discussion about the organizational design, insurance provider relationships, and overall patient/provider benefit of forming an Accountable Care approach.
Next Generation of Reimbursement: The New Reimbursement Model
Bill Ayres, Divurgent, LLC
As care delivery transitions into accountable, coordinated care across a community (ACOs/CLINs), payment reform makes the same movement towards accountable care and value-based reimbursement vs. fee-for-service reimbursement. Currently, care organizations receive incentives and reimbursement for uncoordinated and extremely expensive care. The delay in delivery and payment reform lies in the slow transition from traditional reimbursement models into the next generation of reimbursement. Abandoning the traditional reimbursement model can have short-term and long-term revenue losses associated with the transition, if not done smartly. Divurgent’s Revenue Cycle and Clinical Transformation experts will outline valuable strategies for organizations taking the leap.
Deploying an Enterprise Analytics Program at a Mid-sized Private Healthcare System
Seth Bata, Mission Health
In 2014 an Enterprise Analytics program was deployed at Mission Health System, based in Asheville, NC. Through a comprehensive approach, the implementation included focused efforts around competency-building, infrastructure, prioritization, governance, communication, training, and cultural transformation. This has accelerated the organizational evolution toward data-driven decisionmaking and evidence-based care.
The Critical Functions of Any PMO
Mark Faggion, Shepherdwise
Every healthcare organization has skilled people who get things done. Many have staff trained to lead projects, and may even have an official PMO (project management office). Regardless, with the demands of ARRA, ICD-10, ACA, interoperability, mobility, security, big data, marketing, patient engagement, etc, many healthcare organizations and their vendors are struggling to handle the volume, complexity and impact of projects. How does a struggling organization make changes to address this challenge? Strong and growing project capabilities not only improve an organization’s effectiveness, but also create strategic value to the executive team, and especially the CIO role. This presentation details the critical project capability functions that every organization should focus on developing and/or improving, regardless of whether or not they have a PMO.
How ICD-10 Refocused Revenue Management on Patient Care
Cindy Fessel, Beacon Partners and Marie Thomas, Duke University Medical Center
The anticipation of ICD-10 has already shifted emphasis to improving patient care by focusing operations, education, and automation on providers. In the last two years there has been more focus on clinical documentation and process improvements in preparation for the specificity needed to support the ICD-10 codes. This more accurate, robust clinical data will support more individualized patient care and ultimately improve outcomes and care delivery. Even if we were not moving to ICD-10, patients are already benefiting from the dollars spent to prepare for the transition. This presentation will evaluate some of the efforts that will improve patient care including clinical documentation improvement, more effective staff communications, and creating ongoing educational models for providers and other clinical staff.
Transformative Operations at Carolinas HealthCare System – Improving Value through Targeted Analytics
Jeff Fuller, Carolinas HealthCare System
The Dickson Advanced Analytics (DA2) department at CHS uses innovative tools and technologies to integrate and analyze data to manage the health of individual patients and of communities, and to develop analytics models that can be used to predict population health trends and improve the value of the care we deliver. Operational Analytics was formed as a discipline within DA2 to support improving the value of the healthcare we deliver through a relentless pursuit of higher quality at a lower cost. Through a new approach of targeted analytics, using a flexible BI tool, and subject area specific data structure, we were able to provide analysis on the relationship between all impacted variables with a much shorter cycle time; in some cases it was instant while in a meeting with the subject matter experts and physicians. The most impactful result has been that physician and administrative leaders are better equipped to set meaningful goals for improvement and will be better able to monitor performance. The presentation includes a discussion of two unique case studies detailing how this process was successful and how it differs from a typical approach using analytics.
The Role of Analytics in Bundled Payment Programs
Sheldon Hamburger, The Aristone Group
The U.S. healthcare system is rapidly moving to value-based payment models where quality is rewarded over volume. New models such as ACOs and bundled payments are showing promise to the point that CMS plans on accelerating their adoption. Among the challenges facing providers and payers alike, is the role of analytics needed to measure opportunity, performance, and profitability. This session will focus on the effective use of analytics in bundled payment programs with emphasis on practical use of tools and data. Specific areas where analytics drive success will be covered explaining the key issue(s) and the solution presented through analytics.
Can You Trust (and Use) the Data from Your EHR?
