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1
Advancing Nationwide Person-Centered Health Data Exchange
Session # 102, February 21, 2017
Michael J. Maksymow, Jr., VP and CIO, Beebe Healthcare
Jitin Asnaani, Executive Director, CommonWell Health Alliance
2
Speaker Introduction
Michael J. Maksymow Jr, CHCIO, FCHIME, FHIMSS, CPHIMS
VP and CIO
Beebe Healthcare
Jitin Asnaani
Executive Director
CommonWell Health Alliance
3
Conflict of Interest
Michael J. Maksymow Jr, CHCIO, FCHIME, FHIMSS, CPHIMS
Has no real or apparent conflicts of interest to report.
4
Conflict of Interest
Jitin Asnaani, MBA
Salary: CommonWell Health Alliance
Ownership Interest: Ixora Health Inc., Medullan Inc., Beacinsight Inc.
Advisory: National Health IT Standards Committee
5
Agenda
• Barriers: Why Aren’t We There Yet?
• Opportunities: The Person Imperative
• Approach: The Big Picture
• Call to Action: Baby Steps
6
Learning Objectives
• Discuss the barriers that hinder scalable, nationwide, vendor-neutral
interoperability today
• Recognize how to increase physician access to and use of external patient
records as part of their clinical treatment plans
• Identify the benefits for building person-centric information exchange services into
current health IT systems to reduce time to market and increase end user adoption
7
Beebe Healthcare• Lewes, Delaware
Location
•Community, NFP
Type of organization
•210 licensed beds
Beds
•1 medical center
•4 walk-in care centers
•8 outpatient locations
•16 physician offices
•3 school based wellness programs
•hospitalist program
Facilities
•Over 350
Physicians
•Over 2,000
Employees
•1916
Founded
Mike Maksymow
Vice President & CIO
Beebe Healthcare
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Beebe Healthcare
• Disparate In-Patient & Ambulatory EMR’s
• Demographic changes
– Population increasing 8.2%
– Households increasing 9.2%
– 65+ age group increasing 20%
– 75+ age group increasing 31.4%
• Balance between established and transient population
• Enjoys a progressive state health information network
9
Patient-Centered Exchange affects all the HIMSS STEPS™ for realizing value in Health IT
Are my physicians, staff, and patients happy?
T
E
P
S
S Satisfaction
Treatment/Clinical
Electronic Secure Data
Patient Engagement
and Population
ManagementSavings
Do I have what I need to treat safely and effectively?
Is the data electronic and available in the workflow?
Am I addressing my changing responsibilities?
Are we driving down (unreimbursed) delivery costs?
10
Barriers:Why Aren’t We There Yet?
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Health IT is increasingly frenetic
MU Stage 1
MU Stage 2
Pioneer ACOs
MU Stage 3
MACRA
MIPS
PMI
HITSP ProfilesCCDA
Push
SMART Apps
FHIR
Query/Retrieve
Notify
2010
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Standardization != Execution
• We have been obsessed with standards –
and fundamental misunderstand their role.
• Standards do not execute in a vacuum.
In fact they don’t (usually) execute at all.
technical standard: (usually) a formal document that
establishes uniform engineering or technical criteria,
methods, processes and practices.
13
Paradoxes within the health system
• Profitability
• Strategic Assets
• Patient Retention
• More risk
• Better care
• Openness
• Pop Health
• More data
14
Fragment. Connect. Repeat.
Settings of care
EHRs and apps
Care team members
The static biosphere is an optical illusion
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Opportunities:The Person Imperative
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Value-Based Care: tipping the scales
– Less value in sickness, more value in health
– Alignment of effort with individual health
– Caregivers need to know the patient:
• Where they’ve been
• What issues they’ve had
• How “risky” they are.
• Across the continuum
Local Record
FFS
Person
Record
VBC
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Government is pointing the direction
1. Digitization
2. Interoperability
3. Anti-data blocking
4. Patient engagement
5. Patient empowerment
Local Record
FFS
Person
Record
VBC
Government
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The consumer will have the final say
• Costs are rising patients are noticing
– 2016 Kaiser Family Foundation survey found premiums
for family coverage have increased 20% since 20111
• “Quantified Self” continues to gain steam
• People are becoming more mobile2
• You only need 10% of a population to tip3
1 http://kff.org/report-section/ehbs-2016-summary-of-findings/
2 http://www.thefuturescentre.org/trend-card/increased-mobility
3 http://freakonomics.com/2011/07/28/minority-rules-why-10-percent-is-all-you-need/
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Approach:The Big Picture
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See the elephant!
• “Accountable” care implies that you know the
Person
– Where they have been for health and
care
– Clinical data
– Non-clinical data
– Know his/her STORY
• Fundamental difference between
“exchanging data” and being “person-centered”
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From data to insight to action
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X-Vendor initiatives are enablers
– Build into the workflow.
the health record
the portal
the app
the <insert future here>
– Increasingly widespread
– Future-proof
1 https://dashboard.healthit.gov/evaluations/data-briefs/non-federal-acute-care-hospital-ehr-adoption-2008-2015.php
May 2016 ONC Data Brief:
53% cited the biggest barrier
to interoperability as “shared
information not available to
clinicians in their EHRs”.1
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Caregivers can take it further!
• Build into the clinical conversation
• Further the patient story
• The relationship
• The trust
• The value
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Call to Action:Baby Steps
25
Find out more
• Caregivers:
– Have you talked to your vendor?
– Have you inquired about the options?
• HIT Vendors:
– Have you examined the options?
– Go Participate. Maybe even Lead.
26
Just get going!
• Try it out.
• Get better at it.
• Provide feedback.
• Take the first steps.
“It’s getting late early.” -Babe Ruth
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What we did to get started
Consistent repeatable experience for the clinician
regardless of the vendor or organization submitting the
CCD
Set a Goal
Get Buy-In
Begin Exploration Talk to vendors about options for data exchange;
test in limited environment
Tie the objective back to business and clinical value;
identify a sponsor
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Patient-Centered Exchange really shines because it enables Empowerment
Satisfaction from health IT really comes from empowerment:
• Physicians and caregivers who get what they need to take better care of patients
• Patients who trust their caregivers to be informed
• Consumers who trust that they can get their data
• Office staff that can efficiently find the information they need no matter where care occurred
The benefits percolate across the STEPS™
T
E
P
S
S Satisfaction
Treatment/Clinical
Electronic Secure Data
Patient Engagement
and Population
ManagementSavings
29
Questions
Michael J. Maksymow, Jr
Beebe Healthcare
Email:
LinkedIn: mmaksymow
Jitin Asnaani
CommonWell Health Alliance
Email:
LinkedIn: jasnaani
Twitter: @jitin