Vickie Monteith and Debra Konicek, Deloitte & Touche LLP
This session presents a practical organizing framework to help provider organizations build the capabilities to measure and improve their clinical data quality. We will discuss leading governance processes, data quality and integrity tests, and present a roadmap for providers to evaluate and improve the clinical content quality management within their own EHRs and organizations. We will discuss lessons learned, and use specific common clinical data challenges, real world examples, and case studies to raise awareness of issues and illustrate the topic throughout the session. We will highlight basic practices that can be implemented by the provider organization to create on-going practices to assess, prioritize, and improve the quality, integrity and usefulness of its own electronic health record data in support of today’s interoperability requirements, and the information demands of population health and value-based payment. We will also look at the implications on clinical data of the ONC Interoperability Roadmap and CMS’ announcement of increasing % of reimbursements linked to quality.
HIE: The Value of Electronic Care Transition
Yvonne Hughes, CCHIE
Deployment of an electronic, real-time notification application to community providers supports great value to care transition. The application deployed to our communities allows for notifications to be sent via email or text to providers when their patient is admitted to the emergency room or inpatient facility. The notification can also trigger on a patient list of diagnosis code to target high risk populations. The value and use cases for this application have been defined by our participating community practices: allows redirection of utilization from the emergency room to practice after hours clinic, supports Medicaid patient discharge protocol, and supports hospital-led quality initiatives. There are challenges for adoption as clinical users of the electronic tool have noted the need for workflow redesign for successful adoption. Notifications allow care interventions to be timely and effective in admission avoidance.
An Update on Direct, Direct Exchange, and DirectTrust
David Kibbe, DirectTrust
This presentation provides an overview and summary of the progress made in using Direct for secure, interoperable, and identity-validated health information exchange. The DirectTrust network of 38 HISPs and 17 CA/RAs now serves over 35,000 health care organizations using over 300 certified Direct-enabled EHRs. They have provisioned over 670,000 individual Direct addresses for health professionals who are exchanging hundreds of thousands of secure Direct messages and attachments nationwide each month to improve transitions of care and care coordination, both within the context of Stage 2 MU and beyond. With the new federal interoperability requirements for EHRs to be Direct-enabled, the network will expand and these numbers continue to increase during 2015. Challenges and barriers will be discussed, and opportunities for use of Direct exchange with FHIR and open APIs covered in some detail.
Clinical Decision Support for Fall Risk Assessment and Plan of Care
Kay Lytle, Duke Health Technology Solutions
Patient falls are the most frequently reported adverse event for hospitals. Employing clinical decision support (CDS) tools in the electronic health record can be a key strategy to reduce patient falls. This quality improvement project involved 16 adult inpatient units and used CDS as an intervention to improve documentation fall risk assessments and, for patients at high risk, fall prevention plans of care. Pre and post data were compared using quarterly audits, retrospective chart review, safety reports, alert action data, falls and falls-with-injury rates, and focus groups.
Best Practices for Protecting Your Organization from Cyberattacks
Mac McMillan, CynergisTek, Inc. and Chuck Kesler, Duke Medicine
Recent studies show phishing campaigns are rapidly increasing, some reporting up to a 91% increase in 2013. More importantly, phishing continues to be the primary means of compromising an organization’s security as a prelude to more sophisticated attacks. The healthcare industry is in the mainstream of these campaigns, as attackers believe hospitals and health systems hold a wealth of data, from credit card information to demographic details to insurance beneficiary data. This presentation will identify and explain today’s most pressing cybersecurity threats, including recent and emerging trends in phishing. The presenters will also discuss what the impact of these attacks is on the healthcare industry, sharing real-world examples of data breaches that were caused by phishing attacks. Finally, the presenters will offer attendees proven best practices and expert guidance on how to avoid falling victim to phish attacks and how to create a culture of cybersecurity awareness at their organization.
How Connected Care Helps Meet The Triple Aim
Tony Merlo and Renee Lohman, Agile Edge Health
Increasingly, Primary Care Physicians, especially those having established Primary Care Medical Homes (PCMH), are sharing reimbursement risk with hospital partners to help keep patients recently discharged from the hospital from being readmitted. A compelling option for helping both clinicians and patients monitor daily health status is the use of remote diagnostic / biometric monitoring devices and mobile care-management applications. However, devices and applications alone are not the answer. Only a fully-integrated solution can transform the care management universe for chronic, post-acute, and other at-risk populations. Brandywine Healthcare Solutions LLC (BHS), a medical practice acquisition and consolidation company, has teamed with Agile Edge Health to deploy remote diagnostic monitoring and patient engagement capabilities to connect BHS Patient Centered Medical Homes with individuals that have been identified as being at-risk for hospital readmission. In doing so, Brandywine will facilitate better patient care and realize newfound gains towards The Triple Aim: Care, Health, and Cost.
IT as a Hospital Profit Center (Or How to Get Them to Stop Talking about Cutting Your Budget)
Jim Nelson, Time Warner Cable Business Class
Wireless, Internet, Ethernet, Voice, & Video have revolutionized how IT operates and delivers these services. It also revolutionizes how hospitals can do business. We’ll discuss how these technologies free hospitals from their geographic constraints. Examples of how CIOs can capture new IT healthcare business opportunities to change traditional organization roles to win improved access to organization capital to implement needed programs while meeting deliverables are included.
Telemedicine – The 5 Components
Keith Nelson, Ingram Micro
Telemedicine is a broad category that is comprised of 5 primary components. Consequently, it is important to specifically identify which of these component solutions will enable the desired benefit(s) for a given healthcare provider. The benefits range from optimizing staffing, to allowing expansion beyond the current service area for minimal cost, to reducing the 30-day readmission rate to population management. However, there are additional considerations to weigh when leveraging this technology including state legislative restrictions, malpractice exposure and reimbursement issues.
Social Media and Patient Engagement Strategies at Two Local Raleigh Hospitals
Fay Payton and Natasha Pinto, North Carolina State University
Hospitals are increasingly using social media as a strategic platform to communicate with patients and increase patient engagement. Social media has shown to increase hospital revenue, improve quality of care, and strengthen patient recruitment and retention. But traditional communication strategies are still powerful in engaging patients and should not be put on the back burner. Effective patient engagement strategies need to include both online and offline avenues. Healthcare institutions with strategies that do not address both these avenues risk overlooking a significant demographic of their patient population. The presentation will highlight how two local hospitals engage patients and healthcare providers both online and offline. We will describe some of the difficulties these hospitals face and their efforts to address these challenges. Finally, we will discuss how the Affordable Care Act and an emphasis on value-based healthcare have impacted the digital marketing and patient engagement strategies at these local hospitals.
“MEWS Saves Lives”: A Real-time EMR Dashboard for Rapid Response to Critical Patients
Richard Pollack, VCU Health System
This session focuses on the development of a medical early warning system (MEWS) using advanced EMR tools to provide a real-time and constantly refreshing clinical dashboard of the acuity of patients, relying upon an evidence-based scoring algorithm. This represents a higher level of intelligent clinical decision support, leveraging the rich underlying clinical data within the EMR and taking advantage of the real-time data flows into the EMR from bedside monitoring equipment in the 250 ICU beds in our institution. We will present outcome results indicating that the use of this tool resulted in a steady decrease in the number of codes occurring both in and outside of the ICUs and a downward trend in mortality for this population. Subsequently a pediatric version of the same dashboard was put into place.
Trials and Tribulations of Preparing Your Revenue Cycle for ICD-10
Tim Pollard, New Hanover Regional Medical Center and Kristen Hill, Himformatics
ICD-10 is right around the corner! October 1, 2015 is less than 4 months away, and recent surveys show there is a great deal of preparation that still needs to occur in most hospitals across the country. This discussion will focus on where you should concentrate your time over these next several months to ensure your revenue cycle is ready for ICD-10. Transition planning for the revenue cycle is a critical element that should exist in any ICD-10 program, and we will give you tips for setting this plan up successfully. We will talk about generic planning suggestions for activities to occur months out, weeks out, days out, and right after the transition. Specifically, we plan to talk through overall transition planning activities that need to take place prior to go-live as well as tracking mechanisms for issues and performance after October 1. Some examples include tracking Key Performance Indicators, understanding and preparing for staffing needs and potential backlogs, A/R and DNFB work down, authorization and Medical Necessity activities.
Current HIE Progress, Trends, and Challenges
Charles Rogers, Core Health Technologies and Karen Clark, OrthoTennessee
The HIMSS HIE Committee is formed to provide leadership within HIMSS in the promotion and advancement of health information exchange – both the noun and the verb. The Committee and their related work efforts strive to represent all stakeholders in today’s healthcare information exchange environment including providers, consultants, vendors, payers and life sciences.
Each HIE Committee member is an active volunteer who serves within workgroups focused on producing and delivering specific work products to provide information of value to the HIE and greater healthcare IT communities. The presentation will be based on current market information gained through committee projects over several years. Information presented will be built on factual information gathered through multiple paths of engagement with various HIE stakeholders including surveys, direct dialogue, and market studies.
Data Quality Management – The Fundamentals for Today’s Successful Healthcare Enterprise
Brian Bishop, University of Alabama at Birmingham Health System and Dan Rounds, Immersive LLC
In healthcare’s race to migrate to the electronic health record (EHR) and achieve Meaningful Use, precious little attention was given to data quality at the point of the design and implementation of the EHR. That said, clinical quality measurement/management and reimbursement have always been tied to the core data that resides in the patient medical record. As a result, healthcare enterprises have been quick to store their newfound wealth of electronic data for these purposes with an appreciation for the fact that it would likely serve a “higher purpose” in the future. In today’s era of value-based reform, an organization’s very survival is dependent upon how productively it can use its own data, and the data to which it has access from payers, partners, an HIE, etc. Data quality management entails the establishment and deployment of roles, responsibilities, policies and procedures concerning the creation, acquisition, maintenance, dissemination and disposition of data. In this session, our experts will introduce and explore the fundamentals of data quality management and offer a case study from which one organization began to understand the real impact of data quality to its clinical and operational goals.
Connecting the Dots: Real-life Security and HIPAA
Steven Spearman, Health Security Solutions
This session will provide meaningful insight into how to practically apply the rules in an environment of increasing threats from inside and out. Using real-life examples gleaned from the DHHS Wall of Shame and Resolution Agreements from the Office of Civil Rights, the presentation explores what the rules require and how to think about the trade-offs between security, usability and cost. We will review technical controls and defense in depth as well as explore the part risk analysis plays in ensuring compliance and preventing a breach.
How Many Lights Do You Leave On?
Mary Martha Treadaway, Himformatics and Hampton Haucke, New Hanover Regional Medical Center
Join Himformatics and a North Carolina Health System in a discussion around data management efforts to ‘turn off the lights’ on legacy applications. Determining whether an application is eligible for retirement is a fundamental tradeoff between the business value the application provides and the ongoing fees of supporting and maintaining the application. There are many risks associated with decommissioning each system and the total cost of ownership with each application differs. Organizations are so busy acclimating, supporting, and upgrading complex enterprise systems that their legacy applications often remain active. This presentation will focus on how several North Carolina health systems implemented data retention programs within their own organizations and their specific approaches applied to move forward with decommissioning efforts resulting in improvements to each organization’s application portfolio.
North Carolina’s Medicaid Electronic Health Record Incentive Program – Meaningful Use and Trends in Participation
Rachael Williams and Layne Roberts, NC Division of Medical Assistance
North Carolina’s Medicaid Electronic Health Record (EHR) Incentive Program was created to encourage medical professionals and hospitals to adopt, implement, or upgrade to a certified EHR technology and then to demonstrate meaningful use of that technology. This session provides a brief overview of the program for those who are not yet participating, which will include eligibility requirements, timelines, and guidance on attesting. We will discuss meaningful use, particularly as it relates to North Carolina’s EHR Incentive Program, with a focus on Stage 2 Meaningful Use. Based on the data collected, we’ll discuss trends in participation in the incentive program and in reported meaningful use measures. We’ll report on meaningful use measures that professionals are having greatest success with, look at program participation by factors such as geography and specialty, and give a summary of incentive payments to date.
Mobilizing Your Clinical Workforce
David Thurber, AirWatch by VMware and Mark Heckle, Appalachian Regional Healthcare System
Clinicians are adopting mobile devices at an accelerated rate. In order to embrace the evolving possibilities of mobility, healthcare organizations need to provide essential tools that allow physicians and nurses to quickly, and in real-time, access medical records, submit prescriptions and assist with diagnoses. By adopting new technologies, clinicians gain access to the tools they need to become more productive and provide patients with a better overall experience.
Join this session to discuss healthcare mobility trends, how Appalachian is using mobility within hospital walls, insights on best practices for improving the quality of patient services with mobile, factors to consider when implementing a BYOD program, HIPPA compliance and strategies for increasing adoption rates of mobile devices.
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